American Academy of Pediatrics News - Child care workers in the early months of the COVID-19 pandemic did not have increased odds of contracting SARS-CoV-2, according to a new study, which noted many programs were taking precautions.

Researchers from Yale University surveyed more than 57,000 U.S. child care providers in late May and early June, asking whether programs stayed open, what safety measures the program put in place and what precautions staff took in their personal lives.

Just under half of the programs stayed open or re-opened after a brief closure. A suspected or confirmed case of COVID-19 led to closures of about 9% of those, according to “COVID-19 Transmission in US Child Care Programs,” (Gilliam WS, et al. Pediatrics. Oct. 14, 2020, https://doi.org/10.1542/peds.2020-031971).

The surveys showed that of the child care programs that continued to operate, 90% or more reported staff and children washed their hands frequently and indoor surfaces were disinfected daily. More than half disinfected indoor surfaces three times a day. Most programs performed daily symptom screenings and temperature checks of children and staff and practiced social distancing. Just over half kept children in cohorts that did not mix. However, daily face mask wearing was only 12% for children ages 2 and older and 35% for staff.

There were 427 child care providers who tested positive for SARS-CoV-2; researchers compared them to staff who did not contract the virus as well as to a group of matched controls. They found no association between contracting the virus and exposure to child care.

Odds of having COVID-19 were linked to being American Indian/Alaska Native, Latinx or Black. Taking personal precautions was linked to lower likelihood of contracting the virus.
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“None of these covariates, however, interacted with exposure to child care, suggesting a lack of association between child care exposure and COVID-19 outcome regardless of these other factors,” authors wrote.

​Gov. John Bel Edwards has released details of his proclamation moving Louisiana’s response to COVID-19 to Phase 3. Some businesses will be able to increase their occupancy, and bars may reopen subject to certain restrictions, only in parishes that do not have high incidence of illness and only if local governments choose to opt in.

“We have seen some improvement in decreased COVID-like illness, new COVID cases and hospitalizations in recent weeks, as our strong mitigation measures are working. That said, I want the people of Louisiana to know that moving into Phase 3 does not mean that COVID is no longer a problem for us because in fact it is. That’s why it is incumbent upon all Louisianans to follow the guidance, wear their masks and avoid going out when they are showing symptoms,” Gov. Edwards said. “We all want to see a return to normalcy, but it is going to take all of us working together to get us there. There are still some looming factors that could come to bear on the fragile gains that we have made including students returning to schools at all levels, the outcome of the Labor Day weekend and the displacement of thousands of residents by Hurricane Laura from an area that had among the highest case counts in the state. If we see a spike in cases, we may be forced to go back to a more restrictive Phase 2.”

“I also want people to be realistic, as Phase 3, with perhaps some relatively minor modifications, is likely where we stay until a vaccine is widely available,” Gov. Edwards said. “That doesn’t mean that there won’t be minor changes, but we are going to see things like the statewide mask mandate and crowd size limits in place for quite some time in our state and also across the nation.”

The new order will be in place for 28 days, expiring on October 9. In it, restaurants, churches, salons, spas, gyms and other businesses will be able to open at a maximum of 75 percent of their occupancy, with social distancing in place.
For now, bars will remain closed to on-premises consumption in parishes with high incidence of COVID as evidenced by their test positivity rate, which is a continued recommendation of the White House Coronavirus Task Force, as cases among young people and in college towns continue to grow.

Gov. Edwards’ order also outlines how bars may begin to re-open for on-premises consumption in Louisiana in Phase 3, based on the percent positivity of the parish for a two-week period. Parishes with a positivity rate of 5 percent or lower for two consecutive weeks may opt-in to open bars for on premises consumption, under the restrictions in the Governor’s order.

This two-week percent positivity will be updated every two weeks by the Louisiana Department of Health, with the next update scheduled for September 16.

When re-opened, bars will be able to open at 25 percent capacity, up to 50 people, indoors for customers seated for tableside service. They may have no more than 50 customers outdoors, socially distanced, seated for tableside service. No live music will be allowed. All drinks must be ordered at the table and delivered by bar staff to the table. Sale and service of alcohol at bars, when they reopen, must end at 10 p.m., with all patrons cleared from the building by 11 p.m. When re-opened, no one under the age of 21 is permitted in any bar.

Phase 3 also prohibits the sale or service of alcohol for on premises consumption at all establishments, including restaurants and casinos, after 10 p.m.

The statewide mask mandate will stay in place under the new order. Masks have proven to be a key mitigation measure in the fight against the spread of COVID-19. The more Louisianans who wear masks, the more Louisiana businesses can stay open.

The order continues to recommend those at higher risk of severe illness from COVID-19 stay at home unless they must leave for an essential activity, such as getting food or medical care. People with higher risk include those with compromised immune systems, those 65 and older and those with conditions like diabetes, hypertension, heart or kidney disease and obesity. Consult the CDC guidance on high risk conditions for more information.
Indoor social gatherings, like weddings or receptions, will be limited to the lesser of 250 people or 50 percent capacity of the facility. Outdoors, crowd sizes are limited to 50 percent capacity, up to 250 people, if people will be in close proximity and social distancing is not possible. Casinos will stay at 50 percent capacity and 75 percent of their gaming positions under the new order. Sporting events, like college football games, will operate at a lesser capacity of 25 percent and without alcohol sales.

Nursing home visitation will be prohibited in Phase 3, but the Louisiana Department of Health is working on a pilot program to begin to allow visitation at nursing homes with no new cases for 14 days and in parishes without high numbers of COVID-19. LDH will release details in the coming days.

Click the button below to read the updated Phase 3 order, which includes the closure of bars to on-site consumption, the statewide mask mandate and limitations on gathering size.

​Click the button below to read the extension of emergency provisions that is also extended to October 9.

A quick fix may change the decision if you applied for FEMA help following Hurricane Laura and you disagree with your determination letter.
 
Everybody has a right to appeal. There are common reasons why FEMA may have denied your application. Read your determination letter carefully to understand FEMA’s decision and know exactly what you need to do for your appeal. Often, applicants just need to submit some extra documents for FEMA to process their application.
 
FEMA can reconsider you in some cases if you:

• Submit insurance documents. Provide documents from your insurance company that detail your coverage or settlement is insufficient to make essential home repairs, provide a place to stay, or replace certain contents. FEMA cannot duplicate homeowner or renter insurance benefits.
• Prove occupancy. Provide documents that prove the damaged home or rental was your primary residence by supplying a copy of utility bills, driver’s license or lease.
• Prove ownership. Provide documents such as mortgage or insurance documents, tax receipts or a deed. If you don’t have a deed handy, contact your local or parish officials about obtaining a copy.

 
There are many other reasons you may disagree with FEMA’s decision. If you feel the amount or type of assistance is incorrect, submit a signed, written explanation outlining why you believe FEMA’s decision is incorrect and copies of any documents supporting your appeal, including proof of your disaster losses.
 
Your full name, your FEMA application number and disaster number, your pre-disaster primary residence address and your current phone number and address should be included on all submitted documents. Application and disaster numbers are printed on page 1 of your determination letter, above your name and address.
 
Instructions to submit your appeal documents:
There are four ways you can submit your letter and documents. Be sure to include the cover letter you received from FEMA when you submit them.

1. Mail documents and your letter within 60 days of receiving your determination letter to the address below. Your letter with accompanying documents must be postmarked within 60 days of the date on your letter from FEMA regarding your eligibility. FEMA National Processing Service Center P.O. Box 10055, Hyattsville, MD 20782-7055
2. Fax them to 800-827-8112.  
3. Upload them online at www.disasterassistance.gov if you have a FEMA online account. To set up a FEMA online account, visit the site and click on “Check Your Application and Log In” and follow the directions.
4. Visit a FEMA drive-thru Disaster Recovery Center. The center operates under strict COVID-19 protocols to ensure the safety of all participants. Masks or face coverings are required for entry and service. You will remain in your car. A specialist wearing a face mask will receive your documents through the window and return them to you. Find your closest center by calling the FEMA helpline at 800-621-3362 or TTY 800-462-7585, going online to www.disasterassistance.gov or downloading the FEMA app.  

​You may see Disaster Survivor Assistance team members visiting door-to-door in your area. Check for official FEMA photo identification. They will be able to answer questions and update your records if you need assistance with documents.
 
If you have questions about submitting insurance documents, proving occupancy or ownership, or anything else about your determination letter, call the FEMA helpline 800-621-3362 or TTY 800-462-7585. Those who use 711 or Video Relay Service can call 800-621-3362. 
Toll-free numbers are open daily from 7 a.m. to 10 p.m. Multilingual operators are available.
 
For the latest information on Hurricane Laura, click the button below. You can follow the FEMA Region 6 Twitter account by clicking the button below.