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Non-pharmaceutical interventions and COVID-19 cases in US summer camps: results from an American Camp Association survey
  1. Helen H Suh1,
  2. Julianne Meehan2,
  3. Laura Blaisdell3,
  4. Laurie Browne4
  1. 1 Department of Civil & Environmental Engineering, Tufts University, Medford, Massachusetts, USA
  2. 2 Environmental Health & Engineering, Newton, Massachusetts, USA
  3. 3 Department of Pediatrics, Maine Medical Center, Portland, Maine, USA
  4. 4 American Camp Association, Martinsville, Indiana, USA
  1. Correspondence to Professor Helen H Suh, Department of Civil & Environmental Engineering, Tufts University, Medford, MA 02155, USA; helen.suh{at}


Background Most camps remained closed during Summer 2020, due to concerns regarding child transmission of SARS-CoV-2 and limited information about the effectiveness of non-pharmaceutical interventions (NPIs) within child congregate settings.

Methods We surveyed US camps about on-site operations, camper and staff demographics, COVID-19 cases among campers and staff, and NPI usage as related to pre-camp quarantine, facial coverings, physical distancing, cleaning and facility modifications. For all NPIs, save quarantine, responses were provided on a 5-point Likert scale format.

Results Within 486 on-site camps, a range of NPIs were instituted, most often related to reduced camper interactions, staff face coverings, cleaning and hand hygiene. Camper facial coverings were less common, with campers always wearing masks at ~34% of the camps. Approximately 15% of camps reported 1+ confirmed COVID-19 case in either campers or staff, with three camps reporting a COVID-19 outbreak. In both single and multi-NPI analyses, the risk of COVID-19 cases was lowest when campers always wore facial coverings. Constant use of staff facial coverings and targeted physical distancing measures, but not pre-camp quarantine, also reduced COVID-19 risks.

Conclusions We found constant facial coverings, especially for campers, and targeted physical distancing measures to reduce risks of SARS-CoV-2 transmission within summer camps. Our findings provide valuable insights for future operations of summer camps and other child congregate settings regarding the use of NPIs to reduce the risk of SARS-CoV-2 infection.

  • COVID-19
  • epidemiology
  • child health
  • public health

Data availability statement

Data may be obtained from a third party and are not publicly available. Requests for the data should be made to the American Camp Association.

This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

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Data availability statement

Data may be obtained from a third party and are not publicly available. Requests for the data should be made to the American Camp Association.

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  • Contributors HS conceptualised and designed the study, designed the data collection instrument, drafted, reviewed and revised the manuscript. JM conducted data analyses and reviewed the manuscript. LB reviewed the manuscript. LBR designed the data collection instruments, collected data and reviewed the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Competing interests LBR is the director of research at the American Camp Association and together with HS, designed the survey instrument. ACA subsequently collected the data and provided them to HS for analysis, but did not engage in data analysis. LBR also reviewed the manuscript. LB is the medical director to summer camp. The other authors have no conflicts of interest relevant to this article to disclose.

  • Provenance and peer review Not commissioned; externally peer reviewed.