Autumn always brings with it its fair share of illnesses with coughs and colds, which is a normal part of nursery life. However, this year each sniffle is likely to arouse more concerns than usual, with the threat of swine flu hanging heavily in the air.
Much to the surprise and despair of many parents and nursery workers, healthy children have not been made a priority to receive the swine flu vaccine although they are considered 'super spreaders'. Instead, advice is being given on how to reduce the spread of the virus, and nurseries are being advised not to shut.
But for Blue Sky Day Nursery in Market Weighton, Yorkshire, the worry is that staff absences rather than child illnesses might in fact force it to close. Yorkshire has not been badly hit by the virus, and so far more staff than children at the nursery have contracted the disease, with three having already taken time off.
'We have coped with this so far because it is the school holidays and we have students who can cover,' says nursery manager Carol Gibson-Cass. 'But if it had been term-time, it might have been different and we would have needed to use supply cover, with all its extra costs. I am concerned about the autumn because it has been proving more of a problem with staff than with the children.'
The nursery did have two suspected cases of swine flu, and has kept the parents updated on the situation. 'A few were concerned but only two out of 120 chose to keep their child off,' says Ms Gibson-Cass. 'The local council sent letters out to all childcare establishments with guidelines, and asking us not to close. We have passed these and subsequent letters on to parents. The local authority has been very supportive and we can phone the area development worker any time.'
'Parents have asked what we are doing, and we have kept them informed and have a swine flu update on the notice board. We have revised our sickness policy and if a child has symptoms we immediately ring the parents. If swine flu is confirmed, the child has to be off for at least one week or until their symptoms clear. Parents have been really good and nobody has tried to sneak their child back early.'
Cleaning has also been stepped up. 'Toys which are normally cleaned weekly are now cleaned after each use,' says Ms Gibson-Cass. 'In the baby unit, the morning toys are now cleaned after dinner times, with fresh ones used in the afternoon.'
Nottingham is one of the areas of the country deemed a 'swine flu hotspot'; so many people have developed the virus that the Department of Health recently announced that it would now be focusing on treating people with symptoms, rather than trying to contain the virus.
But parents at the Hickory House nursery in Nottingham do not appear to be worrying too much. 'Parents are not too concerned,' says manager Amy Hitchin. 'They take the view that we are going to get it at some point. They know we are high on hygiene here, and this was actually commented on by Ofsted. We are constantly washing our hands and there are antibacterial washes in all the rooms. The older children know to wash their hands after blowing their nose, following messy activities and after using the toilet.'
The nursery has had one confirmed case and one suspected case of swine flu, and parents have been kept informed, both verbally and via posters in the nursery. 'One or two parents asked if the case was in their child's room, but only one parent kept their child off. This was just before they were due to go on holiday so they didn't want to catch it before going away. Many of our parents work in the NHS, so they know procedures.'
So far the nursery has managed to handle staff absences. Ms Hitchin says, 'We have a couple of girls who are flexible in their hours and can do an extra couple of days if need be. We also use a supply agency which is pretty good. I'm not too worried about the effect on the business. Children are pretty resilient and my staff are not ones for taking sickies.'
But while communication with parents appears to be good, communication with the relevant authorities could have been better. 'When we had the confirmed case, we told Ofsted and the Health Protection Agency,' recalls Ms Hitchin. 'But the HPA told us to tell the NHS instead. It was very difficult to navigate and to obtain the information needed - not overly useful.'
The Matchbox Day Nursery in Tower Hamlets, London, is another nursery in a designated swine flu hotspot, with the east London borough reportedly being hit harder than any other area of the country.
However, Kim Arrowsmith is another manager taking the situation in her stride. 'We have taken all the precautions we can,' she says. 'It doesn't appear to be that different from normal flu.'
Parents appear to be equally calm. 'Only one has asked if we have had any cases, which we haven't,' recalls Ms Arrowsmith. 'They have not asked what we are doing to prevent infection as they see for themselves that we have handwash for people to use before coming into the nursery. Everyone has to use it, including parents. We also wipe surfaces regularly.'
Ms Arrowsmith has been impressed by the level of support provided by the local authority. 'It has been great,' she says. 'It has given us loads of advice and we receive the same updates that the schools receive, telling us what to do and what advice to give parents.'
Much of the focus in the media has been on children and their greater tendency to pick up germs, but at Matchbox Day Nursery staff don't view them as their biggest worry. 'Parents are our greatest concern,' says Ms Arrowsmith. 'Particularly working parents. They are travelling on the Underground and buses when it's busy, mixing with people who could be infected.'
She adds, 'We do not have any worries about the autumn. We expect we will have some staff off sick, but we are confident we can cope.'
Further information
- NHS swine Flu questions and answers, www.nhs.uk/Conditions/Pandemic-flu/Pages/QA.aspx
- Health Protection Agency swine flu information and advice, www.hpa.org.uk/web/HPAweb&Page&HPAwebAutoListName/Page/1240732817665
- The National Children's Nurseries Association advice for members, www.ncna.net/index.php?option=com_content&task=view&id=99&Itemid=62
- Guidance for Schools and Early Years or Childcare Settings, www.teachernet.gov.uk/_doc/11481/ifc_eychildcaresettings.doc
SWINE FLU POLICIES
Sickness policies and procedures should be updated to take into account swine flu, with parents and carers kept up to date of changes. The main points to include are:
- what action will be taken by the nursery if a member of staff or a child contracts swine flu, and what parents/carers should do if they suspect a child of having swine flu symptoms;
- the length of time before an infected child or adult is allowed to return to the nursery following recovery;
- who should be contacted should a child fall ill (this is a good time to check contact details are up to date); and
- what staff should do if they fall ill with swine flu, including details on claiming statutory sick pay.
HOW TO REDUCE THE RISK
Children and young people are more susceptible to swine flu. They are estimated to be four times more likely to catch it than the general population, with the under-fives three times more likely to require inpatient care. To reduce the risk, nurseries should:
- encourage children to cover their mouths and noses when coughing and sneezing;
- use disposable tissues and throw them away after use;
- wash hands with soap and water or hand gel regularly, and particularly after going to the toilet, sneezing, or taking part in messy activities. Encourage parents to use hand gel on entering the nursery too; and
- step up cleaning in the nursery. The virus can survive on a hard surface for up to 24 hours. Setting up a routine to clean toys and equipment more regularly than normal is a good idea, as is avoiding cuddly toys which help spread the disease.
