Surge of child COVID-19 cases complicates start of new school year across US

WASHINGTON (SBG) — The start of the new school year has brought with it new challenges for parents and educators, as pediatric cases of COVID-19 hit record highs and administrators reassess plans to return to something resembling a normal learning environment this fall.

In the week ending Sept. 2, the U.S. recorded 252,000 new COVID-19 cases among children, the most in a single week since the pandemic began. The American Academy of Pediatrics noted severe illness remained uncommon, with children accounting for 1.6% to 4.1% of hospitalizations and less than 0.3% of deaths in states that reported data.

Dr. Beth Theilen, a pediatric infectious disease expert at the University of Minnesota Medical School, said experts had feared an uptick in child cases as the new school year began based on how infectious the delta variant was among adults. With more schools opening around Labor Day, the numbers could get even worse in the weeks ahead.

“Delta really changes the landscape, and that’s something that I think hasn’t been clearly communicated to the public,” Theilen said.

COVID-19 infections in school-age children have risen most rapidly in recent weeks in states where schools opened earliest, The Wall Street Journal reported Sunday. Half of states where the school year began in late July or early August have subsequently seen a record high number of new infections among children.

According to data tracking service Burbio, more than 1,000 schools in 35 states have already temporarily halted in-person classes this school year because of COVID-19 outbreaks. Some have also delayed opening or preemptively shifted to hybrid schedules before classes began.

The North Carolina Department of Health and Human Services reported it is tracking 170 ongoing COVID-19 clusters in schools and child care settings. One of the state’s largest school districts in Union County had more than 5,200 of its 41,000 students under quarantine as of Friday.

In Charleston County, South Carolina, at least seven schools have temporarily reverted to virtual learning for up to two weeks. School districts in other communities have been more resistant to shutting down classrooms even as cases spike.

The Connally Independent School District in Waco, Texas imposed a mask mandate last week after two teachers died from COVID-19. Districts elsewhere in the state have closed classrooms temporarily in response to surges of infections.

“We were hopeful for the start of this year that we wouldn’t have to go back to some of the mitigation strategies that we now have back in place, but as the number of cases with the delta variant has risen in our community over the summer, we had to go back,” Doug Reisig, a superintendent in Missoula, Montana, said at an event Tuesday.

Oregon Gov. Kate Brown urged adults to get vaccinated and comply with public health guidance to protect children and ensure schools can remain open. The state has also discouraged schools from offering extracurricular activities and encouraged families with school-age children to limit nonessential interaction with people outside their households.

“We all play a part in reducing community spread of this virus so our kids can have the best chance at a safe and normal school year,” Brown said at a news conference.

For much of the last school year, students in many states were learning from home or attending in-person classes under strict mitigation protocols. It was unclear how rapidly the virus would spread under normal classroom conditions, but recent data suggest transmission could be prevalent if precautions are not taken.

A Centers for Disease Control and Prevention report released last week detailed an outbreak at a Marin County, California elementary school in May where one unvaccinated teacher was linked to 26 infections among students and their family members. The school had an indoor mask mandate in place, but the teacher read aloud unmasked on several occasions.

A survey released last week by the National Parent-Teacher Association found only one-quarter of K-12 parents felt very comfortable sending their children back to classrooms this fall, and half preferred hybrid or virtual options. In addition to fear of children contracting COVID-19, parents cited the potential disruption of a return to remote learning after the school year begins as a top concern.

In a recent USA Today/Ipsos poll, parents expressed greater concerns about virtual education than they did last year. While about two-thirds favored a return to full-time in-person classes, similar percentages also supported mandates for students and teachers to wear masks and vaccination requirements for all who are eligible.

“Even though there are some government leaders locally who are trying to push back on that, we've got to get the school system masked in addition to surrounding the children with vaccinated people,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN Tuesday. “That's the solution."

Masks and vaccines have become heavily politicized in many communities, and school board meetings on implementing restrictions have grown hostile and, in some cases, violent. Theilen said schools should be able to remain open and avert outbreaks if they layer safeguards like masks, vaccine requirements, improved ventilation, and keeping students in cohorts, but each district needs an individualized response.

“It’s hard to give blanket guidance because policies are so different,” she said.

There are alternatives to quarantines and closures once cases emerge. Massachusetts has instituted a program in which students and staff who have been in close contact with an infected person can take rapid tests every morning for at least five days and continue attending school if they test negative. Similar guidance was issued recently by officials in the United Kingdom and Denmark.

Theilen acknowledged school administrators face difficult decisions if virus cases spike in their communities, and most children do recover relatively quickly from COVID-19. However, the increase in cases among children means cases resulting in serious symptoms are also rising, and some pediatric hospitals are already overwhelmed without a new wave of school-related infections.

“We are already at a point in a lot of places where we are at risk of not being able to provide adequate care for the number of children we’re seeing,” she said.

Forcing children back into virtual learning carries risks, as well, and the damage incurred could exacerbate existing inequities in the education system. A recent study found Black, Hispanic, and low-income children were most likely to experience mental health problems as a result of school closures.

Amid the delta-driven COVID-19 surge, the cost-benefit calculation on in-person learning varies from child to child, and Theilen said school policies should reflect that, possibly by offering a virtual option alongside in-person classes. Unexpected quarantines and closures can create strains on families too, but they might be unavoidable if infections among children continue to rise.

“This is a very fluid situation,” she said.