Fully vaccinated children and teens at the camp this summer could return to normal activities - without masks or physical deviations - the Centers for Disease Control and Prevention said Friday in a much-anticipated summer camp guide.
But this advice almost hides children who will not be vaccinated, a group of children who are likely to build most of the standard summer cameras. There is no Covid-19 vaccine for children under 12 years of age.
"Generally, people do not need to wear masks outside. That includes people who are not fully vaccinated because of the risk of transmission," said Erin Sauber-Schatz, head of the CDC's Community Interventions and Critical Populations Task Force, who wrote the guide.
But "although the outside is very safe, there are still important times when if you are not completely vaccinated, you should be wearing a mask," he said.
Those important moments are left open for interpretation.
"People who are not completely vaccinated are encouraged to wear masks in crowded outdoors or during activities that involve strong contact with other people who are not completely vaccinated," the guide said.
Drs. Fauci: CDC guidelines for children outside the summer camp 'slightly tight'
The guide does not indicate which of the many activities of the outdoor camp are appropriate and do not require masks. However, Sauber-Schatz has mentioned a number of situations.
Kids may want to wear masks or stick to physical distance when they are in large groups, especially while singing camp songs. Sauber-Schatz said research has shown that "breathing drops go away" when people sing, sing and shout.
But during a flag-shooting game, for example, where children are spread out, running in large outdoor areas, "you wouldn't have this very close connection we'd be concerned about," Sauber-Schatz said. "That would be an outside job that you probably don't need to hide."
One important thing in the recommendations of the outer mask: They should not be worn during activities where they can get water, such as swimming or boating.
"A wet mask can make it difficult to breathe and may not work as intended," the CDC guide said.
As for household chores, the lead is very clear: The CDC "strongly recommends" masks for anyone over 2 years of age who remain unvaccinated.
Recommendations, designed for two-day camps and overnight camps, are not binding. They are designed to help camp directors and counselors make decisions about their own rules, which may vary from camp to camp.
"I think the camps will need support and more information," said Dr Richard Besser, former director of the CDC and current president of the Robert Wood Johnson Foundation. "If the CDC can clarify more, it would help."
Children are not as vulnerable to Covid-19 as adults, but they can still get sick and spread the virus.
As of May 20, the American Academy of Pediatrics has reported 3.9 million cases of Covid-19 in children, representing more than 14 percent of all U.S. cases. Of those, 316 children have died. And the CDC has reported that 3,742 children have multiple sclerosis, a rare but potentially dangerous side effect of the virus.
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For anyone 12 years and older, the CDC strongly recommends a Covid-19 vaccine.
That "doesn't help at all," said Drs. Buddy Creech, pediatric infectious disease specialist at Vanderbilt University Medical Center in Nashville, Tennessee. "They got vaccinated before the camp. It made the risk to them and the risk in the camp greatly reduced."
To date, the only vaccine from Pfizer-BioNTech is available for children 12 years of age and older. Moderna expects to apply for authorization for emergency use of children aged 12 to 17 in June. Johnson & Johnson is currently conducting research on the Covid-19 vaccine in young people aged 12 to 17 years.
Pediatricians agree that involvement in summer camps can be of great benefit to children, especially as they emerge from a year of separation and distance learning.
"It is very important that we do not underestimate the benefits of returning children to normal life," Besser said. "The aim is not to jeopardize Covid to the egg; to diminish what is acceptable."