I had an opportunity to chat with one of our camp alumni who is one of Canada's top infectious disease specialists and researchers, Dr. Amy Greer. In between media appearances this week, she talked to me about what camps need to be doing now about the COVID-19 coronavirus.

*Transcript below

Some quick takeaways (many more in the recording):

• Amy asked that we not share this video with our families - the information will become out of date quickly. It was recorded on Friday, March 6th

• You need to be consulting your local Health Department (I assume you're doing this already) for 2 things: what to be preparing now for your medical procedures this summer and making a call closer to this summer about whether/how camp will run

• you should prepare a new procedure this summer to get all families to confirm, no more than 48-hours before camp, that their camper is not symptomatic

• you should be ready with new cleaning/disinfecting procedures this summer.

One of the themes of our call was communication. I think it is important that we start to communicate with our families about the virus right away and in multiple media (website, email & social media).

My hope is that by communicating well and often, you will reduce the number of early cancellations and show that you are prepared for the responsibilities of caring for kids and young adults this summer.

You may also choose to consult an organization that specializes in crisis communications.

I know that many of you have great resources from your local Health Department and/or your insurance company or parent organization that you can share, but, for those who don't... For now, I recommend you include the following (be honest and only include what you are actually doing):

• we are in regular communications with our local Health Department and will take our instructions from them

• we are actively examining and changing our arrival screening and health response procedures for this summer

• we are updating our cleaning procedures to include the specific anti-viral measures suggested/required by our local Health Department

• reminder: our cancellation policy is [copy/paste current cancellation policy that they have already signed off on]

• where to find good/current sources of information on how they can protect their family right now [CDC, Canadian Ministry of Health, their local Health Department or Board of Health]

• we will commit to regular updates about our plans, policies, and new protective & reactive procedures [let them know when and how they can expect the next update]

Notes from Go Camp Pro:

1. Please remember if you have questions about what your camp, specifically, should do - ask your local health authority.

2. If you have questions about the legal or insurance-related aspects of the coronavirus - consult your attorney or insurance agent.

Transcript (edited for clarity)

Travis:

Hello camp pros and welcome to a special edition of the CampHacker podcast. Today I am with Dr. Amy Greer who is one of our camp alumni, one of our All-Stars, and good friend of ours who also happens to be a specialist in communicable diseases and Amy was kind enough to come and speak to me today about the Coronavirus and its impact on camp. I've reached out to her because I knew that she would understand this community that we build at camp and how this stuff could affect things going forward this summer.

Welcome, Amy.

Dr. Amy Greer:

Thank you very much for having me.

Travis:

Amy and I have a long camp past together and a long friendship, but, I'm curious, Amy, how you got started at camp?

Dr. Amy Greer:

How did I get started at camp? That's a good question. I started going to Glen Mhor camp when I think I was about eight or nine. I went mostly because I had a friend who was going and I thought, well, I don't really know anything about camp, but if she's going, I guess maybe I'll go with her. And she hated it and she never went back. And I stayed because I loved it. I came back as a camper and then as a LIT and then on staff and had many senior positions and, and went on to work at a number of other YMCA affiliated camps after that. I did it for a long time and it was a great life-changing sort of opportunity.

Travis:

One of my favourite jobs that you did for us was the year that you did our science and nature program at camp and a particular skill of yours because you were beginning this process of studying science in school and getting into this position that you're in now eventually getting to this. Is there any connection between camp and science stuff or was it just sort of parallel and a compliment to each other?

Dr. Amy Greer:

Yeah, I mean I think it was always something I was interested in. I did that at camp and really loved, you know, to a certain extent the communication part of it, this idea of trying to communicate science with people who are, you know, with kids and, and that kind of continues to roll through. While I don't work directly with kids as much in my day to day, you know, that the idea of trying to communicate complex information to people who are not technical experts continues to be a real and probably increasingly important skill to have.

Travis:

I know that you've done a ton of national media here in Canada and been answering lots of questions about this. So we're grateful that you're spending time with your camping brain on the sciencey stuff too.

We should say a few things to start. Number one, we're recording this on the morning of Friday, March 6th, 2020 and whatever is said today might be totally different whenever you hear. Two other things that I wanted to say based on questions that were received: we are not going to give you any legal advice. That was some very specific legal questions that were there and you need to refer to your insurance companies, to your lawyers if you have specific legal advice about how the virus will affect how your camp runs.

And the last part of this, and we're going to reiterate this at the end as well, that that we're going to stick away from anything that is a decision made by some level of government that affects you, municipal, provincial or state or national government. And we're just going to talk about the things that Amy has expertise in. Anything you'd add to that?

Dr. Amy Greer:

No, I think that's exactly it. I think, you know, the challenge of being early in March and the fact that most camps, you know, are still several months away, recognizing that everybody's still in the planning phase. It's a very fluid situation and so it's very difficult to predict where we will be when your first batch of campers arrives at your front door. It is challenging from a planning perspective, but, my hope is to be able to communicate some of the reasons why public health is doing what they're doing now and what things likely seem reasonable to at least consider as you move through this kind of period of uncertainty.

Travis:

Great. And we're grateful you're here to do that. So overarching, what is the, what are some, what are the messages that you really want us to take home before we dig into specific symptom? The questions?

Dr. Amy Greer:

Yeah, so I think, you know, I think there are two things. So one is that, you know there is a lot of uncertainty around the situation and sometimes that can feel overwhelming, but I think that there are a number of proactive measures that every individual can take that are within your own control which are going to be really important for individuals. Now, even before camp starts, for your own families, for your own communities, your own kids that is, you know, things that are being reiterated in the media constantly: wash your hands. For those of you who don't know, Dr. Bonnie Henry who is a medical officer of health in BC had this great quote a couple of days ago and she said, wash your hands like you just chopped a jalapeno and you need to put in a contact lens. This is not, you know, passive hand-washing. It is rigorous friction, hand-washing. Don't touch your face. It is incredibly challenging to do.

With my own students here at the university, we have kind of this ongoing challenge to call each other out whenever we're meeting. And it's ridiculous the number of times that we potentially self contaminate ourselves with the pathogens that are on our hands. Cough etiquette, cough into your sleeve, all of those good things.

This virus is transmitted by respiratory droplets. It is not an airborne virus. It is transmitted by respiratory droplets. And so coughing into your sleeve means that the droplets that came contain the virus are not going to go directly out into the person who you're with, but it's also important because what it means is that those droplets are quite large and so they fall very quickly and no longer become an issue for people. And so if you're making sure that those droplets are being contained in your arm or in a tissue, that's really helpful.

The other huge thing, stay home when you're sick.

It's especially important now when we're still in influenza season because the symptoms are very similar. You know, staying home when you're sick is just very good advice all around, but especially now. And also lastly to have a plan for yourself in terms of if your region or your area begins to experience a period of intense transmission. The thing about that is that this will be highly variable across the area, you know, all of Canada will not experience intense transmission at the same time. So being aware of your local surroundings and the situation that you are embedded in is important. So plans around school closure, plans around the cancellation of mass gatherings, plans around work from home opportunities are really important. And also just generally trying to reduce your contacts.

So there's been a lot of talk about stockpiling food and I think that it is not that we perceive that, you know, you will be unable to go to the grocery store or necessarily that the grocery store will be empty. But if you are in a period of time when there is intense transmission in your community, you may choose to not go to the store every couple of days like you might be used to. You might want to only go once a week just as a way of reducing the amount of contact you're having with people who you don't know and with environments where you know you may be exposed to the virus. And so, it's not this concern at least within a North American context around an inability to be able to go to the store.

The other thing is about people who are at the highest risk: we know that people who are older and who have chronic underlying conditions are at higher risk of having very severe disease. And so thinking about a plan for your neighbours or your family members who may fall into that group, especially if you don't live nearby them, to try to also minimize their necessity of having to go out into the community during periods of intense transmission.

Travis:

Thank you so much. I also think with my camp marketing communications hat. I think as a camp leader, as running a camp business, it is worth starting to watch how people, good communicators about this happen and how people are allaying fears and not stoking fears and families are probably most focused on what's in front of them, but going to start to think about how's this gonna affect the summer and being a good communicator in this will be essential for your camp getting through this as best possible and also for you being able to support your camp community and all of this stuff that they do.

Dr. Amy Greer:

Yeah, I totally agree. I also was going to say that in public health, that same message has been: we've learned that, over past public health crises that areas where they have really strong leadership, areas where they have consistent messaging and transparent messaging early and often within a communication framework during these types of emergencies families and communities, feel a lot better supported.

Travis:

Excellent. So some of the questions that we got in came. I think the first and most common thing was about international travel in some way. I know and anticipate that a lot of your answers are going to be, "it depends", but any thoughts that you have on international travel, staffing or campers, et cetera? I think the camps that will open the soonest in the Southern United States will open the very last week of May or the beginning of June.

Dr. Amy Greer:

Travis is right. It does depend and it will depend on where we're at as we head into the spring. I think that we are rapidly beginning to realize that we will be losing the travel connection if we have not already lost it in a North American context.

So what that means is if you look at the data, there are more than 50 countries that currently have positive individuals, that likely have many more infections, that are mild and therefore not included in those counts and an ability to screen, you know, we see with travel-related restrictions, the ability to screen based on all of those various countries becomes, you know, impossible really. The issue here is that at a certain point within the context of North America, we will have community transmission. And what that means is that individuals in the community who are newly infected will have become infected in their own communities and we'll have not travelled somewhere and then brought the pathogen back.

That makes a big difference because the risk assessment then becomes significantly different. So you know, your international staff or campers arriving from a country that currently has ongoing transmission present no more of a risk than a camper who's coming from within the state or within the province. And so that's a really important thing to keep an eye on because I would say that once you have significant local transmission within your own country the risk then becomes inconsequential because the risk is the same for all individuals who may be coming to camp.

Travis:

Right. So I jumped ahead of what I wanted to do and my apologies, Amy, for that. Some of the stuff that we asked was just for a bit of clarity on what this virus is like. I think we are all getting the understanding that this is flu-like symptoms and that part of it's no different, that what makes this different and therefore why people are taking so much action on it is about transmission and all of that. What's your overview of that?

Dr. Amy Greer:

Yeah, so that's a really important point. So we should, we should at least talk about why we're so concerned. COVID-19, which is the disease caused by this novel coronavirus, is a new... so the novel coronavirus, which we are now calling, SARS COV-2 (because that's not complicated). This virus has emerged from animals. So it is a virus that the human population globally has never been exposed to.

What that means is that nobody has any preexisting immunity. So when we have a population that is entirely susceptible to a disease, it means that the ability of that disease to transmit and move within the population can occur quite rapidly. And in fact, that is what we are seeing is that the pathogen can transmit quite easily and rapidly between individuals.

The other thing that makes it challenging, which we actually find a little bit unique compared to other respiratory viruses, is that people are able to transmit the virus before they become clinically symptomatic.

So that makes it inherently more difficult to control because if you only become infectious to other people, once you start having a cough and fever, then we can easily identify who may be infected. If you can transmit before you have a cough and fever, that's a real challenge because people who feel well are still going to work, are still going out into the community. So that represents a really challenging scenario from a control perspective. The other part of this is that while for many individuals they will have mild illness. I mean not an inconsequential illness but mild illness. For some people who are higher risk, like those older people, people with chronic underlying conditions they will experience very severe disease. And in fact, some of the oldest age groups, have mortality rates that are extraordinarily high, higher than what we see with influenza as an example and quite significantly higher than influenza.

So that's really the challenge.

The other second part of that is that we know because the disease spreads really rapidly and for people who might be familiar with what was happening in China is that you kind of ended up with a curve where you had rapid takeoff and the case counts were doubling. They were really large on a daily basis, hundreds of new cases. We are currently in the influenza season in North America.

The goal of everything we're going to do in terms of control is really to try to moderate the impact to slow down transmission so that we don't have that situation where you have hundreds and hundreds of cases occurring very rapidly because the healthcare infrastructure will be pressed to be able to manage a situation like that.

Travis:

Do you think Amy or is there any understanding of whether or not this will have waves of spreading based on seasons?

Dr. Amy Greer:

So we see that with influenza and we see it with pandemic influenza. So initially in 2009, we saw kind of this small herald wave, which is a common characteristic of influenza pandemics. It kind of went away over the summer and then you got this much larger wave in the fall. So, while we expect that that seasonality may become important for COVID-19 we expect that to be more the case if this disease becomes endemic. So a disease that now becomes kind of something that we just always have in the population. The current expectation is that while the onset of summer temperatures and humidities may have a very modest impact on damping down that transmission, we don't expect that it will be significant enough to drive this down.

Travis:

I think the most important part of this discussion is that we want everybody to be informed as much as, as possible. So do you think there are parts, other than good communication, that camps need to be doing now?

I want to separately talk about how we make a decision about sort of a GO/NO GO for the summer, but assuming that the camp is going to run this summer, maybe with reduced numbers of kids: medically, procedurally, what should we be thinking about doing to prepare?

Dr. Amy Greer:

I think that all camps are going to have in place some sort of protocol for managing sick kids when they're on site. And so really reviewing what those plans are and do you have the ability to isolate, even if you needed to isolate kids before their parents could come to pick them up, do you have a way to do that? And in open infirmaries maybe you don't have the ability to truly do some good isolation. So thinking about what would that look like? Where would you put a child who needed to be isolated until they could be picked up?

Having really good communication with your local public health authority because there will be important things that they can make you aware of, especially around whether you have kids or staff who have to visit healthcare facilities.

Making sure that you're calling ahead, making sure that you're taking those sorts of appropriate proactive actions, which is really key, because we don't want individuals who may be infected just showing up. We saw that with SARS. We had hospital-acquired clusters because people sat in the waiting room for periods of time without appropriate precautions being taken. I think most healthcare facilities that are doing a really good job right now of identifying and triaging those patients when they arrive but call ahead. It's really just good advice generally because they can also advise you about what the best plan is for bringing that kid or staff into whatever your local facility is.

Travis:

Do you think people should be taking on extra or different medical supplies?

Dr. Amy Greer:

Certainly cleaning supplies. This is droplet transmitted, so kids who are coughing, sneezing, those sorts of things, while you could become infected directly, those kids are also going around touching stuff and we know that kids are not, despite our best efforts, are not the best hand washers. So (getting) additional cleaning supplies specifically for high traffic areas and places where kids touch would be really, really important. In terms of medical supplies, think a part of that depends on whether or not you think you are going to need to manage potentially infected individuals for a longer-term. Then the amount of time it takes for their guardian to arrive.

Having masks available: while I would not normally recommend masks to the average person, I think in a residential setting, having masks, just surgical mass, not N95 fitted masks, but surgical masks that you can provide to a coughing individual while they are in the infirmary and while you're trying to decide what you're going to do with them. We do know that putting a mask on somebody who is actively coughing who may be infectious is really a good way to try to minimize the risk of transmission.

The challenge is that if it is the case, which we believe to be, that individuals are infectious before they become symptomatic in a residential setting, we have a very challenging situation because what do you then do given that it's going to take some time for bunkmates or cabin mates to show their own signs and symptoms if they have become infected and we think it takes from the time one person becomes infectious to the time the next person who they've infected starts to show symptoms could be five to seven days. If they're starting to transmit before they're clinically ill... Really thinking through the logistics of (your summer). Your local public health can help you to think through what the best approaches are given your housing arrangement and all those sorts of things.

One of the biggest questions is how do you manage a single symptomatic kid or staff and having them leave site to go home removes them as a risk factor at that point in time, but now you have nine other kids and probably many other staff who've come in contact with that individual over some period of time. And so what do you do with them? Because they're well, right, and then the optics of isolat(ing) all of these kids and because they might all remain well, right? The flip side is that kids appear to show much milder symptoms but are still infectious to others. And so alternatively, what you could see would be mild asymptomatic infections in kids and the canary in the gold mine is going to be your staff because staff are going to be more obviously ill.

Travis:

Right. So one of the, one of the things that we're NOT going to talk about in detail, but one of the best pieces of advice, and this comes from your provincial, national, state Camp Associations, is good Emergency Planning. One of the things you might have to be communicating with your local health authorities about whether or not you are going to be a quarantine site once kids get in there. And then (there are) lots of interesting implications of that.

But, communicate, have a plan and talk to the (authorities) around you.

Dr. Amy Greer:

I think the other challenge, especially for large camps, because I've been talking with a lot of people lately who are in residential school settings. So private schools where they have a bunch of minors who for whom they're the legal guardians and the parents could be anywhere. The question around that is that it's easy to send a domestic camper or staff member home. How will you manage a minor who is in your care legally if they're an international camper and you cannot send them home? If they have a mild illness, they should not be in the hospital. What does that look like, given that probably a camp does not have sufficient resources or facility to manage, you know, a week or two weeks of having a very clinically ill camper.

Travis:

Or just one who's required to be isolated, who may not be super-ill but still required to be isolated. You talked about cleaning: I wanted to ask if it's like medical grade cleaning supplies or is this just a bleach mixture that would do?

Dr. Amy Greer:

As far as I have heard, either, regular ChlorOxy type cleaning supplies, but also certainly bleach. It does not appear to be especially resistant to those. At this point, everything I've said I've seen has suggested that regular cleanings should be sufficient.

Travis:

One of the themes in the questions that people sent in is "how do we keep this out of camp?" And, I think this is going to be a non-definitive, non-satisfactory answer.

Dr. Amy Greer:

Yeah. I think it will be difficult. As a parent, that kids do not appear to be really severely affected by this virus is reassuring to me. The challenge is that they do get it, they do transmit it to others, but they have a mild illness and so it's going to be much more difficult to screen.

What people would want to do is, you would want to say, we already do lice check and our intake with the nurse or whoever our medical staff are. So the parents and the kids come up and they hand in their form. I think there are probably a number of things you could do that would maybe be helpful, and again, your local public health might already have a form like this. So for instance, right now if you go to a hospital in the province of Ontario at least, as soon as you arrive you are given kind of this screening checklist that has five questions. Now, initially, those questions were very much focused on travel history. Have you been to China in the last 14 days? Those sorts of things.

It would be possible to screen for, you know, respiratory symptoms, that seems reasonable and fair. Have they had known contact with a case? Have they had known contact with somebody with respiratory symptoms? Somebody in the questions had said can we just test them all? That testing is not going to be an option. There's no easy way to test. I think by the time summer rolls around, somebody who has a respiratory disease, the chance that they will have COVID-19, if local transmission in the community is happening, the positive predictive value would probably be quite high because influenza will have gone away. We typically don't have a lot of respiratory illness that circulates in summer. So if you have kids with respiratory symptoms, the probability that this is what they have will be much higher than it is now.

The other thing we know about screening, which is why we don't do a ton of screening at airports for instance, is that you screen a lot of people and they're all negative. The payback on that is really very low. We've screened hundreds of thousands of patients, like in countries they do temperature checks and they do all these sorts of things. I mean it makes us feel better cause it makes it feel like we're doing something, but it's not especially effective and if kids woke up and said they had a headache and had a dose of Advil before they arrived or they get carsick or whatever and so they had some medication, you wouldn't pick up a fever anyways.

So any sort of screening is going to be imperfect. You're going to miss or exclude. You don't want to miss true cases, but you don't want to exclude kids for no reason either. The challenge is that you have these asymptomatic cases. I think screening is going to be challenging. I think the best advice is to take the cue of public health intelligence officers who are working at airports right now. The best strategy, and this in the Canadian context is likely why we are still able to say we are in mostly a contain-and-delay phase, which is that we are providing really good information to returning travellers to monitor yourself.

If you begin to feel unwell, here's what you do: You don't show up at the emergency room, you call ahead. If you have to go in an ambulance, you tell them that you have a travel history and a risk factor for having this virus.

Maybe it's a case of monitoring by the staff. Talking to the counsellors who are with the kids all day about just identifying kids who maybe seem like they're really dragging. It's hard in a residential setting 'cause they get tired and it's not their normal routine. If somebody starts to get a little bit of a cough, maybe we flag them and we start taking temperatures on them to make sure that we're not going to end up with something else. But again, mild symptoms, I don't know how effective it would be.

Travis:

This is a communication issue as much as I think it's going to be "get your health forms in early!" And then I think camps are going to have to do bi-weekly and then weekly check-ins with those families before the kids arrive. You have to develop a habit with your families of communicating with you as well. It can't just be one way 'cause you're going to need families to say 24 hours before "my kid has no symptoms that could be related".

Dr. Amy Greer:

One of the things that I actually wrote down about that is having a 24 or 48-hour check-in with your families and recognizing that it's resource intensive, right? I mean that's resource-intensive to reach out, especially if you're a big camp, to every family within 48 hours of their arrival. I think one of the other things that would be really useful is to be able to say, and you know, economically this is maybe not the best answer, but being able to say, if your kid does have respiratory symptoms or even has mild respiratory symptoms, we would rather err on the side of caution and we would be happy to move them to a different session. Giving without any penalty to you and economically that that is probably not going to be the happiest answer for some people. But I think it demonstrates that you have a level of concern for the community and that you're open to working with parents and I think that that's going to make parents more apt to say, you know, they do actually have a cough or they just are getting over a cough.

I'd rather have them in a different session, personally than the opposite. That, to me, seems better than the optics of having them come anyway. And then you'll have to manage an actual outbreak in a residential setting.

Travis:

Speaking of resource-intensive, that will be much more than the screening phone calls 48 hours before.

I can pull it some questions, but are there ones that you thought were representative or that you had prepared some stuff that you wanted to say?

Dr. Amy Greer:

The only other thing that I specifically made a note about was that I also think, and you talked a little bit about communicating with families, but I think that this idea, even now, to start sending information that says, "the risk is currently low". The risk in the community in which we are located is still being assessed at a very low level. But we're going to provide updates on a biweekly basis and if that risk changes at any point or if our local public health authority believes that the risk changes that we will notify you immediately.

I think that's a very minor thing, but it builds trust.

I think it highlights that you're actively monitoring the situation in a meaningful way and not just "we'll wait until the last minute", especially if you have families travelling. People don't want to be traipsing their kids across the country only to find out that you're going to be closed.

Travis:

This echos something that I say all the time: coming at this at the last minute or just doing a "wait and see" when it comes to kids and families and the trust they put in you - you never want to look sloppy as a camp and you always want to look prepared. And so if you can say we are monitoring this, we have a plan, we will share more as we know it. Currently: the risk is “this”.

That's a pretty simple communication but it is incredibly effective because of the openness of that and the understanding that parents are starting to get very worried about this effect on their kids and I think people are getting very worried about the effect on their lives as well.

Dr. Amy Greer:

Yes. I think the other thing is related to school closure. If our job as public health professionals is to avoid an outbreak that looks like this [makes tent shape with her hands] and to try to, as we say, flatten the curve, so spread the cases out over a longer period of time in order to protect the healthcare system for the most severe cases. If that is our goal and if we don't have a vaccine and we don't have effective treatments, what that leaves us with is this idea of reducing contact.

So between now and June when school is still in, and we've already seen this in some parts of the U.S. where they have documented local transmission in the last like 48 hours, school closure is a way to reduce contact between kids. And if kids are efficient transmitters of this virus, then that should hopefully help to delay and slow down the transmission rate.

What that means though is that if school closure is effective (and there are other countries now that have implemented school closure and have had it in place for a number of weeks at this point. Korea, Japan, Italy), we are starting to be able to look at that data to say "Did it really make a big difference?"

I think if the people looking at that data say, it actually does make a really big difference. and if school closure becomes something that we believe that it will be effective in trying to flatten that curve, it is something that I expect people will start to do in areas where transmission is intense, for potentially four weeks. Maybe longer than that.

Camps are like schools and so if we still continue to have intense transmission as we move into summer, it is also important to know what your contingency plan would be. It is a possibility, if school closure looks like it's working well, if we still want to keep those contacts with kids down, camp it's a different type of "school".

And not to be a pessimist, but I think it's important that we think about it.

Travis:

School closures could have that direct effect like you choose to or you're ordered to close the camp down. The secondary (possible) effect is that if schools are closed for a month, then they may extend the school year into the summer. And that also might be a plan. I think that those that are running school groups right now are starting to notice school travel to camps and outdoor centers is dropping off, and that's affecting things. But one of the pieces is also that you may have to change your summer schedule or be ordered to not open depending on your area, et cetera.

Amy and I are not saying that this is going to happen, but it's something that you need to be thinking about.

Dr. Amy Greer:

I think from a preparedness perspective, I think it is reasonable to think of all of "what if" scenarios and, there's no way to tell what the probability of any of those "what if "scenarios would be but that's an important one to consider.

Travis:

I think the overlying piece of making that decision has to rest between you as the camp and your local health department. It's on their advice or on their orders to do that thing. Communicating regularly with your local health department and if you're a camp that has an office in the city and a camp further away from a larger community than you probably gonna need to be talking to both coordinating with both health departments. We have covered a lot of these things. We haven't answered the specific questions for specific camps, but, I want to take this time again to ask you, Amy, to reiterate the most important things that people should know right now.

Dr. Amy Greer:

1. Monitor your local situation using credible media sources. That would be your local public health department or unit, your state or province, and your federal public health agencies. That is where you will get the most reliable information. It is challenging to exist in a time when the media cycle is 24 hours and it can feel very overwhelming. Check-in with them but don't become obsessive about the newest case count on an hourly basis. Know where to get good information and how to use that to inform your decisions, be proactive, and do the things that are within your control in terms of reducing your own risk and reducing risk in your community.

2. Washing your hands well, try not to touch your face, using good cough etiquette by coughing into your sleeve.

3. Also having a plan if you should be required to or if you should choose to have fewer social contacts: cancellation of schools, cancellation of events that you might have tickets for, changing your working environment to be able to work from home if that is a possibility for you during periods of time when you feel like that is useful.

I think that those are really the proactive things that people can do on a daily basis starting now to really try to minimize the risk and really try to slow transmission down - mostly so that we can get out of influenza season.

Travis:

Thanks Amy. For being a part of this and for continuing to care about the camp community. It means a lot to us.