It’s been a long, weird spring of quarantining, balancing working from home and remote learning for pre-K children through college-aged adults, and now that the school year has ended, many families have asked us whether it is safe to send their child to camp or other activities. Although the American Academy of Pediatrics recently released guidelines for school re-entry in the fall, there is not an easy “yes” or “no” to the question of when to resume activities this summer. We have no way of knowing whether or not your child will be exposed to COVID-19 in each of these environments; however, here we list some of the measures you and the camp or daycare can take to minimize the risk of infection.
All decisions in life require an assessment of the benefit as compared to the risk. Our goal with COVID-19 is to reduce the risk to an acceptable level. We do this in many areas of our lives: for example, whenever we get in a car, there is no guarantee that we will not get in a wreck, but we take that risk because we believe that we have sufficiently mitigated that risk by wearing a seatbelt and driving safely. Ultimately each parent will have to decide whether or not they are comfortable with the safety measures put in place by the camp or daycare to reduce the risk of exposure to COVID-19. To help you in that decision, let’s first review how COVID-19 is spread.
According to the CDC, a person can get COVID-19 by:
- Person-to-person spread, via close contact (<6 feet) or exposure to infectious droplets. Respiratory droplets produced when an infectious person coughs, sneezes, or talks can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
- Touching a surface or object that has the virus on it, and then touching your mouth, nose, or eyes. However, this is not thought to be the main way the virus spreads.
- In general, the more closely a person interacts with others and the longer that interaction, the higher the risk of COVID-19 spread.
One of the reasons COVID-19 has caused a global pandemic is that people can spread the virus before they know that they are sick; as a result, it is necessary to take infection control precautions even when around “healthy” people. Just avoiding people who have fever is not sufficient to avoid exposure to COVID-19. The following are steps a camp or daycare can take to lower the risk of your child being exposed to COVID-19:
- Screen for symptoms of COVID-19
- While simply avoiding people with fever is not sufficient to avoid COVID-19, avoiding people with any possible symptoms of COVID-19 does lower the risk of exposure. According to the CDC, symptoms of COVID-19 include: fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and diarrhea.
- When considering a camp or daycare, investigate whether they are screening children for all of the COVID-19 symptoms.
- Proper hand hygiene
- Washing hands with soap and water for 20 seconds or applying an alcohol-based hand sanitizer is one of the most effective tools available for stopping the spread of COVID-19.
- When investigating whether or not to send your child to camp or daycare, ask about their hand hygiene protocols. It is recommended that children be required to sanitize their hands upon entry into the camp or daycare, prior to meals or snacks, prior to activities where they will touch other children or share items, after activities where they will touch other children or share items, after blowing their nose, and after touching their eyes, nose, or mouth.
- Have activities outside
- When an infected person breathes, they can spread a small amount of virus into the air. If an infected person is in an enclosed room with minimal circulation for a long enough amount of time, they can expel enough virus into the air that someone else can breathe it into their body and get sick. When outside or in a well-ventilated room, it is essentially impossible for enough of the virus to build up in the air to infect someone else by simply breathing.
- If a camp is held outside, then the risk of spread will be lower than a camp held inside, not only due to improved ventilation but also because of the ability to maintain social distancing.
- Wear a mask when indoors or within 6 feet of another person
- Wearing a mask is crucial to limiting the spread of COVID-19 when indoors or in close contact with another person as it decreases the amount of virus a person can expel into the air when breathing.
- Ask what your child’s camp or daycare policy is regarding masks. Be aware that the CDC recommends masks only for children ages 2 and older, and in some situations masks may not be recommended as they may create an additional risk of injury when participating in certain sports or activities.
- Limit exposure by cohorting children and restricting the presence of unnecessary individuals
- The fewer people your child is exposed to, the less risk of exposure to COVID-19.
- All camps and daycare facilities should limit the number of people your child is exposed to. This means that parents should not enter camp or daycare facilities and should remain in their car at pick-up and drop-off if at all possible.
- Your child should be in the same small group of children with dedicated staff throughout the day, including mealtimes, every day. Mixing between groups should be avoided when possible.
The state of New Hampshire has published a set of reopening guidelines for Day Camps, Overnight Camps, Youth Sports, and Child Care which can also be used to help make these decisions.
Even if your child’s camp or daycare implements all of the above suggestions, it does not guarantee your child will not get exposed to COVID-19. We would love to be able to give you a simple “yes” or “no” answer to the question “should my child go to camp”, but unfortunately life right now is not simple. Ultimately each parent will need to assess the risks and benefits of their family’s situation and make a decision. We hope you find all of this information helpful as you try to make a decision. No matter what your decision, we will be here to support you and help care for your child. In our offices we have implemented all of the recommendations listed above, including the recommendation to do activities outside as we have performed curbside visits and testing when necessary. We are also available for virtual visits to assess your child and discuss your concerns. If you have additional questions about the safety of attending camp or daycare, don’t hesitate to contact us and schedule an appointment with one of our providers.
Adapted from an excellent summary by our colleagues at Forest Lane Pediatrics (Dallas, TX)
UPDATE 7/7/20: Boston Children’s Hospital has published their own discussion of the risks and benefits of camp during COVID-19, with input from Dr. Sheila Nolan, Chief of Pediatric Infectious Disease.
