Guidance from the Centers for Disease Control and Prevention (CDC) is clear: it recommends universal indoor masking in schools for all children ages two and up, as well as staff, teachers, and visitors, regardless of vaccination status. The American Academy of Pediatrics (AAP) is similarly clear in its recommendation that all children two and over engage in universal masking indoors at school.
Increasing Rates of COVID-19 in Children
The summer 2021 surge in COVID-19 cases, despite widespread vaccination in the U.S., is particularly concerning for those focused on child health. Several factors have coincided to create a crisis of the spread of COVID-19 through a more infectious mutated strain (the Delta variant)–the continued low adult vaccination rate in parts of the country; the nuances of vaccinating children for COVID; and the pending start of a new school year, mostly in-person.
The rates of children now testing positive for COVID-19 are increasing, representing a larger share of overall cases than it has at any previous time in this pandemic; severe cases resulting in hospitalizations and deaths are still rare, but experts warn that this wave represents a stronger threat to children than previous waves, and data in many states show a recent increase in hospitalizations for children.
Since the beginning of the pandemic to the end of July, a total of about 4.2 million children have been documented to have COVID-19. Children represent 14 percent of all those who have contracted COVID in the U.S. since the beginning of the crisis; i however, from July 22 to 29, children represented 19 percent of new COVID cases–see graphic below.
In the last week of July, 72,000 new pediatric cases of COVID were documented; just weeks before, only 39,000 new cases were reported weekly.
Media reports show that the situation has worsened since in many states, including Alabama, Arkansas, Florida, Indiana, Louisiana, Missouri, South Carolina and Texas. Pediatricians are also reporting a rise in cases of Respiratory Syncytial Virus (RSV), an often mild respiratory ailment that can be particularly dangerous for young children. RSV rates usually increase during the winter cold and flu season; experts attribute this summer surge to people resuming usual activities that had previously been curbed by COVID closures.
Some percent of children also develop “long COVID”–symptoms which persist 5 weeks after infection. It is difficult to determine the exact rate of long COVID in adult and child populations–some estimates suggest 10 percent of children develop it, though others are higher or lower. In a recent New York Times piece, experts highlight symptoms ranging from confusion similar to the experience of a concussion; “post-exertional malaise”; lightheadedness; and racing heart rates in some situations. Long COVID seems to be more common in adolescents who had contracted the virus than younger children, which may be related to their unique development phase; it is thought to be less common for children than for adults.