Adventures of a summer camp doctor: More mental health issues but less viral disease this year

Being a camp doctor was different this year, with COVID-19 prevention protocols in place and campers who missed both school and camp last year. What doctors saw in the summer sun could provide clues of what to expect when school resumes and how the health and wellness of children has been impacted by the pandemic. What camp doctors didn’t see this summer were COVID-19 cases. Summer is not over, but the number of COVID-19 cases related to overnight camps was low. The exception was Muskoka Woods camp in Ontario, which had to close its doors for three weeks after twelve cases, all contained in one cohort of campers and staff. The camp will reopen on August 22. What camp doctors did see were children enjoying time together. After 18 years as a camp doctor at Camp Manitou in Parry Sound, Ont., Dr. Jeremy Friedman said he was sometimes guilty of taking camp for granted. This year, “I was much more conscious of the energy and joy around us,” he said. Dr. Friedman is an associate pediatrician-in-chief at the Hospital for Sick Children in Toronto. Dr. Tanya Wyman’s four children are at Camp Ramah in Utterson, Ontario, where she’s been a camp doctor for a decade. “We’re just so excited for them,” she said. “It is such a blessing that they’re able to be there and be without texts for a month or two just to breathe fresh air, communicate with people and learn how to interact again.” Dr. Wyman is the chair of the medical and wellness committee at Camp Ramah and a family physician in Toronto. She spent a week at the camp this summer. Dr. Friedman spent two weeks at Camp Manitou. When it came to his duties as a camp doctor, “It was actually a lot quieter than an average year,” he said. Usually there are a lot of viral illnesses: coughs and colds and gastrointestinal bugs, but not this year. There were still insect bites, pains and strains, stomach-aches and rashes. Read: Ontario to run school-based COVID-19 vaccine clinics as academic year begins However, “there was a big difference on the mental health side of things,” he said. Camp Manitou proactively hired a mental health counsellor to support an uptick in mental health problems. Dr. Friedman said that camp management reported a significant increase in anxiety and depression in teenage campers and counsellors compared to previous years. It mirrors what Dr. Friedman and his colleagues have seen at Sick Kids: increased numbers, referrals, and admissions for anxiety, depression, eating disorders and other mental health problems. Dr. Wyman said her conversations with other camp doctors around Ontario and the United States revealed that others were seeing higher mental health stressors in campers and counsellors. “We see similar issues every year but I think they were heightened this year,” she said. “Mental health was a huge factor in the camps.” There was more homesickness this year, Dr. Wyman said. Since the 2020 season was cancelled, there were twice the number of new campers and new counsellors. “We were seeing more homesickness in older campers that we weren’t expecting, like 13- and 14-year-olds,” she said. “I think because people were so accustomed to being home and so supported by that.” Dr. Wyman’s advice to family physicians is to ask children about their mental health. “I think every child should be asked about how their mental health is doing because it may not be as evident to everybody but a lot of kids are having (problems) and it is showing up in different ways,” Dr. Wyman said. Dr. Friedman said that the experience of camp shows how important it is to have in-person school. The success of the camp season also demonstrates that you can safely have hundreds of children together in close quarters if proper precautions are taken, he said. Manitou camp is a big camp, with more than 450 campers and 250 staff. “I would strongly ask family physicians and pediatricians to continue to advocate that this coming school year will be as normal as possible for them,” he said. Read: Reopening and restriction update province by province Children in Ontario had online school more than any other jurisdiction in Canada: at least four months in the 2020-2021 school year - more if they had to self-isolate - with high school students having half their class time online even when in-person school was open. From what they observed, children were not missing their screens while at camp, Drs. Wyman and Friedman said. Being a camp doctor was also more involved this year. Usually, the medical staff wouldn’t be consulted on the day-to-day aspects of camp life. “With COVID we had to be involved in everything because it was how to decrease transmission between cohorts because if someone was positive, we wanted to make sure only one cohort was affected, nobody else.” she said Both physicians worked with the Ontario Camping Association to help develop guidelines for a safe camping season, and fine-tuned the requirements with their camps. In Ontario, this meant PCR COVID-19 testing prior to camp arrival, at arrival, and seven days into camp. It meant social distancing, cohorting in cabin groups, meals taken outside, masks worn when inside or interacting with another cabin. It meant no visitors and no time off for staff outside of camp. Vaccinations were strongly encouraged for campers and staff who were eligible. Other provinces had similar protocols. Some overnight camps chose not to open. Many of the more affordable YMCA camps and Scouts Canada camps opted not to operate as overnight camps this summer. Still, they tried to get children outside. Scouts Canada’s Camp Opemikon in Eastern Ontario became a family camp, with some programming offered to families staying in the cabins. YMCA’s Camp Wanakita in Ontario’s Haliburton Highlands did the same, also offering meals to the family groups. Other YMCA camps bused children in for the day. Charities supporting children who want to go to camp continued to fundraise. For those children who were able to attend camp, it will help them get ready for the upcoming school year, Dr. Friedman said. With camp doctors posting on Twitter and Instagram about the joys of seeing sunsets over lakes and happy children playing, camp might have also help doctors regain energy before heading back to their regular clinics. Read: Manna from heaven? It could be rabies vaccine bait if you’re in eastern Ontario

Adventures of a summer camp doctor: More mental health issues but less viral disease this year

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