Camp & The COVID Question

This is the second in the Returning to Webster series, detailing how Herzl Camp gets back up and running for the summer of 2021. To catch up read part one here.  

Dani Frissora has been the family experience manager for Herzl Camp for the past four years, but last fall she added a new title: COVID Czar. And since coming back from furlough, she has been the camp’s point person for all things coronavirus.

“I had camp for summer 2020 planned by March or April,” she said. “Everything was in place and ready to go, so really the planning process for this summer is COVID. Everything else has kind of been in place since last year.”

With COVID being front of mind, Frissora got to start writing the Herzl Camp COVID-19 Working Document, a publicly available document with links to the monthly community information sessions, testing information, camp structure, and more.

“We were lucky that there were a few camps that did run last year,” Frissora said. “Large overnight camps that chose to run and had a COVID preparedness plan for 2020. And they were our starting point.”

The Herzl document was started with how camps ran in 2020, but the information that has become available from the Federal level of the Centers for Disease Control and Prevention has kept everyone on their toes.

“It’s a long shot, but three months ago we didn’t have any vaccines that were going in arms, but there’s this little voice in my head that says ‘For Session Bet, maybe campers 12-years-old and above could be vaccinated,’” Camp Director Drea Lear said. “Since March 1, the ever-changing scenarios, because we have these protocols and policies that we have put into place to keep everybody safe vaccinated or not. And when the who-is-vaccinated target keeps moving, it keeps shifting what those scenarios.”

Vaccines aren’t being required, but Lear said that camp is “strongly, strongly, strongly” suggesting those who can get their shots to do so.

(Editor’s note: Because of the ever-changing scenarios, check with Herzl Camp, the CDC, and the Wisconsin Department of Health with any questions).

Both Minnesota and Wisconsin have opened up their vaccinations to people 16 and over. Since the March 1 announcement from the CDC that said vaccinated people can be together in an indoor space, Lear said there have been a lot of questions about how that will impact the camp-imposed restrictions.

“It is a fascinating question. Because just as we had in March 2020, we are constantly thinking about both the community as a whole and the most vulnerable within our community,” Lear said. “We have to think about it from both the individual, most vulnerable, and the community perspective. There are a fair amount of pieces that we know we are going to keep in place because we just don’t have the data yet.”

Answers From Maine

Looking at how to run camp in 2021 starts, in part, with Dr. Laura Blaisdell

Blaisdell, who lives in Maine, is a pediatrician and has a Master’s Degree in public health, a consultant in communicable disease policy in camps and schools as well as vaccine hesitancy policy and research. She’s not just a policy wonk, though. She’s the medical director of Camp Winnebago in Fayette, Maine — which her husband is the third generation owner-operator of. The camp is one of the handful in Maine that ran last summer, and Blaisdell authored a paper published by the CDC about how they were able to make that happen. 

“It became clearer over last spring to me as a public health trained pediatrician in infectious disease that because kids weren’t born generally, in terms of the numbers, having the same outcome as our older individuals were and then understanding the kind of the transmission characteristics of COVID, I became increasingly convinced that camps could open,” said Blaisdell, who also helped Camp Winnebago and other Maine camps go through the H1N1 Pandemic. “The mitigation layers that we put into place then could certainly help camps opened last summer.”

Blaisdell helped the American Camp Association write its Field Guide, a 170-plus page document that is helping camps stay on the path to opening this summer. 

“The message from the study is one that public health interventions work for COVID and that they need to be done diligently,” Blaisdell said. “Multilayers of public health intervention that we used in camp were the key to success. In terms of thinking of what I’ve recommended for camps this year, it’s pretty much the exact same thing and we’re not going to be changing any of our protocols. But we, additionally, have this additional layer of comfort of being vaccinated.”

The mitigation strategies that Blaisdell employed at Winnebago helped create, arguably, the healthiest summer she’s ever presided over.

“We had one fever. One,” she said. “No impetigo, no lice, no summertime cold. it was incredible. Mostly what I saw were musculoskeletal complaints and feet that needed calluses. Their feet were unprepared to be outside.”

But even with a successful summer health-wise in 2020 for Blaisdell, the summer of 2021 is different. 

“I think this year as compared to last year, the prevalence of COVID in the pediatric population is much higher this year,” Blaisdell said, pointing out that many children finished their school years remotely and were very much in lockdown, compared to now when many more schools are open. There are three main things that need to be done to try and ensure COVID doesn’t come to camp: 

  • Change pre-camp behaviors to being low risk: “We know low-risk behaviors are those that can be masked, distanced and outdoors, and you shouldn’t be unmasked with anybody but your family. I think camps really need to work with families to explain how that behavior change is going to protect the camp bubble.”
  • The second, Blaisdell said, is pre-camp testing: “Testing was not as ubiquitously available last year, but this year, there’s really no reason for a camp to not require a pre-camp test, I think most people can get it.”
  • Traveling to camp safely: “It’s great if parents can directly drive their children to camp. But we’ve found out how to do busing safely and flying safely. But it has to be done diligently, and people need to understand the masking and distancing that needs to happen in those areas to travel safely.”

Getting Community Buy-In

Lear starts each monthly Zoom meeting with the same slide and equation: Mitigation Strategies + Community Buy-In=Safe and Healthy Camp Season.

“Things like creating a camp bubble, creating pods within the bubble that interact with one another. And if you’re interacting across different pods, there will be additional strategies put in place,” Lear said. “The community buy-in is so, so key.”

The camp has made public its COVID Preparedness Plan, and in it, implores campers and their families to “remain vigilant and refrain from non-essential contact with people outside of their households and immediate family for the time period recommended by the CDC at that time.” 

In the two weeks prior to sessions starting, the document also askes household members to take appropriate social distancing and preventative measures including, but not limited to: Wearing a mask, staying at least 6 feet away from people outside the household, utilizing curbside store/restaurant services only, and washing hands with soap and water frequently.

However, Frissora recognizes that — particularly for Aleph Session campers that will be arriving in Webster on June 14 — that may be difficult particularly as many schools are still in session until the week before.

“Obviously, we can’t force a strict 14-day quarantine because of school and work; we are saying ‘school and work are okay,’” Frissora said. “Beyond that, please be mindful of what activities you’re doing, and we’ll put out some documents and a lot of communication. We are starting that communication very early.”

Frissora said that she believes that there will be a sense of community pressure to follow the guidelines. 

“In those two weeks before the session, people are traveling and taking trips, it’s not going to be hidden. And I think that’s going to be stressful on families that they try to hide things,” she said. “And then there’s the other piece of you’re taking this risk, if your kid tests positive, they can’t come to camp. And when they come to camp, they’re also going to have another round of testing. And if they have another [positive test], you have to pick them up. That’s really hard for our out-of-town families.

“If you don’t want to take this seriously, you know, that’s, that’s your choice. And here are the consequences of that. You want your kids to be at camp, here’s what you need to do, because otherwise, they can’t be there.”

Testing Strategy

With around two months to go until camp, Frissora and the medical committee are focussing closely on two areas: vaccines and testing.

Before campers and staff get on the bus to camp, they have to show a negative COVID test. At this time, the preparedness plan says that the camp will use a saliva-based RT-PCR test kit. The results have to be known before the camper gets on the bus to camp, and taken within three days of their arrival date. “Given that tests are coming back within 24-48 hours, we are asking people to get the tests with enough time to get the results back,” Lear said. 

What has changed in the camp’s process is that there is no longer a plan to do a rapid COVID test at the luggage drop-off the day before the campers take the bus to camp. However, early luggage drop-off is mandatory for in-town campers. Lear said they will work with families coming from out of town in order to put their kids on the bus on the timing for putting luggage on the truck. 

“The advice given both by the medical professionals on our team and just general information out there is that [rapid tests] are not effective for asymptomatic individuals,” Frissora said. “For a screening purpose, they’re not going to be helpful. The false positives from that are too high for our comfort level.”

However rapid tests will still be available at camp in the event an individual shows symptoms.

Everyone will also be retested within a week of the session starting. The type of testing that will be used is still being discussed.

Staff is required to be at camp six days prior to campers arriving for what is being called “quarientation.” Campers will also be screened and tested upon arrival.

The pre-camp and post-arrival screenings, Blaisdell’s study found, are crucial. She found that testing had caught four positive cases prior to coming to camp in 2020 and forcing isolation at home, and another four individuals who tested positive on post-arrival tests and were immediately isolated. 

“Nobody subsequently contracted COVID because of the layers that we had put into place,” she said. 

Lear and Frissora meet every two weeks with the camp’s medical team, which is led by Doctors Jordan Marmet, Bruce Cantor and Hope Frisch Kalin. 

“Drea and I feel so confident in everything that we’re doing this summer that we feel really good about the protocols we have in place, and all of the things that we have planned,” Frissora said. “And we realize it’s because every two weeks, we’re meeting with 12 doctors to go through it.”

So if no one can be on the property without a negative test, why is the camp enforcing its mitigation strategies?

“The test tells us what the status is at that very moment you took the test and sometimes it can take a couple of days once you’ve been exposed for your test to turn positive,” Kalin said. “If someone takes a test on Tuesday and it’s negative, but on Monday they just got exposed but haven’t made enough viral particles for it to pick up on the test yet. We still have this window of time where we need to be safe with masks and distancing until its been some time since the test and then retest again. 

Marmet said that, in a typical summer, campers will have symptoms that in today’s climate, would raise a question about COVID.

“Kids have stuffy noses, kids have sore throats when they’re running around yelling at the top of their lungs (and) when they’re not getting as much sleep as they should,” Marmet said. “And they’re having a blast. But they do end up with some symptoms that raise questions. So we are fully expecting that we’re going to have people who meet the testing criteria and will need testing at camp.”

Blaisdell said that approach is the one she took last summer with the one fever she had to deal with.

“I needed to figure out who were his exposures. And I had enlarged the cohort, but I had kept some cohorting firewalls within camp,” she said. “So I didn’t have to think about testing all of camp, quarantining all of camp, and retesting all of camp. I think that camps need to be very careful this year for another year, in letting their guard down. Because even if it’s not COVID, we have to treat it like it’s COVID.”

Lear said that is something that has been regularly discussed in preparation for this summer.

“The nervousness about getting sick at camp, it’s a very valid concern,” Lear said. “It’s also likely that people will get sick at camp.”

Kalin said that the risk is low of severe illness for children, but she understands that people may still be nervous.

“If someone is extremely nervous about their kids being at camp all summer and are going to be worried about it every day, then this may not be the summer for you to go to camp,” she said. “Camp’s optional. And it is a little scary this year. We’re all taking this leap of faith, but I think we have a lot of great strategies in place to keep it safe. And hopefully, that risk would be low.”

Coming up next in the series: How to create programming with the camp’s mitigation strategies that are in place.