The U.S. has seen a wave of COVID-19 outbreaks linked to summer camps and health officials fear it could be a preview of what’s to come in the new school year.

In rural Hudson, New York, where 67% of those 12 and up are fully vaccinated, news of a COVID-19 outbreak at nearby Camp Pontiac has rattled the community. “By Monday, it was 23,” said Jack Mabb, the health director of Columbia County. “By Wednesday, it was 31, all in the seven to 11 age group. So they’re of course unvaccinated.”

“Our reaction is we haven’t seen this,” he said.

Outbreaks have been reported at camps around the country. In North Carolina, a camp outbreak has been linked to at least 75 cases across 17 states. At Pontiac, almost all older campers and staff were fully vaccinated and everyone was tested on the first day.

“COVID can get in there, whether it’s the variant or not, despite everything that you do,” Mabb said. “I think that’s a harbinger for the school year to come.”

This fall in Columbia County, school funding is being allocated for nurses to do rapid on-site testing. But protocols for cafeterias, athletics and buses are up in the air as the county waits on guidance from New York state.

“If buses still have to keep us six feet between students, that’s not going to allow us to bring all of our students back,” said Gladys Cruz, the superintendent of Questar III Boces.

“My granddaughter starts here in five weeks as a five-year-old,” Mabb said, adding that he was worried about her.

“A worry that will only grow as summer winds down and the school year starts.”