I’m the father of two elementary school aged children in Fairfax, Va. Each year, my wife and I send our children to a day camp in rural Maryland, where they spend all day rock climbing, canoeing, and swimming. They look forward to it all year and, after the stress of the past two months of homeschooling and working from home, we’re especially looking forward to it this year. I’m wondering, though, if it’s ethical for me to send them there in mid-July? We’re assuming that the camp will be open by then. The camp is outdoors, and the staff insists that they’ll be taking safety precautions—masks for the counselors, social distancing for the campers, etc.—and I know that children in nearly all cases don’t get very sick from the virus. But I worry that simply contributing to a gathering of people during this time is increasing the health risks to us all. How do I balance these public health concerns with my own need for a break from 24/7 parenting? Is it ethical for me to send my children to this camp?
Daniel P. Sulmasy, MD, PhD, acting director of the Kennedy Institute of Ethics and a faculty member of the Pellegrino Center, Georgetown University: Questions for this column, like yours, are now evolving from those concerning how to behave during the lockdown to those concerning the “opening up” phase after months of stringent public health measures. You, your wife, and the staff of your children’s camp seem fully aware of a point I need to emphasize for all readers: The end of the lockdown does not mean the end of the virus. Substantial risk of infection will remain. The virus remains in circulation. Current treatments are imperfect, still experimental, and not yet widely available. No vaccine will be ready by the summer even on the most optimistic schedule. The only tools available to mitigate the effects of Covid-19 are social distancing, hand-washing, and the appropriate use of masks.
No one doubts, however, that we need to “open up” the economy. Public health measures have kept the Covid-19 pandemic from getting out of hand and overwhelming medical resources. We should pat ourselves on the back. For example, we never came to the point of needing to ration ventilators, even in New York. Most citizens did their parts and the curve was at least blunted. In many places, including DC, the curve was truly flattened. But the social costs of these public health efforts have been huge. Too many people have lost their jobs. We need to re-start the economy, but we need to be wise about how we do it. If we just return to business as usual there is a strong possibility that cases of the virus could surge again in a so-called second wave.
This is the context in which your question must be considered. In your particular case, there are several very good moral reasons to send your children to summer camp. Camp will be good for them. It will be good for the camp’s owners and good for those who work there. It is not selfish but perfectly reasonable for you and your wife to want to have a break. And if more people are able to do things like send their children to summer camp without undue public health consequences, the economy will begin to recover.
Sending the children to camp will not be risk-free, however, and the risks are both hard to predict and potentially unknowable. Here is what we do know: Children can contract the virus but the overwhelming majority have no symptoms at all, not even the sniffles. Nonetheless, a very, very small number of children (something on the order of one in 5,000 who become infected) seem to be at risk for developing a serious and even potentially fatal immune disease similar to Kawasaki disease. We know that schools and camps are often places where infectious diseases spread readily, and camps could become potential hotspots for SARS CoV-2 infection. We know that even asymptomatic children can transmit infection to others, so they could spread it to camp counselors, bus drivers, and you. Healthy adults of parenting age are often symptomatic with Covid-19, but rarely become sick enough to be hospitalized. We know that children and adults who are healthy can spread the disease to others who may be at higher risk. We know that social distancing, handwashing, and mask wearing are extremely helpful in combatting transmission, but not foolproof. We also know that many people greatly exaggerate risk as a psychological bias and that this bias can be counter-productive.
With all this in mind I think you could make provisional plans to send the children to camp provided that: (1) the camp is really serious about public health measures, including assuring compliance on the part of any ancillary services such as bus drivers. (2) Neither your children, nor you, nor anyone else who lives at home with you is at high risk, such as a grandparent or someone with a compromised immune system. (3) You remain vigilant about social distancing, hand-washing, and mask-wearing yourselves, and you drill such practices into your children. (4) You remain aware of the changing situation and look for any new information that might alter the balance of risks and benefits. (5) The camp agrees not to penalize you if you change your minds based on such new information, or the camp asks only for a very small, non-refundable deposit.
This virus keeps us humble. Right now, to the best of our knowledge, the risks we can predict in sending your children to summer camp in July do not seem so disproportionately great as to warrant forgoing the potential benefits. You should not feel guilty about making provisional plans to do so. But be ready to alter your plans—everything might change in a month.