CDC: Maine overnight camps hosted over 1,000 kids and counselors, and only 3 contracted the coronavirus. Here is the safety plan they followed.
The camps all followed the same plan that included rounds of screening, testing, and quarantining before and after camp arrival. Campers and counselors were split into cohorts that quarantined together like family units. Three asymptomatic attendees at three different camps tested positive for COVID-19 after arrival, but none of them spread the virus to others at camp. Visit Insider's homepage for more stories.
Four overnight camps in Maine implemented a multi-layered strategy to prevent the spread of the coronavirus, and, in doing so, successfully avoided secondary transmission, according to a report out today from the Centers for Disease Control and Prevention. The four camps hosted a combined total of 1,022 kids and staffers from across the US and abroad. Two staff members and one camper at three different camps tested positive for COVID-19, though they showed no symptoms, after arriving at camp. They were quickly isolated and their contacts were quarantined, resulting in no spread to other camp members. A recent outbreak at a camp in Georgia demonstrated how just one case can spread rapidly without proper containment, as 260 campers and counselors tested positive after one staffer came down with the virus. While the campers in Georgia were not required to wear masks, campers and counselors in Maine were masked when participating in activities outside of their assigned cohorts, which ranged from five to 44 people depending on the camp. Employing a multilayered strategy allowed the camps to mitigate the spread of coronavirus Laura Blaisdell, lead author of the report and a camp mom herself, said there's not one gold-standard strategy that is 100% effective at preventing the spread of coronavirus. She said this intervention was successful because it combined multiple strategies including early identification and isolation, quarantining, cohorting, masking, and physical distancing. "It's like a piece of Swiss cheese. Every layer has a limitation, and it's the putting of the layers on top of each other that allows us to cover up those holes," Blaisdell said.
Camp attendees were instructed to quarantine at home with their family units for 10-14 days before arrival, then quarantined with their cohorts for 14 days after arrival. The camps required attendees to show negative coronavirus test results from 5-7 days before arrival, with four attendees delaying their arrival because they tested positive. At one camp, 15 campers were isolated while they waited to learn their test results. Campers and staffers were tested again a week after arrival, which yielded positive results for three attendees. The positive individuals were isolated until they tested negative, and their cohorts quarantined for 14 days. The camps also implemented daily temperature checks and questioning about COVID-19 symptoms. The cohort system limited indoor interactions that could lead to transmission By assigning campers and counselors to small, stable cohorts, the camps cut down on scenarios that could spread the virus and set clear expectations for mask-wearing. "Those cohorts acted essentially and functionally as family units," Blaisdell said. The groups initially quarantined together, and campers were allowed to not wear a mask while within their cohort. The cohorts dined together, bunked together, and used the same bathrooms. The camps limited mixed-cohort indoor activities where the virus might spread, and encouraged sports that allowed physical distance between cohorts, according to the CDC report. Blaisdell said the camps were able to create a "culture of compliance" around mask-wearing within the larger camp community, and they didn't have any issues with people not wearing masks. "As a public health trained physician, I'm thrilled about the results because we entered into the summer with a small degree of trepidation and a large degree of uncertainty," Blaisdell said. "As a camp mom, I'm equally grateful because my sons were able to play and to connect with friends and to enjoy being outdoors after having a tough spring."Join the conversation about this story » NOW WATCH: How the Navy's largest hospital ship can help with the coronavirus
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It's too late to trace infections at the White House Rose Garden ceremony, experts say: 'I bet you we'll never find out'
Summary List Placement Recent visitors to the White House received a letter from health officials on...Summary List Placement Recent visitors to the White House received a letter from health officials on Thursday. It came with a warning: If they had worked in the White House in the past two weeks, attended the recent Supreme Court announcement ceremony, or had close contact with people who fit that description, they should get tested for the coronavirus. Ideally, they should already be quarantining as well. The letter, signed by 10 health departments in the Washington, DC, area, expressed concern about a lack of contact tracing following a superspreader event at the White House. Nearly 200 people gathered in the White House's Rose Garden on September 26 to see President Donald Trump officially nominate Judge Amy Coney Barrett to the Supreme Court. The majority of those attendees didn't wear a mask. Many hugged and shook hands. A smaller group attended an indoor reception following the ceremony, where they again mingled without masks. At least 34 White House staffers and contacts have since been infected with the coronavirus, according to an internal memo from the Federal Emergency Management Agency. That includes bodyguards, family members, pastors, journalists, GOP senators, and advisors. Trump tested positive for the virus on October 1. Shortly after, the Centers for Disease Control and Prevention offered to help the White House with contact tracing, The Washington Post reported. The White House initially rejected the invitation, a CDC official told The Post, but finally began cooperating with two CDC epidemiologists on Wednesday. On Thursday, a senior White House official told The Post that the White House had finished contact tracing related to the president's infection. But White House staffers and administration officials said that many people with potential exposure hadn't heard from health officials yet. Epidemiologists say attempts to identify infections at the Rose Garden ceremony may have come too late. "It's hard enough to do a normal contact trace. I'm in the middle of doing one right now, and it's hard enough to do when people are cooperative and you're doing it by the book," Yvonne Maldonado, an epidemiology professor at Stanford University, told Business Insider. "But when you have a random email out to a bunch of people and some people might respond, some won't, it's going to be really hard to know." The administration's delayed efforts could forever obscure the true scale of the outbreak, she added. "I bet you we'll never find out because you're assuming that everybody got tested whether they had symptoms or not and that never happens," Maldonado said. "You'd need to test everybody over two-week period." At the very least, experts say, the list of infected individuals is probably longer than what has been confirmed thus far. "These are people with extremely busy jobs and a lot of people that they come in contact with every day," Rachel Graham, an assistant epidemiology professor at The University of North Carolina at Chapel Hill, told Business Insider. "It's reasonable to assume that it's also spread beyond the White House at this point." Early contact tracing could have contained the outbreak Epidemiologists rely on a three-step strategy to contain the virus: test, trace, isolate. Those steps must go in order. If any one of them fails, the whole system falls apart. That's why testing a person right after they've been infected is so important. The quicker epidemiologists can identify cases, the better chance they have of getting people to isolate before infecting others. But it's not enough to test each person once. "If you're negative on day one post-exposure, that doesn't mean anything," Graham said. "You'd need to be negative on day seven post-exposure for that to start to mean something." White House Press Secretary Kayleigh McEnany is a prime example: McEnany tested negative for several days following the Rose Garden ceremony. During that time, she continued to brief reporters in person, without wearing a mask. Then her test came back positive on October 5. Health officials usually advise people to isolate for 14 days from their date of exposure or 10 days after their symptoms start. Two weeks is enough time for the virus to grow to detectable levels inside the body, so people who haven't tested positive by then aren't likely to have been infected. Data also shows that COVID-19 patients stop shedding enough virus to infect others after seven to 10 days of symptoms. It's not clear how many people who attended the Rose Garden ceremony were tested during that window. But since the event was more than two weeks ago, testing them now probably won't yield many answers. "Basically all of those people are either infected or not infected by this point," Maldonado said. It's also unclear how many people have isolated after coming in contact with suspected cases. "Since we do know for a fact that there are people who have tested positive that have since returned to work too fast, the chances of additional transmission can't be guaranteed against," Graham said. If everyone at the Rose Garden ceremony was tested and all those who tested positive were quarantined, she added, the White House may have been able to contain the outbreak. But a lack of contact tracing probably allowed infections to ripple into the surrounding community. "Basically this is how the pandemic started," Maldonado said. "This chain of transmission could just keep going." Tracking down patient zero White House officials seem to have abandoned the idea of tracking down patient zero at the Rose Garden ceremony. "There were a number of guests who have been at the White House who maybe tested negative, but then later tested positive," White House spokesman Brian Morgenstern told reporters on Wednesday. "So, it's sort of an unknowable question as to where it entered the environment. But where do we go from here is trying to mitigate further transmission." But experts say early contact-tracing efforts would have made it much easier to identify the original source. For example, at least nine people in the first four rows of the outdoor ceremony have tested positive so far. And at least five confirmed cases went to the indoor reception. That may offer clues about where contact tracers should start. From there, contact tracers would also consider how long people were interacting with one another. People who went within six feet of someone who tested positive or had contact with an infected person for 15 minutes or more would have the highest risk of getting sick themselves. Graham said it's more likely that the virus spread indoors, but the size of the Rose Garden ceremony still presented ample opportunities for transmission. "If you're still crowding a bunch of people into one place, it almost doesn't matter if it's outdoors. You're still producing a large cloud of respiration that can be easily transferred to the person sitting next to you," she said. "So it really is if you're not wearing a mask, if you're not protecting yourself from droplet transmission, you are becoming part of the potential chain of transmission." But identifying patient zero would prevent contact tracers from having to test every person in the crowd. "I'm sure they have an idea of who the source is, but we'll never find out probably — or maybe we'll find out after the election," Maldonado said. "Somebody's dying notes will say, 'Oh, you know, we knew who it was.'"Join the conversation about this story » NOW WATCH: How the Navy's largest hospital ship can help with the coronavirus
I'm a former camp director. Here's why we shouldn't get too excited about the CDC report showing how Maine camps hosted 1,000 kids and counselors with only three coronavirus cases.
A recent CDC report revealed how four summer camps in Maine were able to operate while...A recent CDC report revealed how four summer camps in Maine were able to operate while successfully limiting COVID-19 transmission. Jack Hodgson, a former director at a non-profit New Jersey summer camp, now a postgraduate researcher at Northumbria University in Newcastle, England, says this is encouraging news — but there are several caveats. Not every camp will have the infrastructure and resources in place to pull off what occurred in Maine. The "culture of compliance" was a major reason for the Maine camps' success — and that will be difficult to achieve on most college campuses, not to mention within the rest of the country. To keep students and faculty safe, colleges must meet high standards of safety; right now, camps are showing them up. Visit Business Insider's homepage for more stories. A recent CDC study showed how four Maine summer camps operated successfully without COVID-19 transmission this summer. It's great news for an industry that has taken a big hit, and the study also includes important takeaways for schools and colleges. As a former summer camp director who now works in higher education, I won't be breaking out the S'mores or deleting my Zoom app just yet. Here's why. What the Maine camps did right When it comes to coronavirus, you cannot be hopeful or casual in your approach. Things can go wrong quickly. A single camp in Georgia saw 260 cases. The University of Alabama had at least 560 after being open a week. The folks in Maine showed us what can work. Staff and campers isolated pre-arrival and were tested on arrival. Positive cases were isolated, and contacts quarantined. Camp also looked a little different: Indoor programs were minimized, sports were played with kids staying apart, and strict mask-wearing rules were in place. Small groups were formed who dined together, and bathroom access was limited to single cohorts. Despite this, a small number of cases came up. Thorough monitoring, speedy isolation, and quick testing prevented any transmissions from those cases. What this means for other camps In a normal year, camping is a $26 billion industry that employs over a million staff to host over 25 million kids. Only 18% of overnight camps opened this year. In an industry that includes a significant number of non-profits, who provide transformative experiences to the most deserving, this is tragic. For the first time since 1899, my old stomping ground, YMCA Camp Mason (Hardwick, New Jersey) did not host summer camp. Camps like Mason have adapted their business models to these uncertain times. The CEO there, Keith VanDerzee, told me how renting cabins out to families, who agreed to staggered amenity access and other rules, had helped ensure camp would be there for kids next summer. His focus now is on helping local schools learn safely in cohorts by using the camp's 500 acre facility. This CDC report helps camps look to next year with optimism. The American Camp Association has commissioned four more research projects. Their president and CEO Tom Rosenberg told me the priority is safety as the ACA works to "harvest all the knowledge possible" from this summer for 2021. Putting my director's hat back on, I think that there will be some that don't open. Not every camp will have the infrastructure and resources in place to pull off what they did in Maine. Suitable buildings for isolation of individuals and cohorts will need to exist. Someone will need to pay for a lot of tests and an enhanced cleaning regime. Improving ventilation may mean expensive construction work for some camps. These measures will be more important, too, with kids back in school and guardians back at work, making pre-arrival isolation challenging. The ACA is right to be putting measures in place for next summer already. What about schools and colleges? For residential schools, the findings of this report will be easily applicable. For typical schools, with kids going home to parents with public-facing jobs, the same level of protection is impossible. Decision-makers need to understand they are more vulnerable. In such cases, the lead author of the CDC study, Dr. Laura Blaisdell, says it's increasingly important that all other measures are strictly implemented. Given the size and riches of institutions, colleges have come up with laughable and flimsy reopening plans. Yale even told students to "emotionally prepare" for deaths in their community. That's not a reopening plan. Dr. Blaisdell's study sets the standards needed for success, but some measures will not work for colleges. Outside programming at summer camp, the world of "liquid sunshine" and rainbows, works — but that's not going to fly in Vermont in December. Creating and enforcing cohort bathroom usage seems like a nonstarter too. Leaders must consider if they are meeting enough standards. If they are not, they need to reconsider plans for face-to-face teaching. Camps and the "culture of compliance" In an email to me, Blaisdell highlighted to me how important a "culture of compliance" was in the success achieved in Maine. This is the solution — but it's also a problem. America in 2020 doesn't seem to vibe with a "culture of compliance" when it comes to social distancing and masks; the very phrase is probably going to get some folk hollering "freedom" and reaching for the nearest star-spangled-banner. In camps, you can have that culture. As a camp leader, I've had teenagers don tin-foil hats, crush watermelons (alien eggs), and explore a hole (meteorite crater) for clues. Last year, I couldn't get all undergraduates to do the reading or double-space their essays. Hoping for a "culture of compliance" in a large college community for a prolonged period seems fanciful. The bottom line The CDC report is great news for camps, showing what is possible. The industry is wasting no time in learning everything it can for next year so more kids will get back to camp. The planning going into that is showing up those in higher education. Leaders there must quickly figure out if they can realistically achieve the same standards to keep students and faculty safe. Jack Hodgson is a former director at a non-profit New Jersey summer camp, a freelance writer, private tutor, and a PhD candidate at Northumbria University in Newcastle, England. He teaches both history and American studies. SEE ALSO: Colleges across the US are turning to outdoor instruction for in-person classes this fall to combat the spread of COVID-19 infections Join the conversation about this story » NOW WATCH: A cleaning expert reveals her 3-step method for cleaning your entire home quickly
A CDC report from a Georgia hot spot illuminates just how easily kids can spread coronavirus,...A CDC report from a Georgia hot spot illuminates just how easily kids can spread coronavirus, adding to our understanding of kids’ role in transmission.