State-run program to provide COVID tests to daycares could expire this summer

As COVID case numbers drop around the state, testing may seem like less of a priority for adults. But for children under the age of five, who can't be vaccinated, experts say testing can still be a crucial tool for preventing the spread of the virus.

Since last summer, the state has been ramping up a program to provide free COVID tests for thousands of daycare operations, but the contract for that program is up in the summer, and the state has not yet committed to extending it. That worries some experts who fear that COVID cases may rise again in the fall.

Even though adult caseloads and hospitalizations have declined and vaccination rates have soared, “nothing has changed in childcare, and I think people forget that," said Sarah Muncey, who leads a Massachusetts childcare nonprofit called Neighborhood Villages, which is leading the COVID testing program for the state. The fact that most children don't get as sick as adults when they get COVID is not really reassuring to parents, Muncey said.

“And so everybody else gets to let go of the fear and laugh about how we used to Lysol our groceries," she said. "And if you’re a parent of a zero- to five-year-old or if you have a childcare center, nothing has changed.”

Last year, the state contracted with Neighborhood Villages to run a COVID testing program for daycares. Unlike K-12 schools — overseen by a state commissioner and local superintendents — the roughly 7,400 daycares in the state have spent the past two years largely figuring things out for themselves. The state's Department of Early Education and Care contracted Neighborhood Villages to reach out to daycares and get them testing resources and training, Muncey said. They started back in June, offering weekly PCR testing, with samples sent back to a lab. In January, they made rapid antigen testing available.

“As folks have gotten better at using them and more comfortable using them, I think it’s become clear that this type of testing is something we’re going to need on an ongoing basis to get through the next couple of years, and it’s doable,” Muncey said.

With case numbers lower now, it may not be necessary to test kids every week, said Stephen Kissler of Harvard T.H. Chan School of Public Health.

“But [rapid antigen tests] are still hugely helpful if a kid develops symptoms or if a kid has been exposed to someone, either at the daycare or at home, who has COVID,” Kissler said. “That can really help prevent a kid from showing up to the daycare while infected and causing a much bigger outbreak there, or vice versa from an outbreak happening in the daycare that they don’t bring home to their family.”

Among the daycares testing kids is Better World Family Childcare, which Sandra Rodriguez runs with her husband out of their Revere home.

“It's time to do ‘one, two, three!’” Rodriguez called out to the kids one day last month, using a term she invented for taking test samples, because she counts to three while swabbing each of their nostrils. The kids all did a great job holding still, because they’re used to it by now. They’ve been doing these tests weekly since the state launched PCR tests for daycares last summer. Now, Rodriguez said, she’s using rapid antigen tests from the state program, too.

“But it’s only when they have symptoms,” she said. One of the children was tested earlier in the week because of a runny nose, but his test came back negative, she said.

So far, about half of the state’s daycares are taking part in the free rapid antigen test program. And fewer than 300 daycares are currently doing the weekly PCR surveillance testing.

Other daycares may not be participating because they already have a lot on their plate, said William Eddy of the Massachusetts Association of Early Education and Care.

“The early education system in Massachusetts is extraordinarily stressed right now,” Eddy said. “Our staffing levels are difficult. We have classrooms across the state closed because we can’t get a teacher in the class. And I think many programs were hesitant to take on a new task of testing children, and were much more comfortable leaving it to parental discretion and letting parents do it at home.”

The state does let daycare programs send the tests home, so parents can do the testing there if a classmate of their child tests positive. But some daycares say even the administrative burden of distributing those tests, making sure they’re properly used and reporting the results back to the state program is too much for them to bear.

The thousands of daycares that are using the free PCR and rapid antigen tests could potentially lose access to the program this summer. Neighborhood Villages’ contract to run the testing program in daycares is up at the end of June — potentially just before another COVID spike.

“We have seen large increases in cases here in the Northeast that really have coincided, a lot of the time, with the fall and winter months,” Kissler said. “So at least having the tests available to use would be really important and really valuable.”

Kissler added that new variants and subvariants — such as the BA.2 subvariant that’s contributing to a COVID spike in Europe — continue to make the pandemic unpredictable.

“So I think the most important thing is to have the ability to make our response rapid and agile to be best tailored to the situation on the ground,” he said. “And I really worry that if we start removing some of these programs, that it’s going to be too difficult to fire them up when we need them again.”

A spokesperson for the state Department of Early Education and Care says they’re looking at the daycare testing program and what the needs will be going forward.