Effectiveness of Non-Pharmaceutical Interventions on Child and Staff COVID-19 Cases in US Summer Camps
Authors: Suh Helen H. , Meehan Julianne , Blaisdell Laura , Browne Laurie 
Published: February 2021

Background

Most camps remained closed during Summer 2020, due to concerns regarding child transmission of SARS-CoV-2 and limited information about the effectiveness of non-pharmaceutical interventions (NPIs) within child congregate settings.

Methods

We surveyed US camps about on-site operations, camper and staff demographics, COVID-19 cases amongst campers and staff, and NPI usage as related to pre-camp quarantines, facial coverings, physical distancing, cleaning, and facility modifications. For all NPIs, save quarantines, responses were provided on a 5-point Likert scale format.

Results

Within 486 on-site camps, a range of NPIs were instituted, most often related to reduced camper interactions, staff face coverings, cleaning, and hand hygiene. Camper facial coverings were less common, with campers always wearing masks at ∼34% of the camps. Approximately 15% of camps reported 1+ confirmed COVID-19 case in either campers or staff, with three camps reporting a COVID outbreak. In both single and multi-NPI analyses, the risk of COVID-19 cases was lowest when campers always wore facial coverings. While less effective, constant use of staff facial coverings and targeted physical distancing measures, but not pre-camp quarantine, also reduced COVID-19 risks.

Conclusions

We found constant facial coverings, especially for campers, and targeted physical distancing measures to reduce risks of SARS-CoV-2 transmission within summer camps. Our findings provide valuable guidance for future operations of camp and other child congregate settings with regard to efficient and effective NPI usage to mitigate SARS-CoV-2 infection.

What’s Known on This Subject

Approximately 82% of US overnight camps did not open during Summer 2020 due to concerns regarding children’s ability to transmit SARS-CoV-2. Camps that did operate during this time instituted varied non-pharmaceutical interventions (NPIs) to reduce SARS-CoV-2 transmission, with little information available on the effectiveness of these NPIs within child congregate settings. Large population-based studies are needed to improve our understanding of the extent of SARS-CoV-2 infection amongst children and their caregivers and to determine whether and to what degree child congregate programs can safely open during the pandemic.

What This Study Adds

Our study, the largest survey of COVID-19 cases in child congregate settings at the national level, provides new information on the relative effectiveness of NPIs on mitigating COVID cases among children and staff within camp settings. We showed COVID-19 case rates in campers and staff to be low relative to corresponding case rates in the US and found constant camper facial coverings to be the most effective risk reduction method for SARS-CoV-2 transmission within camps. While less effective, constant use of staff facial coverings and targeted physical distancing measures, but not pre-camp quarantines, were also shown to reduce COVID-19 risks. Our findings has important implications for child congregate settings, helping to guide their successful opening and operation.