key: cord-1044531-8b0bjxdt
authors: Murray, Thomas S.; Malik, Amyn A.; Shafiq, Mehr; Lee, Aiden; Harris, Clea; Klotz, Madeline; Humphries, John Eric; Patel, Kavin M.; Wilkinson, David; Yildirim, Inci; Elharake, Jad A.; Diaz, Rachel; Reyes, Chin; Omer, Saad B.; Gilliam, Walter S.
title: Association of Child Masking With COVID-19–Related Closures in US Childcare Programs
date: 2022-01-27
journal: JAMA Netw Open
DOI: 10.1001/jamanetworkopen.2021.41227
sha: 1acd847b14961aa5c7c952e4f76690c7ea0aff6f
doc_id: 1044531
cord_uid: 8b0bjxdt

IMPORTANCE: It is not known how effective child masking is in childcare settings in preventing the transmission of SARS-CoV-2. This question is critical to inform health policy and safe childcare practices. OBJECTIVE: To assess the association between masking children 2 years and older and subsequent childcare closure because of COVID-19. DESIGN, SETTING, AND PARTICIPANTS: A prospective, 1-year, longitudinal electronic survey study of 6654 childcare professionals at home- and center-based childcare programs in all 50 states was conducted at baseline (May 22 to June 8, 2020) and follow-up (May 26 to June 23, 2021). Using a generalized linear model (log-binomial model) with robust SEs, this study evaluated the association between childcare program closure because of a confirmed or suspected COVID-19 case in either children or staff during the study period and child masking in both early adoption (endorsed at baseline) and continued masking (endorsed at baseline and follow-up), while controlling for physical distancing, other risk mitigation strategies, and program and community characteristics. EXPOSURES: Child masking in childcare programs as reported by childcare professionals at baseline and both baseline and follow-up. MAIN OUTCOMES AND MEASURES: Childcare program closure because of a suspected or confirmed COVID-19 case in either children or staff as reported in the May 26 to June 23, 2021, end survey. RESULTS: This survey study of 6654 childcare professionals (mean [SD] age, 46.9 [11.3] years; 750 [11.3%] were African American, 57 [0.9%] American Indian/Alaska Native, 158 [2.4%] Asian, 860 [12.9%] Hispanic, 135 [2.0%] multiracial [anyone who selected >1 race on the survey], 18 [0.3%] Native Hawaiian/Pacific Islander, and 5020 [75.4%] White) found that early adoption (baseline) of child masking was associated with a 13% lower risk of childcare program closure because of a COVID-19 case (adjusted relative risk, 0.87; 95% CI, 0.77-0.99), and continued masking for 1 year was associated with a 14% lower risk (adjusted relative risk, 0.86; 95% CI, 0.74-1.00). CONCLUSIONS AND RELEVANCE: This survey study of childcare professionals suggests that masking young children is associated with fewer childcare program closures, enabling in-person education. This finding has important public health policy implications for families that rely on childcare to sustain employment.

1. We are sending this survey to you because you completed a survey for us last Spring 2020 and said you were interested in participating in follow-up surveys.

All children are picked up and dropped off outside of the program (families did not come inside

This survey is for anyone who is either currently employed as a child care provider OR has worked in child care at any point during or just prior to the pandemic. This includes but is not limited to: