Coronavirus Resources - Coming clean

Settings that remained open for key workers at the beginning of the outbreak in March did not have the luxury of making informed decisions based on all the evidence that is now in the public domain: how long the virus is estimated to live on different surfaces, and the most effective hygiene measures to keep staff and children safe. Instead, they took a cautious but commonsense approach, with hand-washing at the top of the agenda and effective cleaning of equipment and nursery resources.

While some settings have removed difficult-to-clean items, such as soft furnishings, where necessary, as stated in the Government guidance published on 25 May*, others have been steam-cleaning their rugs and cushions each night, determined to ensure that their enabling environments are safe havens for children in their care.

Sand pits and malleable resources such as playdough that harbour germs are off the menu in some settings, while others have come up with innovative ways to retain these resources by providing children with individual trays of sand or carefully packaged pots of dough. Some are even resorting to washing the sand in their sand pits with nappy sterilising solution at the end of each day.

As to what resources settings should continue to provide, Stella Ziolkowski, director of quality and training at NDNA, says settings should carry out risk assessments.

‘If the setting feels the risks cannot be adequately controlled, it is advised that these resources are minimised or removed,’ she explains. ‘This should be sensitively balanced with the reduced risk due to stringent hand-washing procedures and enhanced cleaning and the fact that the environment should continue to provide and invite learning across all seven areas as far as is practicable.’

ON THE SURFACE

Although research is ongoing, various studies have looked at how long the virus can survive on different surfaces. A study published in the New England Journal of Medicine states that Sars-CoV-2, the name of the virus that causes Covid-19, survives up to 24 hours on cardboard and up to two to three days on plastic and stainless-steel surfaces.

Johns Hopkins University professor of cell biology Carolyn Machamer maintains that just 0.1 per cent of the virus material remains on plastic after that time, making infection unlikely. Another study, published in The Lancet, found that viable virus could not be detected on wood surfaces after two days.

However, when it comes to sand, there is some debate. Current public health advice is that as sandpits cannot be cleaned thoroughly between uses, they should not be used at this time*. However, some argue that the guidance points to sandpits, as opposed to the sand itself.

A play safety expert from the Royal Society for the Prevention of Accidents (RoSPA) told Nursery World, ‘We do not know whether Covid-19 remains in sand. We are, therefore, unable to confirm that sand can be used at this time. In general, under normal conditions, sand should be provided due to its high play value, but at the current time we are unable to confirm.’

Some of the larger nursery chains, such as Busy Bees, have decided to remove a small selection of resources that are difficult to clean and are normally used by multiple children, thus increasing the risk of infection – such as sand, water and playdough. However, Busy Bees head of safety, Emily Brimson-Keight, says, ‘We are actively working towards a safe way of reintroducing them in the coming weeks and months ahead.’

SAND AND WATER PLAY

Children who attend Reach for the Stars Nurseries in Staffordshire and Cheshire, which have been open during lockdown, are outdoors as much as possible throughout the day. Director Adam Hindhaugh says, ‘Although wooden toys have been removed, children still use natural materials outside as the virus does not live as long outside.

‘We are still using sand, which is sterilised at the end of each day using diluted Milton. Children are involved in lots of water play, washing the toys in warm soapy water, and we are purposely giving the children messier activities so they have a visual reason to wash their hands.

‘Good, effective hand-washing is more important to us than what the children are using resource-wise. We are still using metal resources, but these are washed after every session. All resources used by the children during each session, either am or pm, are removed and placed in Milton until they can be cleaned ready for the next use.

‘We are trying to make the environment as normal as possible for the children. Their emotional well-being is extremely important to us.’

Water play is off the menu for children attending Ilminster Avenue Specialist Nursery School in Bristol, which has been open daily for up to ten children since March. Acting head teacher Matt Caldwell says he would be comfortable for children to use running water, but adds, ‘How safe would it be if an asymptomatic carrier put their hands in the water trays and we find out the virus is waterborne? I’m holding off until we can find something that is antibacterial and chemical-free and that is proven to kill off the virus in standing water.’

He also says that unlike the sand area, which is so big it is called ‘the beach’, children gather close together at the water trays. ‘In Australia, where there is lots of sand play, they rake the sand – they never disinfect it. There’s also strong evidence that UV light kills off bacteria in sand very quickly. We have a large sandpit and children are spaced out when they use it. Each of our six bubbles get to use the beach one day a week and the areas are zoned off with no free-flow access. If the Government advice is that it is OK to go to the beach, we are viewing our outdoor areas in the same way.’

Soft play and soft furnishings have also been removed since the DfE published the guidelines on reopening childcare settings. ‘We had already removed dressing-up materials,’ Mr Caldwell explains. ‘We continue to use cardboard boxes for den and role play, and children are encouraged to do mark-making activities outdoors, where they dunk the crayons in water pots after use, which are then dried in the sun. Staff wash down the Community Playthings chucky wooden blocks with our hospital-grade MRSA screen disinfectant.’

The nursery school is closed on Wednesdays and Fridays for deep-cleaning.

CASE STUDY: Tops Day Nurseries

Tops Day Nurseries has been caring for up to 350 children a week during the pandemic, as around 27 per cent of their parents are employed by the NHS. Cheryl Hadland, managing director of the group of 30 settings, says that through the ‘minefield’ of information, common sense has prevailed, and she has turned to scientific evidence rather than follow what has often been seen as conflicting Government guidance.

She says, ‘I’ve never had to use my courage reserves and resilience in my working life as much as I have to now.’ It’s an immense load to bear, she adds, knowing that mistakes at this time could be fatal… ‘but actually we can only focus on the children and our staff.’

Playing with sand is one area that has been through various risk assessments since March. ‘We initially banned it indoors, but we now use it both indoors in a bubble of children and outdoors as normal but with additional cleaning. I live above a beach, and every day children are playing in the sand there, yet not allowed to play only 100 yards away in the sand in the play area.’

Ms Hadland’s book, Creating an Eco-Friendly Early Years Setting, published at the end of May, explains that sand is a ‘relatively poor harbour for disease, and easily washed for normal bacteria and mould’. She says, ‘We are currently spraying it with the most powerful in the Biovation Range, actually Steridose sanitiser. It isn’t ideal for the environment and previously we only used it in the kitchen, but killing the virus is sadly a priority over the environment for now.’

Other resources are very little changed from before the pandemic, and good hygiene throughout the day has more of a profile than ever before. ‘We are much quicker to remove soft toys for washing once they are put down and we have a steam cleaner for rugs and fabrics within the home corners, and these are done every night, and even in-between if necessary. We are also encouraging parents to leave their child’s comforter with us – and have a second at home – and washing them on site for the next day rather than them going backwards and forwards.’

Although the nursery group’s risk assessments have changed frequently as new evidence emerged, Ms Hadland says they are now trying to ‘stop the knee-jerk fear reaction that was a problem at the beginning’.

She continues, ‘We know the risk to small children is actually really negligible, the much higher risk is to colleagues, and thus to their families, and it is very important we help them help themselves to protect themselves, and to stay fit, happy and healthy.’

MORE INFORMATION

• *https://bit.ly/2AJyl2N
• https://bit.ly/2N8okik
• https://bit.ly/2USBMLf
• New England Journal of Medicine, https://bit.ly/2YDAh4Q
• Johns Hopkins University, https://bit.ly/2N8YGd3
• The Lancet, https://bit.ly/37D6ihl
• https://bit.ly/2YXUP8v