Sniffles no longer keep kids from daycare — THL doc explains updated guidance

Covid testing of kids under 12 is no longer being recommended, except under exceptional circumstances.

Some of the THL's new guidance is subject to interpretation, so Yle asked the institute's chief physician Emmi Sarvikivi for help with navigating the recommendations. Image: Antro Valo / Yle

As Finland's Covid situation improved, children were no longer required to be completely free of cold symptoms to attend daycare. But many parents are left wondering if it is OK to bring their kids to daycare if they're recovering from a cold, among other things.

During most of the coronavirus crisis, Finland maintained a strict policy that kids who came down colds or the flu could only return to daycare centres if their symptoms had significantly faded and also tested negative for Covid.

The testing requirement has been waived. According to Emmi Sarvikivi, chief physician at the Institute for Health and Welfare (THL), requirements for kids to be asymptomatic was unreasonable, because young children get a lot of respiratory infections and their symptoms often linger for quite a while after they recover.

"If being totally asymptomatic was required, in practice, children under the age of three wouldn't be able to go to daycare at all during cold and flu seasons," Sarvikivi explained.

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Emmi Sarvikivi Image: Juha Heikanen / Yle

The THL's latest coronavirus guidance for parents of young children (siirryt toiseen palveluun) now recommends that daycare kids should stay home when initial cold symptoms appear. But after a few days of improvement, the agency said it was okay to head back to daycare.

Some of the institute's guidance is subject to interpretation, so Yle asked Sarvikivi for help with navigating the recommendations.

1. Mild early symptoms

In its new guidelines, THL recommended that youngsters stay home from daycare and school if they have new symptoms of a viral infection. However, Covid testing of kids under 12 is no longer being recommended, except under exceptional circumstances.

"The instructions clearly state that kids can't go back to daycare or school with early symptoms, no matter how mild they may be. That's when it's good to stay at home," Sarvikivi said.

In the days before coronavirus became a part of daily life, going to work, school or daycare with a runny nose or mild cough was common. But that's not recommended now, because viral infections are their most contagious when symptoms first appear.

Sarvikivi said she hopes that people will follow this guidance even after the pandemic subsides, pointing out that staying home during the onset of cold or flu symptoms helps to prevent the spread of viral infections in general.

2. Fever = stay at home

A child who has a fever or has green-coloured nasal mucus should not attend daycare or school, according to THL.

"If a child has a fever or green snot, it means that the child isn't well. That's when it's time to stay at home," Sarvikivi said.

3. What to do as symptoms improve

Unlike in the spring, Finnish daycare centres no longer require children to be fully asymptomatic or have tested negative for Covid. The THL's updated guidelines say that kids can go back to daycare or school after their symptoms have improved. However, this guidance leaves room for interpretation.

It is very challenging to assess when it's OK for kids to return, according to Taina Markkanen, the director of the early childhood education unit at the Nurmi Castle Nursery daycare centre in Kouvola.

"We just have to trust what the parents say. If they say that the child was in worse condition when they were at home and that they are clearly better, yes, we trust that," Markkanen explained.

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Taina Markkanen Image: Antro Valo / Yle

Sarvikivi pointed out that it is difficult to create these kinds of guidelines so that there's no room for interpretation. According to THL, the recommendations are meant to be used as a general guide which may be subject to various interpretations.

"Symptoms cannot be scored or given a [time scale], as their onset is often difficult to determine. In practice, the risk of infection decreases sharply after the onset of symptoms and is low after the first couple of symptomatic days," Sarvikivi said.

Similarly, like other viral diseases, the infection risk of coronavirus rapidly decreases after the onset of symptoms.

4. When it's OK to head back

Children can return to daycare after spending a few days at home, when parents should keep an eye on their symptoms.

"[It is OK for kids to return] if they have a bit of a runny nose or cough. But if, for example, the cough is severe and distracting to the child, it's not nice to be in daycare. The situation must always be assessed in terms of the child's ability to cope [with the situation]," Nurmi Castle Nursery's Markkanen said.

A child's condition is also assessed by daycare staff.

"If, in our opinion, we see the child not having the energy to play, for example, then we'll make a telephone call home," Markkanen explained.

If children's runny noses are caused by allergies or such symptoms go away after they come indoors, THL has advised they can continue attending daycare, given that their health is otherwise good.