Sending kids back into classrooms as schools reopen during the COVID-19 pandemic is a decision many families are grappling with, but child care both before and after school is another complicating factor in the equation.

Sending kids back to classrooms this fall is a decision many families are grappling with, but before- and after-school child care is another complicating factor in the equation, especially for parents who work outside the home. 
Christine Ens and her husband, Matt Miles, decided to send their daughter, Audrey, back to school in part because the only child has missed socializing with friends and classmates. However, Audrey, who is almost seven, won’t be returning to her after-school program. 
“We were thinking about the risk and the exposure she would have,” the Winnipeg mother said, noting that school alone will put the second-grader in a cohort of up to 75 people.
A cohort is a group of students who remain together throughout the school day to minimize exposure to other groups, according to the U.S. Centers for Disease Control and Prevention. Ideally, teachers and staffers would also remain with a specific cohort.
The after-school program, which requires Audrey to take a school bus to another location, includes children from other schools. “Her risk and her bubble becomes just exponentially larger,” Ens said.
Ens and her husband are adjusting their work schedules to support the decision, but they acknowledge that not everyone is as fortunate. 
“Before- and after-school care is a huge issue for families. It’s difficult to find and it’s difficult to co-ordinate,” she said. “The folks who are involved and invested in education decisions really needed to think through the child-care challenge that families are facing.”
School reopenings have been a logistical and operational challenge for those running school-aged care programs.
Guidelines for daycare operators often seem to conflict with the guidelines for school divisions and boards, said Amy O’Neil, director of Treetop Children’s Centre, which operates inside Toronto’s Oriole Park Junior Public School.
Cohorts are one of the areas of inconsistency, she said. Large class sizes in schools have sparked heated discussion, but O’Neil said not enough attention has been paid to caregiver-to-student ratios and the mixing of school populations and age groups that typically happen in school-age care.
Ontario and British Columbia have, for example, urged on-site care providers to work with school officials to apply protocols. Keeping students with their same school-day cohorts during before- and after-school care is recommended, but both governments have acknowledged that won’t always be possible. 
“I hear what you are saying [with] mixing the groups of kids. But I know the ministers work diligently with the boards and each board is gonna come up with their own plan,” Ontario Premier Doug Ford said when asked about these concerns on Friday, during his daily press briefing. 
“We understand parents’ concerns about the number of people their kids come into contact with,” a spokesperson for B.C.’s Ministry of Education told CBC News on Friday.
“Every open, licensed child-care facility in B.C. has a COVID-19 safety plan in place to keep children, families and staff safe and healthy…. We’ll be carefully monitoring child care in September and will make adjustments as needed.”
O’Neil said she worries that if provinces don’t expressly mandate it, “operators and principals are left to their own devices as to how and if they will cohort.”
Daycare providers across the country have a lengthy list of concerns over school reopenings, including a lack of consultation and co-ordination with the child-care community on developing reopening guidelines and procedures, said Martha Friendly, founder and executive director of the Childcare Resource and Research Unit, a policy group based in Toronto.
School-aged child care in particular has been “an afterthought,” she said.
“It’s not considered part of the child’s and parent’s day, despite conditions such as the size of groups and space for the class or program being pretty similar” to school itself.
Cohorts have been incorporated as part of a successful suite of school reopening strategies in other countries, said epidemiologist Cynthia Carr, founder of EPI Research Inc.
She said that having defined, separated groups of students helps to minimize chains of transmission and lets officials more quickly identify and isolate those who might be affected if there is a positive COVID-19 case, without necessarily having to completely shut down a school. 
WATCH | An epidemiologist offers advice for before- and after-school programs:
Consistent protocols between schools and before- and after-school programs makes sense, said Winnipeg-based Carr.
“The age groups at higher risk of spread should have the same rules, whether it’s a daycare or a school, because you’re still talking about the same enclosed space. You’re still talking about duration of exposure.”
While “within the school context, we know there can’t be zero risk,” Carr said that what’s most important is that operators of school-aged care facilities enact the many layers of safety measures from maintaining physical distancing and masking to increased cleaning and attention to ventilation in order to get down to the lowest risk possible.  
A student’s school cohort might in effect be “broken” due to conditions in before- or after-school care, Carr said, but that can also happen if, for example, that student plays on an outside sports team or mixes in different social or family settings as well.
The work establishing school cohorts isn’t completely negated if students end up alongside kids outside those defined groups say, when taking the bus or during after-school care provided that safety protocols are being followed in each of those different areas they access, said Dr. Monika Dutt, a public health expert and family physician in Sydney, N.S. 
“Understandably, many caregivers and parents are really worried…. At the same time, I would say there are really strong guidelines from what I’ve seen and what I’ve been working with that are given to daycares, after-school programs, schools and camps.”
As a baseline, we all need to work at keeping community transmission as low as possible and to follow public health guidance, Dutt said.
Care providers can additionally work toward consistency by keeping the same students and staff together all year in before- and after-school care, she said, adding that regular communication between schools, parents and school-age caregivers this fall will be key.
Care operators “don’t want children to be sick. They don’t want staff to get sick. You want your family to stay as safe as possible,” Dutt said.
“We’re all trying to accomplish the same goals, in a way that allows people to be able to go to work and children to be able to to learn in school settings.”