'It takes just one case to cause an outbreak:' Why summer camps are seeing campers, staff fall ill during pandemic
Summer was cut short last week for 82 children and staff members who tested positive for the coronavirus at one of Kanakuk Kamps' overnight camps, in Lampe, Mo. The network of Christian camps is just the latest to contend with outbreaks amid a record-breaking crisis in America.
A July 6 Facebook announcement from the Stone County, Mo., Health Department read in part: “Kanakuk is working with SCHD and made the decision to shut down the K-2 camp for this term after being alerted to the suspected COVID-19 cases. The decision to close has resulted in all campers, counselors and staff to return to their homes. SCHD will be working closely with Kanakuk Kamps to identify exposed individuals and quarantine those individuals, as necessary.”
The K-2 age group is for teens ages 13 to 18, according to the camp’s website. Representatives from Kanakuk did not reply to Yahoo Life’s requests for comment. According to the Stone County Health Department, “many of these cases returned to their place of residence and then tested positive.” Stone County, where the camp is located, reported 30 cases of COVID-19, according to Tuesday data from the Missouri Department of Health and Senior Services. There are currently 28,826 coronavirus cases in Missouri.
Since May, coronavirus outbreaks have forced camps in Arkansas, Alabama and Texas to pause for the summer, while ones in Michigan, New York and Maine closed out of precaution. “Our preliminary projections estimate 19.5 million campers will miss out on in-person day and overnight camp programming this year due to the pandemic,” the American Camp Association (ACA) tells Yahoo Life.
And that’s despite the best efforts to follow medical guidelines — after the four-day closure of a day camp at Walter Fuller Recreation Center in St. Petersburg, Fla., it opened its newly deep-cleaned facility to continued temperature checks, restricted visitors and mandates to physically distance and wear face masks, a spokesperson tells Yahoo Life. And when 14 staff members at Eagle Lake Overnight Camp in Colorado Springs, Colo., tested positive, the organization closed for the summer, cooperating in an El Paso, Colo., County Public Health investigation, a department spokesperson tells Yahoo Life.
“This summer, the option for camps to operate in-person really depends on [each] state and in some cases, county and local public health authorities,” the ACA tells Yahoo Life. The organization has joined efforts with YMCA-USA to publish educational resources for camps with ideas from experts in epidemiology and infectious disease management.
Additionally, the Centers for Disease Control and Prevention’s Suggestions for Youth and Summer Camps document suggests isolating sick campers, having children sleep head-to-toe and 6 feet apart and making bathrooms no-toothbrush zones. And the American Academy of Pediatrics published a set of questions that parents should ask prospective camps, warning, “Camps that follow recommended safety steps during the pandemic can reduce, but not completely avoid, the risk of a COVID-19 outbreak.” Meanwhile, camps in Arizona and Chicago have asked parents to sign waivers acknowledging the risks of the virus.
According to the CDC, the lowest-risk scenario in a camp setting is when small groups of campers who are from the same geographic region “stay together all day, each day.” These campers remain 6 feet apart, stay outdoors and do not share objects. The highest risk for campers is those who “mix between groups and do not remain spaced apart.”
Yahoo Life Medical Contributor Dr. Dara Kass tells Yahoo Life that sleepaway camp is riskier than day camp, echoing the CDC’s classification of “lowest” to “highest” risk camp settings. “Sleepover camp is a low-benefit, short-term experience with opportunities for failure,” Kass tells Yahoo Life. “With campers coming from different geographic locations, it’s harder to trace outbreaks. It’s a complicated web.”
However, Kass says, at day camp it’s easier to track outbreaks because children are geographically local and sleep at home, where parents can track symptoms based on an intimate knowledge of their children’s health.
Here is what concerns emergency doctors and infectious disease experts about camps reopening this summer.
Physicians are concerned about the lack of on-site testing
The use of testing at overnight camps would be beneficial, says the ACA, if only it were widely available. Kass agrees. “We need to test responsibly and safely, but right now point-of-care testing is private and prohibitively expensive to scale,” she says.
She and Dr. Jill M. Baren, a professor of emergency medicine, pediatrics and medical ethics at the University of Pennsylvania, elaborated in a May New York Times opinion article titled “Cancel Sleepaway Camp”: “If followed, the [CDC] guidance, which does not support any form of on-site quarantine or testing for the virus, effectively ends the feasibility of overnight camps,” they wrote.
“Without reliable testing, the inability to distinguish between other viral illnesses and COVID-19 places an enormous burden on doctors and nurses. ... In camp-age children, the newly described multisystem inflammatory syndrome can be deadly. Even experienced clinicians will have a difficult time figuring out exactly what to do with a child who has seemingly benign symptoms. A cold may or may not really be a cold, and a few of these cases at a camp’s health center could effectively shut down the entire operation.”
There are many unknowns about the pandemic among children
When the pandemic began to spread in the U.S., the CDC said that people above the age of 65 and those with certain underlying health conditions were at risk for severe COVID-19 illness. In June, however, the organization clarified that severe outcomes increase with age (removing “the specific age threshold”) and added more conditions to its list. And more states are reporting rising infections among young adults.
“We don’t have enough information to make camp safe because we don’t fully understand transmission among children,” infectious disease epidemiologist Brian Labus, a public health professor at the University of Nevada, Las Vegas, tells Yahoo Life, adding that camps aren’t designed for social distancing. “Campers aren’t sitting at desks, they’re sitting on top of each other in bedrooms or during group activities,” he adds. “They’re not going to camp to sit by themselves at desks.”
Saskia Popescu, an infection prevention epidemiologist at George Mason University, agrees. “[At overnight camp], kids are in cabins in close quarters for a prolonged period of time,” she tells Yahoo Life. “Often, they don’t have great air ventilation, so we know this can increase the risk for transmission. And [group meals] are high risk, as several kids are together, face to face, without a mask on for a period of time.”
Camps took a leap of faith during the pandemic
Dr. Wilbur Chen, an adult infectious disease specialist in the Center for Vaccine Development and Global Health at the University of Maryland School of Medicine, points out that even among highly controlled settings, outbreaks may be inevitable.
“We can test all we want and make ourselves feel comfortable, but it takes just one case to cause an outbreak,” he tells Yahoo Life. He refers to evidence that transmission is less likely outdoors and the neurocognitive benefits of social interaction as to why some camps opened. And he praises those that acted quickly amid outbreaks.
It will take time before we understand how camp has paved the road for children-centric events, says Kass. “We need to find and learn from any camps who have done it right.”
For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides.
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