Summit Camp & Travel
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Summit Camp & Travel

Summit Camp COVID-19 Response Plan

SUMMIT CAMP COVID‐19 RESPONSE PLAN      

Introduction       

            The CAMP COVID‐19 RESPONSE PLAN (CCRP) has five essential elements that combine to protect the health and welfare of our campers and staff: Prevention, Monitoring, Managing, Caring and Confidence.  

            Camp cannot open unless (1) we have the appropriate supervisory and support staff to safely and effectively operate; and (2) we can implement an effective plan to prevent COVID-19 from entering our camp community and, should that fail, have the procedures, equipment and staff in place and trained to detect it early, contact trace, contain it and care for those infected.  

Key Assumptions and Requirements    

  • By mid-June, Wayne County will be in the “Green Zone.” Based on the PA State traffic light re-opening schedule.
  • Studies continue to show that COVID-19 is, overwhelmingly, not life-threatening to   children under 18, and severe symptoms in children remains relatively minimal;
  • The camps have access to in-home administered saliva-based diagnostic tests for  COVID-19 – or better – as well as in-camp COVID-19 testing capacity, both of which are approved and significantly accurate;
  • We have the staff to properly supervise and operate camp; and
  • Government decides that camps can open and operate safely.  

Prevention            ‐ Creating a Protected Camp Community        

(A) Testing – Multi-Layered 2-Type Approach to Improve Reliability of Results

(I) At home, self‐administered diagnostic saliva tests w/24‐48 hour results   

  1. Mandatory testing for ALL campers.  
  2. The lab will mail home tests directly to campers 5 days prior to camp.
  3. Tests are TAKEN 5 days prior to arrival and sent FedEx back to Lab.
  4. Lab results are sent to patient – then parents/staff email to camp.
  5. No one without a NEGATIVE test result is admitted to camp.
  6. Email and video explanations are sent to every parent & staff in early June.
  7. Parents must sign a statement agreeing to comply with the test regimen             & attendees must self-quarantine between days -3 and their arrival.
  8. Camp will pay for campers NOT COVERED BY THEIR OWN INSURANCE.
  9. We are using tests provided by Vault Health through Rutgers University’s   

       RUCDR  Infinite Biologics laboratory. [https://www.vaulthealth.com/covid]

(II) In‐Camp Mandatory Antigen Re‐Testing using swab w/15 min. results                  

  1. Mandatory testing for ALL staff with in 72 hours after arrival at camp.
  2. Mandatory re-testing for ALL campers upon arrival at camp. Arrival day testing will be billed to Parents ($50).
  3. Rapid tests will be used appropriately for diagnostic purposes if symptoms present.
  4. Rapid tests will be used for any needed contact tracing testing.
  5. We are using the Quidel Sofia 2 SARS First FDA-authorized EUA Antigen Test

[https://www.quidel.com/immunoassays/rapid-sars-tests/sofia-2-sars-antigen-fia]

  • All costs of in-camp antigen testing for diagnostic or contact tracing purposes will be covered by the camp.

             (B) Staff

  1. Staff, having tested NEGATIVE, will be temperature-checked twice daily before campers arrive.  Any sign of illness or fever of 100 will result in quarantine.
  2. All staff will demonstrate strict mitigation measures until they are tested in camp.
  3. Camp will coordinate airport arrivals and direct staff pick-up to avoid the use of any public transportation and to minimize contact with non-camp personnel.
  4. Every staff member will have a health interview upon arrival. 
  5. During Orientation, staff will be housed no more than 4 per bunk (cabins).
  6. During Orientation, staff will be seated in the Dining Hall at tables of 6 or less.
  7. Orientation activities will be conducted outdoors wherever possible.
  8. Staff time off will be in-camp or at a secure camp-controlled site that is properly sanitized in advance.
  9. An extensive entertainment program has been developed for staff to ensure that they receive the necessary recreational time and off time to keep each staff member performing at his or her best.

            (C) Campers

  1. Every camper will have to test NEGATIVE with our home test before arriving.
  2. Parents & campers must follow the protocols stated in the Testing program (A).
  3. Health Center staff will do an Opening Day health overview with every camper including a temperature check and retest.  

(D) Arrival Day

  1. Staggered drop off by division across two days. (7/11-7/12)
  2. On camp car drop off only.  Siblings remain in the car.
  3. Pre-Camp Covid Screen form required to be complete at drop off.
  4. Parents must wear masks.  Campers do not need.
  5. All families must maintain the 6-foot social distancing rule in effect.
  6. Carry-on items (Small Backpack only) will be disinfected by staff at camp.
  7. Covid-19 Antigen Testing and Health Screening completed by Health Center staff while Parents still on camp. No camper will be accepted with any Signs/Symptoms of Covid-19 or a positive test result.

                             

            (E) Visitors & Tours

  1. No tours will be conducted during camp.
  2. Camp will be a closed system.
  3. Van Drivers will follow mitigation measures. Will be screened and isolated as necessary.

(F) Visiting Day – Canceled

  1. There will be no Visiting Day, campers will “visit” with their parents during the summer through video calls as scheduled.  

(G) Out‐Of‐Camp Trips

  1. All off camp trips are cancelled.
  2. All regularly scheduled Day Trips are cancelled.

(H) Cleaning & Disinfecting         

  1. A designated team of staff will disinfect all cabins, bathrooms, public areas and sports equipment daily using CDC recommended Covid19 sensitive cleansers and disinfectants.
  2. Kitchen/Dining Hall will be disinfected after every meal.
  3. Hand sanitizers placed in every bunk, Dining Hall table & throughout camp.
  4. Staff will be instructed on and will supervise campers to ensure that proper handwashing procedures and hand sanitizers are used liberally.

(I) Deliveries, Packages, Repairmen

  1. ALL delivery personnel must don masks when leaving their vehicle.
  2. Luggage will be disinfected upon arrival.
  3. Food cases and other wrapped items will be disinfected before handled.
  4. All delivery & repair personnel MUST maintain a 6 foot distance from camp         personnel. Mitigation measures will be used if this can not be maintained.

            (J) Dining & Food Service

  1. Campers and staff will sit divisionally in clusters no larger than 6 tables.
  2. A 6-foot distance will be maintained between each 6 table cluster.
  3. One counselor per table will be designated the meal’s kitchen server.
  4. Counselor-servers will wear camp-issued gloves and masks.
  5. Only counselors at the table will serve campers food off of platters.
  6. Only disposable plates and silverware will be used.

(K) Health Center 

  1. An outdoor waiting site will be designated for sick call to avoid crowding.
  2. Multiple Clinic times daily to help avoid over-crowding.
  3. Campers & staff will be called inside the clinic in appropriate numbers to maintain social distancing to be evaluated.
  4. Health Center staff will have available PPE in good supply for discretionary use.
  5. Nebulizing of any camper must occur outdoors, to avoid aerosolization.
  6. When evaluating campers with any COVID-like symptoms, Health Center Staff will wear PPE. 

           (L) Hospital & Other Out‐Of‐Camp Medical Runs

  1. Camp drivers will wear face masks and gloves at all times.
  2. Campers and accompanying counselors will wear face masks whenever they leave the vehicle – in any hospital or doctor’s office.
  3. Vehicles will be sanitized and disinfected daily.
  4. No stopping for food or shopping of any kind.  Meals will be packed.
  5. Pharmaceutical items will be called in and over-nighted when possible and treat per (I).

            (M) End‐Of‐Camp Testing

– At parents’ discretion, campers may be Antigen tested within 4 days of their departure from camp. Cost of test will be billed to Parent.

Monitoring           – Keeping Campers & Staff Healthy All Summer      

            (A) Regular Health Screening

  1. Nursing Staff and Unit Leaders (ULs) will be equipped with the infrared thermometers.
  2. ULs will be trained on symptom identification and daily temperature checks to assist nursing staff as necessary.
  3. Nursing staff will monitor all health checks and identifying areas of concern.
  4. When in doubt, the doctor will order and Health Staff will conduct a COVID-19 test.
  5. Campers with particular health issues will be subject to daily monitoring.

            (B) COVID‐19 Specific Symptom Alerts

  1. Medical staff will be trained to identify all known COVID-19 symptoms.
  2. Any patient found to have suspected symptoms will be tested per Doctor’s order.
  3. Parents will be notified of any decision to test based on suspect symptoms.
  4. Positive test will initiate contact tracing – test all possible exposures.
  5. Bunks with 1 positive case will be tested & isolated until results are returned.

(C) COVID Symptoms [SEE ADDENDUM]

  • Cough
  • Fever
  • Shortness of breath
  • Muscle aches
  • Sore throat
  • Unexplained loss of taste or smell
  • Diarrhea
  • Headache
  • Fatigue

                        And, if after all of the measures that we have put into place, a case of COVID 19 is identified in camp – as unlikely as that is – below is a series of protocols to address that case and ensure that any virus is contained.

(D) COVID Alert System    

  1. Level 1 – 1 positive case of COVID-19 in camp – contact tracing testing initiated.
  2. Level 2 – 2-5 cases of COVID 19 in camp – contained all within the same bunk.
  3. Level 3 – Multiple cases of COVID-19 in multiple bunks within 1 or 2 divisions.
  4. Level 4 – Camp-wide outbreak with multiple cases in multiple bunks throughout multiple divisions in camp.  

ACTION STEPS:

  1. Level 1 
    1. Entire bunk on Modified Isolation – no other outside contact.
    1. All bunkmates tested. 
    1. Arrange parent pick-up or transport staff to designated on camp site – use PPE.
    1. Out of region campers’ parents must provide Tri-State contact.
    1. Entire bunk needs spray disinfection and maximum sanitizing. 
  2. Level 2
    1. All positive cases need to be moved out of bunk – home or staff designated on camp site.
    1. All campers in the Division tested.  Division on Modified Isolation.
    1. Entire Division – all bunks – spray disinfected & sanitized.
  3. Level 3
    1. Level 2 action plus: test entire camp – all campers and staff.

(E) Twice Daily Briefing for Camp Director     

Managing – Containing COVID‐19 if it Breaches our Defenses   

  (A) Modified Isolation (Individual or Group) – While waiting for Covid-19 test results 

Modified Isolation occurs whenever a possible case of COVID-19 is suspected and tested for.  Suspected patients must be immediately isolated from the rest of the camp population.  No cohorting of patients with fever until patient test results are negative.

  1. Individuals restricted to a quarantine site at the Health Center until negative.
  2. Individuals quarantined with suspected COVID-19 will have two staff members assigned with them at all times.
  3. Food is brought to the patient(s) by Health Center staff with proper PPE.
  4. Health check at least 4 times daily to monitor any symptoms.
  5. A segregated & supervised outdoor isolation site may be designated.
  6. Absolutely no visitors.
  7. Patient will have access to electronic games & other forms of entertainment.

(B) On‐Campus Quarantine – In the case of a positive Covid-19 result

1. We will keep at least 1 bunk on campus empty and ready for medical use.

2. In order to contain any suspected COVID-19 case, patient will be isolated until results are returned.

3. Campers with COVID-19 will be taken home by their parents.  They will remain in quarantine until such time as their parents can pick them up.

4. Local staff (within 3-1/2 drive) should return home or be picked up by parents.

5. Out-of-area staff will be transferred to the designated on camp site for quarantine.  Meals will be provided and camp medical staff will check on staff throughout the day. If health worsens, the need for hospitalization will be determined by the camp physician. 

Confidence – Maintaining Parent Confidence All Summer         

A note to Parents prior to camp: Included at the end of this document is general information regarding Covid-19 and how it affects our camp population.  The symptoms of Covid-19 are like MANY common illnesses. We ALWAYS get colds, sore throats, rashes, fevers, etc at camp. This year may not be different. As much as we would like to believe that it will not happen, we would be foolish not to prepare for that possibility.  The purpose of this document is to lay out our plan. We will always be transparent about ANY positive tests in camp.

 

 

 

ADDENDUM 1 – Symptoms     

The most common symptoms in humans include:

  • Cough
  • Fever
  • Shortness of breath
  • Muscle aches
  • Sore throat
  • Unexplained loss of taste or smell
  • Diarrhea
  • Headache
  • Fatigue

Recently published research found that on average, the time from exposure to symptom onset (known as the incubation period) is about five to six days. However, studies have shown that symptoms could appear as soon as three days after exposure to as long as 13 days later. These findings continue to support the CDC recommendation of self-quarantine and monitoring of symptoms for 14 days post exposure.

Early symptoms reported by some people include fatigue, headache, sore throat or fever. Some people experience a loss of smell or taste. Symptoms can be mild at first, and in some people, become more intense over five to seven days, with cough and shortness of breath worsening if pneumonia develops. But it is important to know that the type and severity of the first symptoms can vary widely from person to person. During the recovery process, people with COVID-19 might experience recurring symptoms alternating with periods of feeling better. Varying degrees of fever, fatigue and breathing problems can persist for days or even weeks.

Source: https://www.hopkinsmedicine.org/health/conditions-and diseases/coronavirus/coronavirus-symptoms-frequently-asked-questions

Cough was observed in less than half of the mild cases in the largest included study and in two thirds of cases in a systematic review, suggesting it is unreliable as a key diagnostic symptom.

  • Fever (< 39.1 °C) was the most frequent symptom for mild and moderate cases of COVID-19, though a recent UK study suggests anosmia (loss of smell) may be a stronger predictor of COVID-19 than self-reported fever amongst people in the community.
  • Overall, we found scarce and inconclusive evidence on symptoms that easily distinguish mild and moderate cases of COVID-19 from severe cases.
  • The majority of available evidence was from hospitalized patients. Mild and moderate cases were usually defined as those without pneumonia, acute respiratory distress syndrome (ARDS) or Intensive Care Unit (ICU) admission. Applicability to community cohorts is therefore uncertain.

Source: https://www.cebm.net/covid-19/in-patients-of-covid-19-what-are-the-symptoms-andclinical-features-of-mild-and-moderate-case/

THE STANDARD 3 SYMPTOMS

Fever:            Some patients can experience fevers that last for days, while others might see their temperature go up and down, with peaks often occurring in the evening, says Dr. David Aronoff, chief of the Division of Infectious Diseases at Vanderbilt University Medical Center. “I think if someone has a fever, regardless of how long it’s lasting, unless they can clearly attribute it to something else, that’s a very reasonable symptom to seek an evaluation for,” he says.

Stavropoulou’s systematic review of the medical literature found that fever was reported in 82% to 87% of mild to moderate cases.

Dry cough: Cough was the second most common symptom after fever, though “coughing was not always there,” Stavropoulou notes. “So while we think it’s a main symptom, it appears only two out of three times for patients with COVID-19.” That said, cough remains a “very, very common symptom of the pneumonia that the virus can cause,” says Aronoff. Given this fact, “if someone has a new cough or a new shortness of breath that’s cropped up in the last three days or so, they should definitely get tested.”

Shortness of breath: Stavropoulou’s review found that this symptom occurs more frequently in severe cases “and indeed, in some studies, was a marker of severe disease.” The two largest studies she looked at found that shortness of breath occurred in fewer than 8% of milder cases.

THE NEW 6 FROM THE CDC:

Chills/repeated shaking with chills: The chills generally precede a fever, though people don’t always perceive when their temperature has spiked, Aronoff says. Sometimes, those chills can be accompanied by shaking, since shivering is our bodies’ way of generating heat and raising our temperature, he says.

Muscle pain:            Nearly 15% of COVID-19 patients experience muscle pain, according to a report published by the World Health Organization in February that analyzed nearly 56,000 confirmed cases in China. But that’s hardly unique to this disease: Lots of viral infections can cause muscle aches and pains, which can result from an inflammatory response to a virus.

“I think all of us who have had the winter cold or flu have had experience with muscle pain, headache, sore throat,” notes Aronoff. Given that we’re no longer in the typical cold and flu season, if you’re experiencing muscle pains and other flu-like symptoms, “we know that those can be associated with COVID-19,” he says. “And it is very reasonable to get people thinking, you know, maybe I should get tested.”

He added: “I would also include new-onset fatigue, out of proportion to what a patient would expect to be experiencing under whatever circumstances they are [in],” as a symptom.

However, fatigue on its own is not very predictive of disease, because it is also frequently reported by people who don’t test positive, says Claire Steves, a geriatrician and senior lecturer at King’s College London. She’s one of the lead researchers on the COVID Symptom Tracker, an app-based project that has so far recruited 3 million people across the U.K. to log any symptoms — even if they are not feeling sick. Researchers can use data from those who are eventually diagnosed with COVID-19 as an early radar on how symptoms develop in the population. (The COVID Symptom Tracker is now recruiting people in the U.S. to sign up as well.)

Steves’ research is finding that certain symptoms tend to cluster together in people who test positive. For instance, fitter people in the 20-70 age range who experience loss of smell often also experience fatigue, and they tend to have a milder course of the disease, she says.

Headache:    Headaches are a common experience for many adults. On its own, a headache should probably not be cause for alarm, especially if it behaves like other headaches you’ve experienced, says Aronoff.

“If somebody is only going to use headache as a trigger to go get tested for COVID[-19], that headache should be something that either is a headache that’s new for them or that is sticking around a bit longer than they are used to,” he says. “Or it’s associated with another symptom that may also be subtle, like fatigue or feeling kind of worn out” — especially if there’s no good reason for the tiredness.

In fact, Steves says research out of the COVID Symptom Tracker suggests that headache “is an important symptom” seen early on in the course of the disease and it commonly occurs alongside other symptoms.

Sore throat: “We’re seeing sore throat in COVID-19 patients,” says Aronoff. “But it’s what I would say [is] a minor symptom” — one that’s common to lots of other ailments.

Loss of taste or smell: This symptom has emerged as a strong indicator of infection — one distinctive enough that it alone should be cause to seek testing, says Dr. Carol Yan, an otolaryngologist and head and neck surgeon at UC San Diego Health.

If someone is experiencing this symptom, “I would tell them that they should consider self-quarantining themselves and contacting their health care providers,” says Yan. Most people who experience loss of smell or taste also have other symptoms, commonly fever, fatigue and malaise, she says. “But there’s certainly a subset of people that we know have only smell and taste loss and no other symptoms” who ultimately test positive.

Yan’s research has found that about 7 out of 10 patients reported an acute loss of sense of smell or taste at the time of their diagnosis.

Similar findings have emerged from the COVID Symptom Tracker. Among fit and healthy people ages 20 to 70, “the loss of sense of smell is a really good marker” of infection, Steves says.

In fact, this symptom is seen as such a strong indicator of infection that patients at UC San Diego Health are now routinely asked not just if they have a cough or fever but also if they’re experiencing a loss of smell or taste, says Yan. “It’s really being used as a good screening question and in helping triage patients.”

The good news is that both Yan and Steves have found that people who lose their sense of smell or taste tend to experience a milder course of the disease. Yan says patients generally recover these senses in two to four weeks on average.

OTHER POTENTIAL RED FLAGS  

Confusion and gastrointestinal issues: Stavropoulou’s review of the medical literature found that, in most studies, gastrointestinal issues were reported in fewer than 10% of mild cases of COVID-19. But Steves says emerging data from the COVID Symptom Tracker suggest that problems like diarrhea, nausea and abdominal pain tend to be more prominent in the frail elderly — people who are over 70 and need help to get around. Acute confusion also seems to be an important symptom in this group, she says. “Older and frailer and more co-morbid people” — those with underlying conditions such as heart disease, diabetes or obesity — “tend to be getting this cluster of abdominal symptoms and delirium symptoms and headache as well,” Steves says. She says it’s important for caregivers to recognize that these symptoms in the frail elderly could be indicative of COVID-19, particularly in situations like nursing homes, “because that’s where spread could occur.”

“COVID toes” and other skin manifestations: Dermatologists are now reporting that certain skin conditions appear to be emerging as symptoms of infection in milder cases. Among the most common — and striking — is “COVID toes,” a condition resembling chilblains, or pernio, on the feet or toes, says Dr. Esther Freeman, director of global health dermatology at Massachusetts General Hospital and director of the international Dermatology COVID-19 Registry. The registry has received more than 400 reports from dermatologists in 21 countries, and a little under half are cases of COVID toes, she says.

Normally with chilblains, “you would see pink, red or purple lesions on the toes or sometimes on the hands,” Freeman says. “That’s often accompanied by swelling and can also be accompanied by a burning, itching or tender sensation,” she says.

Chilblains are caused by inflammation in the small blood vessels of the skin, usually in reaction to colder temperatures or damp weather, Freeman says. “So, for example, spending a lot of time outside in wet socks could do it.”

What’s unusual is that during the coronavirus pandemic, “we’re seeing patients who are living in warm climates or patients who have been sheltering inside and staying warm developing these lesions for the first time,” she says.

“I have seen more toe consults in the past two weeks than I have in my entire prior career combined,” Freeman says.

She says some patients develop COVID toes early on, along with other symptoms such as fever or cough. Others develop the condition well after their other symptoms have passed, almost like a post-viral response. And a third category of patients seems to develop COVID toes as the sole symptom.

Other skin conditions reported include hives and morbilliform, a measles-like rash on the chest, back, arms or legs. Freeman notes that viruses — for example, those that cause measles or chickenpox — often cause rashes, so dermatologists were expecting that with the coronavirus. But the toe manifestations were surprising.

While data are still emerging, Freeman says that in her opinion, dermatologic symptoms, such as COVID toes, should be considered as criteria for testing. But if you’re having these symptoms, she says, “Please don’t panic. Most of our patients who are developing these COVID toes are doing extremely well and are able to recover fully at home.”  “I think it’s also important to know that the purple lesions will go away on their own,” she adds.

Source: https://www.npr.org/sections/goatsandsoda/2020/05/06/850707907/from-loss-ofsmell-to-covid-toes-what-experts-are-learning-about-symptoms           

 

ADDENDUM 2  – Kawasaki Symptoms    

Kawasaki disease signs and symptoms usually appear in three phases.

1st phase      

Signs and symptoms of the first phase may include:

  • A fever that is often is higher than 102.2 F (39 C) and lasts more than three days
  • Extremely red eyes without a thick discharge
  • A rash on the main part of the body and in the genital area
  • Red, dry, cracked lips and an extremely red, swollen tongue
  • Swollen, red skin on the palms of the hands and the soles of the feet
  • Swollen lymph nodes in the neck and perhaps elsewhere
  • Gastrointensinal issues may be present as well

2nd phase      

In the second phase of the disease, your child may develop:

  • Peeling of the skin on the hands and feet, especially the tips of the fingers and toes, often in large sheets
  • Joint pain
  • Diarrhea
  • Vomiting
  • Abdominal pain

3rd phase      

In the third phase of the disease, signs and symptoms slowly go away unless complications develop. It may be as long as eight weeks before energy levels seem normal again.

When to see a doctor:       

If your child has a fever that lasts more than three days, contact your child’s doctor. Also, see your child’s doctor if your child has a fever along with four or more of the following signs and symptoms:

  • Redness in both eyes
  • A very red, swollen tongue
  • Redness of the palms or soles
  • Skin peeling
  • A rash
  • Swollen lymph nodes

Treating Kawasaki disease within 10 days of when it began may greatly reduce the            chances of lasting damage. 

Source: https://www.mayoclinic.org/diseases-conditions/kawasaki-disease/symptomscauses/syc-20354598     

KEY FACTS ABOUT KAWASAKI DISEASE

  • It is not communicable – one child does not catch it from another.
  • It is a reaction to some other virus or bacteria and seems to have a genetic connection.
  • The symptoms are readily apparent (rash, fever) and camp will immediately test any campers who present any of those symptoms and return them to their parent’s care for timely treatment.
  • Medical care within a few days allows for successful treatment.
  • Kawasaki disease is not new.  Annually, there are 3500-4500 US cases and 1 in every 10,000 children are afflicted worldwide each year – a preponderance in East Asia.

Source: https://www.nytimes.com/2020/05/05/nyregion/kawasaki-disease-coronavirus.html