A Duke Health analysis of COVID-19 cases among youngsters attending YMCA camps in six central North Carolina counties shows minimal spread of symptomatic infections among the children and the camp counselors.
The study, appearing online Feb. 3 in the journal Pediatrics, adds to a growing body of literature documenting nominal spread of the pandemic virus among children in group settings when known mitigation measures are strictly followed, including masking, social distancing and hand washing.
“Our study suggests that appropriate measures to reduce the spread of disease can create an environment where normal childhood activities such as day camp, school and after-school recreation can be provided with minimal risk,” said lead author Emily D’Agostino, DrPH, MEd, MA, an assistant professor in Duke’s Department of Family Medicine & Community Health.
“The study also highlights the critical importance of academic partnerships with community organizations for promoting pediatric health,” D’Agostino said.
D’Agostino and colleagues, including co-senior author Ibukun Akinboyo, MD, assistant professor in the Department of Pediatrics at Duke, analyzed data collected from 54 YMCA camps in the greater Raleigh-Durham-Chapel Hill area. The study period spanned from March through August, when community cases of COVID-19 were escalating.
Of the camps, 39 percent primarily offered indoor activities, 38 percent were outdoors and 23 percent offered activities in both settings. All of the camps required staff to receive training in COVID-19 mitigation strategies, and camps adhered to symptom screenings for children and staff, masking, hand washing/sanitizing, daily cleaning/disinfecting and minimizing group sizes to no more than 10 children.
With those measures strictly enforced, the researchers found only 19 cases of symptomatic disease among 6,830 children and staff members. The limited number of confirmed infections among the 10 children and nine staff members occurred despite rising incidences of COVID-19 in the community. Only two cases were possibly traced to campers passing infections to others at camp; the majority were infected outside of camp.
The researchers noted that the study used data gathered before the larger, second wave of infections arose after the holidays. Additionally, testing for COVID-19 in the first months of the pandemic was limited to people with symptoms, so potential cases of asymptomatic infection were not identified.
The study adds to research published last month in Pediatrics by another group of researchers from Duke who reported that transmissions of COVID-19 within schools was rare. The research team – representing Duke Clinical Research Institute and other universities as part of the ABC Science Collaborative -- studied 11 school districts in North Carolina over a nine-week period of in-person instruction.
That study reported there were 773 community-acquired COVID-19 infections among school children and staff, but only 32 infections acquired within schools. No instances of child-to-adult transmission of COVID-19 were reported within the schools.
“These data should be helpful to school systems and childcare providers as they navigate this exceedingly difficult time, yet work to promote the wellbeing of children and primary caregivers,” Akinboyo said.
In addition to D’Agostino and Akinboyo, study authors include Sarah C. Armstrong, MD, professor in the Department of Pediatrics at Duke, Lisa Humphreys, Stacey Coffman, and Gordon Sinclair at the YMCA of the Triangle, and Sallie R. Permar, MD, PhD, chair of the Department of Pediatrics at Weill Cornell Medicine and Pediatrician-in-Chief at New York-Presbyterian Hospital/Weill Cornell Medical Center.