With the potential spread of the coronavirus disease (COVID-19), we wanted to do our part in sharing relevant resources for camps – some of our most common clients. This resource is designed to help minimize the emergence of communicable diseases at camp, part of a larger resource titled Communicable Disease Management in the Camp Setting by Linda E. Erceg, RN, MS, PHN.
The strategies below have the potential to minimize the emergence of communicable diseases at camp. When going through the list, keep in mind that no single strategy will be 100% effective; rather, campers & staff have stronger protection when more prevention strategies are in place. The key message: implement as many as possible.
- Augment pre-camp agreements with camper parents and staff to address these information points:
- Ask that each camper and staff member arrives well rested, nourished and hydrated. The goal is for individuals to arrive as resilient as possible.
- Tactfully state that the camp reserves the right not to admit people who pose a communicable disease risk to others.
- Direct that ill people not come to camp until they are healthy. Provide parents/staff with the name and contact information of an appropriate camp professional should questions arise in the days before arrival. Be prepared to discuss a delayed start for ill people and/or the option of coming to a different session. Note: the Healthy Camp research (2010) determined that between 5-7% of illness at camp actually started before the person arrived
- Briefly describe, in both parent and staff policies, the potential actions taken by camp should a communicable disease outbreak occur. If this might include sending campers home early, be sure to state that. Consider providing access to an insurance that covers the cost of “camp interruption.”
- Request immunization history for each camper and staff member on the health history form. This is particularly important when illness associated with lack of immunization occurs. That being said, note that some immunizations, once thought to provide lifetime immunity, may no longer do so (e.g., pertussis/whooping cough) or they have a high failure rate (e.g., varicella immunization). Consequently, remind people to work with their healthcare professional to update their immunization profile.
- Pre-screen health history forms before Opening Day to identify those who may be more at risk for communicable illness. Follow this by talking with appropriate people to develop a plan that minimizes the risk potential for these people. Note: the Healthy Camp research (2010) noted that individuals with chronic illness diagnoses have a greater potential to get ill while at camp.
- Conduct Opening Day screening of both campers and staff that includes assessment for communicable diseases.
- Orient all staff to illness-reducing strategies. Couple this with assessment of each staff member’s ability to implement and personally use the strategies (e.g., through performance appraisal process). Consider utilizing resources such as ACA’s online course, “No Outbreaks Here” (American Camp Association, 2010).
- Implement practices that minimize potential for communicable disease once camp is in session:
- Appropriate hand-washing and/or hand sanitizing. This assumes adequate wash basins and/or sanitizing pumps are at key locations.
- Cough/sneeze “into your sleeve.” Covering coughs/sneezes with one’s hands is no longer desired behavior; bury coughs/sneezes in one’s shoulder. Note: view “Why Don’t We Do It in Our Sleeves?” on YouTube.
- Keep peoples’ hands away from their faces.
- Make it a camp rule that personal supplies – hairbrushes, pillows, caps, contact lens solutions, make-up – belong to the owner and should not be shared with others. o Make it regular practice that one drinks only from one’s personal drinking cup; no sharing, even “to be nice.”
- Increase the social distance between people, especially in dining rooms.
- Sleep head-to-toe rather than nose-to-nose – in bunks, tents & so forth. Go for the greatest distance between sleeping heads.
- For resident camps: maintain at least 30” between beds and sleep head-to-toe (top bunk has the person’s head at one end, the bottom bunk has the person’s head at the other end). o Utilize universal precautions – for and by everyone.
- Direct Health Center staff to isolate people with questionable symptoms until communicable illness can be ruled out.
- Instruct staff to direct campers complaining of gastro-intestinal upset to the Health Center for assessment. Don’t wait for kids to throw up!
- Make certain that food service staff know and implement safe food handling practices.
- When food service personnel have questionable symptoms, especially those associated with the gastro-intestinal track, keep them away from food preparation until appropriately improved.
- Maintain access to reliable sources of information about communicable illness.
- Provide a copy of the American Public Health Association’s Control of Communicable Diseases Manual (Heymann, 2015) to Health Center staff.
- Reference the CDC website (www.CDC.gov) for information about outbreaks (consider where your campers and staff come from) and for information specific to a given illness.
- Continue membership in ACA and ACN; both organizations provide supports to camp professionals and pro-actively survey for emerging threats. Stay linked to these resources!
- Learn what community supports/resources might be available should an outbreak occur and how to access those resources. Examples include:
- Public, community and/or county health nursing: this may be a resource for extra nurses and a conduit for access to other resources attached to the community’s emergency plan.
- County/local emergency preparedness coordinator: this may provide access to supplies such as extra cots, blankets and canvas wall tents for creating a large admit area.
- The business that supplies Port-a-Potties: extra toilet units with exterior hand-washing units can be a real boon when dealing with sick campers and staff.
- Define your “Tipping Point.” Minimize the potential to be “surprised” by an outbreak. Instruct Health Center staff to alert camp administration when four, five people present with similar symptoms within a given time period (3-4 hours). This is especially important when the symptoms are gastro-intestinal in nature.
For more relevant information, visit Coronavirus COVID-19 Considerations for Camps from campnurse.org as well as the COVID-19 Resource Center for Camps on the American Camp Association website.
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