Last week saw dramatic changes to how positive cases of COVID-19 are managed in ECEC settings. In NSW, the approach has shifted from closure of services and mandatory isolation for children and educators exposed, to a ‘high, medium and low’ assessment of individuals exposed at the service, to now only recommending that those who assess themselves as high risk using the NSW Health advice isolate for seven days.
Mandatory isolation for positive cases and contacts only applies to those at home. For instance, if your child catches COVID-19, you are a household contact and therefore are required to isolate with your child and take Rapid Antigen Tests on Day 1 and 6 (and if symptoms develop) to check whether you have acquired the infection too. If a child at your service is COVID positive and you were in close contact with the child, NSW Health asks that you and others at the service assess your own personal risk, but it has been recommended that people isolate for seven days and take a RAT test on Day 1, 6 and if symptoms develop.
While the benefit of this approach is that service directors can exercise discretion and judgement about how to best manage the risk of further infection among the service’s families and educators, the question remains as to what is driving this relaxation of requirements:
- An overall assessment that the risk of serious health implications due to catching COVID-19 are now lower;
- A lack of access to PCR and Rapid Antigen Tests;
- A political decision to ‘let it rip’ to enable the economy to recover, without concern for the consequences for individuals’ health or the health system’s capacity to cope with rising hospitalisations.
Perhaps it's a combination of all three?
OzSAGE, an Australian independent network of experts formed in response to the pandemic, recently expressed deep concern for the current approach1, instead calling for Australian governments to immediately take action to tackle the present COVID crisis by delaying the return to face-to-face schooling, and reinstating necessary infection mitigations and financial supports.
The effects of Omicron on young children
OzSAGE is highly critical of the ‘let it rip’ approach as the predicted late January peak of this outbreak will threaten every sector, not just the health system. They note most primary school aged children aged 5-11 will not have had a chance to get double-vaccinated. As of the date of writing, only 9 per cent of children in this age group have received a single dose2 and none have received their second dose. Children aged below 5 of course have received no vaccination as none have been approved for use – meaning that the best way to protect this cohort is to ensure the people around them – adults and older siblings – are vaccinated.
There are reports in the media that Omicron causes milder disease in children when compared to Delta; and indeed, the latest World Health Organisation briefing released on 11 January refers to a study which shows a Risk Ratio of 0.19 for admission to hospital for children 0-5, compared to 0.36 for Delta.
While this is reassuring, the very high transmissibility of the Omicron variant will drive an increase in the number of paediatric hospitalisations. No parent wants their child to be one of the unlucky ones who becomes so seriously ill they need to be admitted to hospital – though most children only need to stay for a couple of days and don’t need the intensive supports that very ill adults with the virus tend to need. Children who have pre-existing health conditions, including asthma are more likely to be those who develop severe disease3.
OzSAGE notes the World Health Organisation advice is that Omicron is not mild and should not be described as such. Given its high level of transmissibility, (some research indicates it spreads twice as fast as Delta4) hospitalisations will increase as the overall number of cases increase. OzSAGE is calling on governments to provide free rapid tests and N95/P2 masks.
What will Omicron and the Government's response mean for education and care services?
Decreased attendance, leading to viability issues for services
To some extent, we have all been here before, first with the Alpha variant and last year’s Delta variant. Many anxious families choose to keep their children home, which presents viability challenges for services who rely on both CCS funding from the Commonwealth and fees from families.
Current support from the Commonwealth only includes the option to waive the gap fee for families who are a positive case at the service – and there are currently no Business Continuity Payments available as there were in the second half of 2021.
Families who are notified that there is a positive case at the service and who may therefore decide that they do not wish to send their child can use up additional allowable absences, but that’s all. Services cannot waive the gap fee for families who want to keep their child at home because they are worried about them catching COVID-19 at the service. The only way that services can waive the gap fee for all of their families is if they are directed to close or partially close by their regulatory authority due to COVID-19 – which may occur if services cannot open due to staff shortages related to COVID-195.
Workforce shortages
We also know that staffing becomes more difficult. The new measures, where staff only need to isolate if someone in their household has COVID-19, will dramatically reduce the requirement for isolation in the context of a positive case at a service. It may be that it becomes even more relaxed if National Cabinet agrees this week to enable educators to continue to work even if there is COVID-19 in their household. However, it is unclear whether it will help in practice. Most educators will wish to follow the best practice advice recommended by NSW Health to test and isolate for seven days to prevent unwittingly spreading it further, particularly as many children in services have health vulnerabilities.
Unfortunately, there are no clear financial supports for educators who choose to self-isolate after being exposed to COVID-19 at work, meaning it is up to services to provide sick leave for those staff. Many staff will have already depleted their sick leave provisions, so staying away may become an expensive option.
Staff who contract COVID-19 (or families caring for a child with COVID-19) without any sick leave may be eligible for the Commonwealth Pandemic Leave Disaster payment of $750 for the seven days they are required to isolate.
Temporary service closures
CELA understands that in the past 7 days, a significant number of long day care services in NSW have made a COVID related notification, indicating the substantial impact Omicron is having on service provision. As Omicron spreads further, it is reasonable to expect that there will be rolling temporary closures over the next few weeks due to positive cases and staff shortages as educators test and isolate.
Our advocacy for early education and care services and children
Last week, CELA, Early Learning Association Australia (ELAA) and Community Childcare Association (CCA) met with Minister Robert’s office and representatives from the Commonwealth Department of Education, Skills and Employment to make recommendations to reduce the adverse impact of the COVID-19 pandemic on education and care service provision.
On behalf of our members, we raised the following issues:
1. High levels of onsite exposure and staff absences
The levels of COVID-19 in the community and the contagiousness of the Omicron variant mean that services are regularly experiencing exposures onsite to staff and children. This results in both children and staff being absent due to contracting COVID-19 and/or meeting state and territory workplace and household isolation requirements.
Member services are currently reporting that more than 25% of staff are absent due to testing positive, exposure to positive cases, or having symptoms. The combined effect of service exposures and high levels of community transmissions impacting on staff are resulting in severe workforce shortages which often results in room and service closures.
2. Lack of access to Rapid Antigen Tests
Services do not have access to the Rapid Antigen Tests (RATs) they need to ensure that their services can operate safely. Staff and families do not have access to the required number of Rapid Antigen Tests to ensure that they are not carrying and further transmitting the virus within services. Without access to RATs, staff who have been exposed but are asymptomatic are attending work with vulnerable children who cannot be immunised, which further increases the risk of COVID spreading within services.
Access to RATs would reassure families and other staff that the workplace is as safe as it possibly can be.
3. Reduced attendances
Attendance numbers are reported as being markedly down, a trend which is expected to worsen in the coming weeks as the peak of the outbreak is reached.
Families are not sending their children because of concerns they will catch the virus and others are delaying starting their children for the first time at a service. Some families are isolating because of positive cases, close contacts or awaiting test results.
It is anticipated that the additional extra allowable absences of 10 days for the 2021-22 financial year (in addition to extra absences granted during COVID-19 lockdowns) will not be sufficient. The reduced attendances are also impacting on service viability as services are unable to collect the same fee income as was budgeted.
As has been reported in the media, some children aged 5+ years who are scheduled to receive their first vaccination are being turned away due to a lack of supply. This means children who could have been vaccinated may have a delayed return or start date if families choose to wait until they believe their child is better protected.
4. Fee waivers
Many families are requesting fee waivers as they cannot, or do not wish to, send their children to the service for reasons stated above or are reluctant to send their children given their lack of protection from the virus. Some services have families withdrawing their enrolment, so that they don’t have to continue to pay fees while their children are not attending. Services are keen to retain families because of their connections to local communities and a desire to provide uninterrupted service. The current guidance about waiving fees is no longer broad enough to cover the current situation.
Services can currently waive gap fees for a child that does not attend care because they, or a member of their household, have been directed to isolate due to COVID-19. Services can also waive gap fees and receive Child Care Subsidy (CCS) where a child cannot attend care because the service, or a room within a service, is closed due to COVID-19 on advice from the state or territory government.
Services can continue to waive gap fees for children not attending care where a state or territory restricts access to childcare in a region. However, they cannot waive gaps fees if they do not have enough staff to accommodate some (or all) of the enrolled families or if families are choosing not to attend because of safety concerns.
5. Service viability
Staff absences, reduced attendance and fee waiving are all having a significant impact on service viability. Many services are currently unable to offer fee waivers for all families who are not attending due to COVID, because of the negative financial impact this would have on their service. Without fee waivers, more families are at risk of withdrawing their children completely.
We note that many of our members have not increased fees in over two years and we have received feedback that they need to increase fees at this time to ensure their services remain viable into the future.
Our joint recommendations to Government
Together with ELAA and CCA, we made the following recommendations to ensure unvaccinated children are kept safe, families can continue to participate in their workforce activities and staff in education and care services are available to deliver services:
1. Australian Government institutes a COVID absence payment as part of the Child Care Subsidy (CCS) System, which protects service income, while allowing for a range of expanded COVID related absence criteria including parents' anxiety and restriction of service provision resulting from services not being able to meet ratio due to staff illness. As part of opting into this scheme the service provides a staffing guarantee.
2. Australian Government encourages all State and Territory Governments to:
- Make COVID-19 boosters a mandatory requirement for ECEC staff
- Secure sufficient supply of RATs and distribute free of charge to all education and care services, and
- Prioritise early educators as essential workers and have priority of access to vaccine booster appointments.
3. Australian Government increases allowable absences to include unlimited COVID-related absences
4. Australian Government does not consider reducing child staff ratios or staff qualification requirements in response to this COVID outbreak.
We would like to acknowledge and thank members for the essential work you are doing during this difficult time. CELA understands the pressure services are under as the sector responds to the enormous challenges of operating safely in the context of COVID-19.
For regular updates to our advocacy, please check our Advocacy on the Agenda page.
For member COVID specific news updates, please check our COVID-19 member news page.
Footnotes:
1OzSAGE, 10 January 2021, https://ozsage.org/media_releases/major-covid-course-correction-immediately-required/
2Australian Government Department of Health, “COVID-19 Vaccine Rollout Update – 14 January 2022”, https://www.health.gov.au/sites/default/files/documents/2022/01/covid-19-vaccine-rollout-update-14-january-2022.pdf
3Murdoch Children’s Research Institute, “Research Brief: COVID-19 in Early Childhood Education and Schools”, 18 October 2021, https://www.mcri.edu.au/sites/default/files/media/documents/covid-19_in_early_childhood_education_and_care_and_schools.pdf
4The Scientist, “Omicron propagates 70 times faster than Delta in bronchi: Study”, (17 December 2021), https://www.the-scientist.com/news-opinion/omicron-propagates-70-times-faster-than-delta-in-bronchi-study-69540
5Department of Education, Skills and Employment https://www.dese.gov.au/covid-19/childcare#toc-gap-fee-waiving Accessed 16 January 2022