Preventing and Mitigating SARS-CoV-2 Transmission - Four Overnight Camps, Maine, June-August 2020

Abstract

The World Health Organization declared coronavirus disease 2019 (COVID-19) a pandemic on March 11, 2020.* Shortly thereafter, closures of 124,000 U.S. public and private schools affected at least 55.1 million students through the end of the 2019-20 school year.^† During the summer of 2020, approximately 82% of 8,947 U.S. overnight camps did not operate.^§ In Maine, only approximately 20% of 100 overnight camps opened.^¶ An overnight camp in Georgia recently reported SARS-CoV-2, the virus that causes COVID-19, transmission among campers and staff members when nonpharmaceutical interventions (NPIs) were not strictly followed (1); however, NPIs have been successfully used to mitigate SARS-CoV-2 transmission among military basic trainees (2). During June-August 2020, four overnight camps in Maine implemented several NPIs to prevent and mitigate the transmission of SARS-CoV-2, including prearrival quarantine, pre- and postarrival testing and symptom screening, cohorting, use of face coverings, physical distancing, enhanced hygiene measures, cleaning and disinfecting, and maximal outdoor programming. During the camp sessions, testing and symptom screening enabled early and rapid identification and isolation of attendees with COVID-19. Among the 1,022 attendees (staff members and campers) from 41 states, one territory, and six international locations, 1,010 were tested before arrival; 12 attendees who had completed a period of isolation after receiving a diagnosis of COVID-19 2 months before arrival were not tested. Four (0.4%) asymptomatic attendees received positive SARS-CoV-2 test results before arrival; these persons delayed their arrival, completed 10 days of isolation at home, remained asymptomatic, and did not receive any further testing before arrival or for the duration of camp attendance. Approximately 1 week after camp arrival, all 1,006 attendees without a previous diagnosis of COVID-19 were tested, and three asymptomatic cases were identified. Following isolation of these persons and quarantine of their contacts, no secondary transmission of SARS-CoV-2 occurred. These findings can inform similar multilayered public health strategies to prevent and mitigate the introduction and transmission of SARS-CoV-2 among children, adolescents, and adults in congregate settings, such as overnight camps, residential schools, and colleges.

FIGURE

Camp population, by home state and by 7-day daily average rate of SARS-CoV-2 infection in home state as calculated on July 1, 2020 — four overnight camps, Maine, June–August 2020 * Combined attendance by quintiles of home state of the four camps included 642 children and 380 staff members aged 7–70 years, representing 41 states; 18 attendees (10 staff members and eight campers) originating from six international locations (Bermuda, Canada, Mexico, South Africa, Spain, and United Kingdom) and Puerto Rico are not shown on the map. States with incidence <10 cases per 100,000 population not designated. Jenks natural breaks used for attendee classification by home state. ^† Average case rate indexed to the state-specific population sourced by Harvard Global Health Institute (https://globalepidemics.org). ^§ July 1, 2020, is when the state of Maine allowed overnight camps to open for business.