Last week, nearly 250,000 children tested positive for COVID-19 - the biggest weekly surge yet. Let’s break the data down. (All data is from the American Academy of Pediatrics and the Children’s Hospital Association joint report found here unless otherwise noted.)
A QUICK NOTE ON REPORTING
Who does (and doesn’t) report on children cases? Most states report age distributions for their cases. However, Texas (ugh, y’all) provided age distribution for only 3% of cases (so ALL data I present needs to be taken very lightly - in other words, children cases in Texas that are reported in this report are not accurate). Only 24 states provide age distributions for hospitalizations. Other limitations include: Florida stopped reporting child hospitalizations in late June, and there is a 6 week reporting delay for Alabama (including child deaths). So, those nuances need to be taken into account as we look at the numbers.
OVERVIEW
As of September 2nd, 5 million total COVID cases have been among children - equating to 15.1% of all cases. This is an overall rate of 6,709 per 100,000 children in the population.
HOWEVER, over the past two weeks that total climbed by 455,000 - which is an increase of 10% on average. Certain regions and the Southern region saw a higher increase that we will talk about below.
OVERALL PERCENT OF CASES
Earlier I mentioned that overall children equate to 15% of all cases. However, 13 states exceed that percentage. VT, AK, TN, SC, WV, ME, and NM lead. Among the states reporting (remember that’s only 11 states, ugh), children made up between 111-21% of TOTAL cases. A whopping 11 states reported 150,000+ cases.
RATE PER 100,000 CHILDREN
Earlier we also mentioned the average rate during this pandemic per 100,000 children in each state’s population was 6,709. However, more than half of the states exceed that with 18 states reporting more than 9,000 per 100,000 children. TN, SC, RD, ND, AK, MS, AZ, and FL lead the way. TN and SC are nearly DOUBLE the average rate for children. Yikes.
WHERE ARE CASES INCREASING THE MOST?
The below chart shows the states with the greatest % increase in chidren’s cases in the past two weeks - some southern states have a whopping 25% increase.
You can see how this difference by region in the below charts. The South leads the way in children COVID cases in the past week by a huge surge - double (or triple) the surges in the Northeast, Midwest, and West regions.
Lastly, the percentage of COVID-19 cases attributed to children is climbing. Nearly 27%! The average I mentioned at the beginning of this newsletter was only 15%.
PEDIATRIC HOSPITALIZATIONS AND ER VISITS (data source here)
Since July 4th, pediatric hospitalizations are up by 600%. This is partly due to the number of new infections increasing too. But, it does underscore that children can still get very sick and require hospitalizations. We also do not know enough about long COVID-19 among children - this is one of my biggest worries for our kids.
Emergency room visits are coming down slightly. But I want you to notice that the ER visits for 12-17 year olds are HIGHER than young adults. I point this out since this age group can get vaccinated (my 12 year old is). If your 12+ child is not vaccinated, now is a great time to do so.
WHAT ABOUT STATES WITHOUT REPORTING IN THE MAIN AAP REPORT?
It’s not hard to google child COVID-19 cases in states like Texas and Florida and see slews of reports of pediatric surges - in schools and hospitals - and the dual infections of COVID-19 and RSV, particularly for littles. For most states, you can dig around and find the numbers I presented above.
Let’s look at Texas - if you live there, you know that 1,000s of kids are getting sick. The Dallas Morning News reported:
Texas also has a positivity rate of 14% - so if they were reporting with the other states, I would highlight suspect they would exceed the case rate for children and increases we look at above. Florida too.
A FINAL WORD
The problem with pediatric cases is that the virus is taken home to other siblings and family members. Children can also get very, very sick and be hospitalized. Yes, the hospitalization rates and death rates for children are not as high - but, I’ve seen people using that statistic as a reason to simply open schools with no precautions (or with things that don’t work like distancing without masks and plastic partitions that don’t work either). This pandemic is still about our communities and these surges among our children have a spill-over effect into homes, friends, and communities. Delta doesn’t mess around. TN, SC, TX, FL, NM, AK, LA - although we are seeing a decrease in national cases (thankfully), the peak was really high. That peak mixed with positivity rates and unmasked schools make an ideal environment for Delta.
Another point to make is interruptions in school attendance due to exposures. As a parent, these interruptions are hard - especially in schools where at-home online learning is grossly underfunded or just not available. IF schools would make masking mandated, these interruptions would be greatly reduced - particularly when combined with other precautions like better air filtration, distancing, etc. But, masking is the biggest issue here.
OTHER HELPFUL ITEMS FOR SCHOOLS
Keep advocating for mask mandates, friends! So many of you are continuing to write your mayors, school administrators, school boards, or started your own reporting COVID school dashboards when states/districts aren’t reporting. Keep up the good work. Here are 2 previous posts I wrote that might be helpful as you continue on.
For an example of how 1 teacher spread to half of her class - go here.
For the data on why masking is important in schools - go here.
TN parent of school-aged children here (both under 12). It is absolutely infuriating to see so many school boards refusing to require masks ("recommended" and "encouraged" just don't cut it). It doesn't help that we have a governor who said parents can still opt out just by writing a note, even if the school board mandates it. A few school districts are suing him over this, and winning.
There are a lot of people here who are vehemently anti-mask and it is frustrating that we are still arguing over efficacy 18 months later. People who chase doctors and nurses to their cars after school board meetings and threaten them because they spoke in favor of masks. People who say "if you are that worried, stay home" instead of caring about their children, their teachers, and their community.
We made it 3 weeks in before our county schools had to shut down for a week due to the number of covid positive students and staff. No learning took place during this period. Talk about disruption.
Last night there was a school board meeting in a neighboring County, and a lady attending literally laughed as a student was talking about his experience of his grandmother dying of COVID.
School boards are also making quarantine less strict, saying if you're asymptomatic you should still come to school.
I'm exasperated at this point, and it feels like just a matter of time before some huge horrible event happens. I'm disappointed that so many seem to not care about their community, kids, and teachers. I'm angry that this has become so political. I'm feeling so powerless to protect my kids.
My concern is do we have any data regarding impaired immunity post covid as seen with post measles infections? I am very concerned for humanity and how getting covid will effect ones overall immune system. For over a year we hardly saw any influenza at our clinic and hardly any strep. Strep is on the rise back to normalcy (yuck I know) and with “flu” season around the corner, is Delta going to outcompete influenza again? Or now that many have had covid is their immune system going to be lower and now they will be more susceptible to influenza A,B,H1N1…. Any data on that Dr. Emily?
TN parent of school-aged children here (both under 12). It is absolutely infuriating to see so many school boards refusing to require masks ("recommended" and "encouraged" just don't cut it). It doesn't help that we have a governor who said parents can still opt out just by writing a note, even if the school board mandates it. A few school districts are suing him over this, and winning.
There are a lot of people here who are vehemently anti-mask and it is frustrating that we are still arguing over efficacy 18 months later. People who chase doctors and nurses to their cars after school board meetings and threaten them because they spoke in favor of masks. People who say "if you are that worried, stay home" instead of caring about their children, their teachers, and their community.
We made it 3 weeks in before our county schools had to shut down for a week due to the number of covid positive students and staff. No learning took place during this period. Talk about disruption.
Last night there was a school board meeting in a neighboring County, and a lady attending literally laughed as a student was talking about his experience of his grandmother dying of COVID.
School boards are also making quarantine less strict, saying if you're asymptomatic you should still come to school.
I'm exasperated at this point, and it feels like just a matter of time before some huge horrible event happens. I'm disappointed that so many seem to not care about their community, kids, and teachers. I'm angry that this has become so political. I'm feeling so powerless to protect my kids.
My concern is do we have any data regarding impaired immunity post covid as seen with post measles infections? I am very concerned for humanity and how getting covid will effect ones overall immune system. For over a year we hardly saw any influenza at our clinic and hardly any strep. Strep is on the rise back to normalcy (yuck I know) and with “flu” season around the corner, is Delta going to outcompete influenza again? Or now that many have had covid is their immune system going to be lower and now they will be more susceptible to influenza A,B,H1N1…. Any data on that Dr. Emily?