A church day care center in Decatur was closed Wednesday after an infant who attended it developed symptoms over the weekend and tested positive for COVID-19.
Senior pastor Matt Haines of Central Park Baptist Church said he learned from the parents of the positive test on Tuesday.
“Our understanding from the conversation our child care center director had with the parents was that this child began to show symptoms of a fever Saturday, and that’s when the parents took her to get her checked. That’s when the test was administered. She was never symptomatic when she was here at the day care center,” he said.
She had last been in the day care Friday. Haines said all children are checked for fever before entering, and she did not have a fever Friday.
“We made the decision yesterday, just out of precaution, that we would close right now. We informed all of our parents that there was a child in the infant room that had tested positive. We are asking the parents if they have any concerns to let us know, or if any of their children develop symptoms or get tested to let us know so we can keep informing our parents if it shows up in any of our other classrooms,” Haines said.
He said that, in compliance with an emergency health order, the number of infants in the room where the infected child had been was under 12.
Dr. Michael Saag, director of the Division of Infectious Diseases at UAB School of Medicine, said most children who test positive do not develop serious symptoms, but they spread the disease for days before any symptoms develop.
“Whether the child has symptoms or not, there’s a period of time — estimated at about seven days, maybe 10 days — where they will be distributing infectious virus into the environment,” Saag said. “The peak time of transmissibility — that is, the peak time when somebody who’s infected with this virus spews out the most amount of virus to the environment — is in the 24-hour period prior to getting sick.
“The day before the child developed symptoms, that child was distributing virus into the environment. If they were in the day care center on Friday and got sick on Saturday, that child could have infected a number of people.”
Haines said Central Park Baptist Childcare Center reopened about two weeks ago, several weeks after a revised state health order allowed reopening of child care facilities with restrictions. A revised health order announced Thursday will end the limitations on the number of children who can be in a child care room beginning at 5 p.m. Saturday. It prohibits employees from knowingly allowing parents or other guests to congregate within 6 feet of a person from another household, and requires employees to wear masks.
“We were closed for about three or four weeks. We made the decision a couple weeks ago to open back up. This child, she had been attending for a few days,” Haines said. “This child was in one isolated room, an infant in a baby bed. The parents bring them in, take them to the room, come back and pick them up later. The child never leaves the room.”
He said there was no need for widespread testing of staff and other children.
“There was no reason for anyone to be tested at this particular point because we had not had anyone who had shown any symptoms or been exposed to it in our day care at this point. That child has not been back since Friday, so she was not here the last three or four days. Out of precaution, we have asked our teachers in that classroom to self-quarantine,” Haines said.
Saag said caregivers are at particular risk of contracting the virus, especially in the 24 hours before symptoms appear, because of the close and sustained physical contact that usually takes place when caring for an infant.
Haines said his understanding was that the child was the first person in her family to exhibit symptoms, but the other family members are now being tested for the coronavirus.
While most infected children fare well with the virus, Saag stressed that "for everything we know about this virus there are a thousand things we don't know."
He and Dr. Ali Hassoun, an infectious disease specialist at Huntsville Hospital, both mentioned pediatric inflammatory multisystem syndrome (PIMS) as a risk factor in young children. It’s rare, but serious.
“In general, children — even infants — have a good ability to fight this virus,” Hassoun said. “The ones in the U.S. haven’t generally been severe as an initial infection. In New York they’ve seen maybe 37-40 cases of (PIMS). But it’s not active infection. It’s the after-effect of the infection, meaning the infection is gone but because their immune response is very robust, they’ll get some of these symptoms attacking their heart, their circulation and stuff like that.”
According to Johns Hopkins University School of Medicine, symptoms of this rare complication from COVID-19 include abdominal pain, vomiting and diarrhea, a red rash, red and cracked lips, red eyes, swollen glands on the side of the neck, and swollen hands or feet. It can cause permanent damage to the heart or other organs if not treated.
Haines said neither he nor the child care center had been contacted by contact tracers from ADPH as of Thursday afternoon.
“That worries me,” Saag said.
The role of contact tracers is to immediately determine who has been exposed to an infected person and to quickly isolate them so, if infected, they don’t spread the virus to others.
“To reduce chances of transmission, they need to get early diagnoses of other cases,” Hassoun said. “It’s really important to have good track and trace.”