On July 31, 2020, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). Limited data are available about transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), among youths. During June 17-20, an overnight camp in Georgia (camp A) held orientation for 138 trainees and 120 staff members; staff members remained for the first camp session, scheduled during June 21-27, and were joined by 363 campers and three senior staff members on June 21. Camp A adhered to the measures in Georgia's Executive Order* that allowed overnight camps to operate beginning on May 31, including requiring all trainees, staff members, and campers to provide documentation of a negative viral SARS-CoV-2 test ≤12 days before arriving. Camp A adopted most † components of CDC's Suggestions for Youth and Summer Camps § to minimize the risk for SARS-CoV-2 introduction and transmission. Measures not implemented were cloth masks for campers and opening windows and doors for increased ventilation in buildings. Cloth masks were required for staff members. Camp attendees were cohorted by cabin and engaged in a variety of indoor and outdoor activities, including daily vigorous singing and cheering. On June 23, a teenage staff member left camp A after developing chills the previous evening. The staff member was tested and reported a positive test result for SARS-CoV-2 the following day (June 24). Camp A officials began sending campers home on June 24 and closed the camp on June 27. On June 25, the Georgia Department of Public Health (DPH) was notified and initiated an investigation. DPH recommended that all attendees be tested and self-quarantine, and isolate if they had a positive test result. A line list of all attendees was obtained and matched to laboratory results from the State Electronic Notifiable Disease Surveillance System ¶ and data from DPH case investigations. A COVID-19 case associated with the camp A outbreak was * https://gov.georgia.gov/document/2020-executive-order/06112001/download. † Notable adopted measures included cohorting of attendees by cabin (≤26 persons), staggering of cohorts for use of communal spaces, physical distancing outside of cabin cohorts, and enhanced cleaning and disinfection, especially of shared equipment and spaces.

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On September 22, 2020, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). Contact tracing is a strategy implemented to minimize the spread of communicable diseases (1,2). Prompt contact tracing, testing, and self-quarantine can reduce the transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (3,4). Community engagement is important to encourage participation in and cooperation with SARS-CoV-2 contact tracing (5). Substantial investments have been made to scale up contact tracing for COVID-19 in the United States. During June 1-July 12, 2020, the incidence of COVID-19 cases in North Carolina increased 183%, from seven to 19 per 100,000 persons per day* (6). To assess local COVID-19 contact tracing implementation, data from two counties in North Carolina were analyzed during a period of high incidence. Health department staff members investigated 5,514 (77%) persons with COVID-19 in Mecklenburg County and 584 (99%) in Randolph Counties. No contacts were reported for 48% of cases in Mecklenburg and for 35% in Randolph. Among contacts provided, 25% in Mecklenburg and 48% in Randolph could not be reached by telephone and were classified as nonresponsive after at least one attempt on 3 consecutive days of failed attempts. The median interval from specimen collection from the index patient to notification of identified contacts was 6 days in both counties. Despite aggressive efforts by health department staff members to perform case investigations and contact tracing, many persons with COVID-19 did not report contacts, and many contacts were not reached. These findings indicate that improved timeliness of contact tracing, community engagement, and increased use of community-wide mitigation are needed to interrupt SARS-CoV-2 transmission. Routinely collected case investigation and contact tracing data from June 1-30, 2020, for Mecklenburg, and from June 15-July 12, 2020, for Randolph counties were analyzed. Case investigations were conducted for persons with laboratoryconfirmed COVID-19, including the elicitation of persons potentially exposed to the index patient (3). Contact tracing was performed for persons identified as close contacts and included inquiry about COVID-19-compatible symptoms † and instructions to self-quarantine for 14 days since last exposure (3). Health

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On August 21, 2020, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). On June 1, 2020, with declines in coronavirus disease 2019 (COVID-19) cases and hospitalizations in Rhode Island,* child care programs in the state reopened after a nearly 3-month closure implemented as part of mitigation efforts. To reopen safely, the Rhode Island Department of Human Services (RIDHS) required licensed center-and home-based child care programs to reduce enrollment, initially to a maximum of 12 persons, including staff members, in stable groups (i.e., staff members and students not switching between groups) in physically separated spaces, increasing to a maximum of 20 persons on June 29. Additional requirements included universal use of masks for adults, daily symptom screening of adults and children, and enhanced cleaning and disinfection according to CDC guidelines. † As of July 31, 666 of 891 (75%) programs were approved to reopen, with capacity for 18,945 children, representing 74% of the state's January 2020 child care program population (25,749 children). High compliance with RIDHS requirements was observed during 127 unannounced program monitoring visits (C Molina, RIDHS, personal communication, 2020). Program administrators reported that maintaining stable staffing was the most difficult requirement to implement because of the need to rotate staff members to cover teacher breaks, vacation, and sick leave and that continued adherence to small, stable classes might not be feasible without additional funding. During June 1-July 31, the Rhode Island Department of Health (RIDOH) conducted investigations of any reported COVID-19 case in a child or adult, including staff members, parents, or guardians, present at a child care program. Reported cases were classified as confirmed if a person received a positive reverse transcription-polymerase chain reaction (RT-PCR) test result for SARS-CoV-2, the virus that causes COVID-19, or probable if a person met clinical and epidemiologic criteria with no laboratory testing. § Child care classes with a symptomatic person identified were required to close for 14 days or until * h t t p s : / / w w w. b o s t o n g l o b e .

The aim of this study was to describe and evaluate the impact of the programme intervention of the Rivers State Antiretroviral Treatment (ART) Surge, a collaboration between the US President's Emergency Plan for AIDS Relief (PEPFAR) and the State Ministry of Health, to increase HIV case-finding and ART access in Rivers State, the state with the largest ART gap among people living with HIV (PWH) in Nigeria.Design: During April 2019ÀSeptember 2020, the intervention included six specific strategies: using local government area-level ART gap analysis to guide case-finding; expanding targeted community testing; tailoring comprehensive key population HIV services; engaging HIV treatment programme stakeholders; synchronizing team efforts; and using near real-time data for programme action.Methods: Weekly reported facility and community data on tests conducted, PWH diagnosed, and PWH initiated on ART were aggregated. The total number of PWH maintained on ART was reported quarterly.Results: During May 2019ÀSeptember 2020, the weekly number of newly diagnosed PWH initiated on ART supported by PEPFAR in Rivers State increased from 82 to 1723. During October 2019ÀSeptember 2020, the monthly number of people screened for HIV testing eligibility in the community increased from 44 000 to 360 000. During April 2019ÀSeptember 2020, the total number of PWH on ART supported by PEPFAR statewide increased by 3.8 times, from 26 041 to 99 733. Conclusion:The strategies applied by HIV program stakeholders contributed to scaleup of PWH identification and ART linkage within the Rivers State ART Surge. Continued