Even with mitigation measures, attack rates outpaced the Diamond Princess cruise ship.
President Trump’s repeated statements that children are “almost immune” to COVID-19 got a fact check from state and federal public health investigators examining an outbreak at a Georgia summer camp.
Among 597 Georgia residents, including campers, staff members, and trainees, the attack rate was 44%, reported Christine M. Szablewski, DVM, of the Georgia Department of Public Health, and colleagues.
The attack rate was highest among staff members (56%). Younger children ages 6-10 had a rate of 51%, those ages 11-17 had a rate of 44%, and those ages 18-21 had a rate of 33%, the authors wrote in an early edition of the Morbidity and Mortality Weekly Report.
By contrast, 19% of Diamond Princess cruise ship passengers tested positive for COVID-19 in February and March.
Among 136 cases with symptom information available, 26% reported no symptoms, with the authors specifically characterizing asymptomatic transmission as “common.” The flip side of that figure, however, is that a minimum of 100 children did develop symptoms. The report did not address symptom severity, outcomes, or transmission after leaving camp, as the investigation is still continuing, the authors indicated.
“This investigation adds to the body of evidence demonstrating that children of all ages are susceptible to SARS-CoV-2 infection and, contrary to early reports, might play an important role in transmission,” Szablewski and colleagues wrote.
Until recently, data on U.S. children contracting COVID-19, a key point in the argument to reopen schools, were scarce and conflicting. But recent evidence chipped away at the claim that kids are unaffected, with new research emerging this week about the association between school closures and declines in number of cases and deaths. Researchers also found children under age 5 may have far more SARS-CoV-2 viral nucleic acid in their noses than adults, which raises questions about their ability to transmit the virus.
While sleepover camps are not schools, and staff members are not teachers, the authors said the camps adopted CDC guidelines for youth and summer programs. All trainees, staff members, and campers provided documentation of a negative test for SARS-CoV-2. Cloth masks were required for staff members, though not campers, and the camp did not open doors and windows for increased ventilation, as recommended. Campers engaged in “a variety of indoor and outdoor activities,” including “daily vigorous singing and cheering,” they said.
The session was scheduled for June 21-27, and on June 23, a teenage staff member left after developing chills one day prior. The staff member tested positive for SARS-CoV-2. On June 24, campers were sent home, and on June 27, the camp was closed.
However, the damage was done. After excluding out-of-state attendees, researchers examined data from 597 Georgia residents at the camp. Campers were a median age of 12, and 53% were girls, while staff members were a median age of 17, and 59% were girls.
Of the 344 available testing results, 76% were positive for SARS-CoV-2. Not surprisingly, they found attack rates increased with increased time spent at the camp. Average occupancy was 15 per cabin, with a median attack rate of 50% among 28 cabins with one or more positive cases.
Among 100 patients reporting symptom data, two-thirds had fever, about 60% had headache, and 46% had a sore throat.
While the researchers said “consistent and correct” use of cloth masks, as well as physical distancing measures, should be emphasized to mitigate transmission in “congregate settings,” they acknowledged that “the multiple measures adopted by the camp were not sufficient to prevent an outbreak in the context of substantial community transmission.”
“An ongoing investigation will further characterize specific exposures associated with infection, illness course, and any secondary transmission to household members,” the group added.