While federal officials warn of a potential fourth wave of COVID-19 infections, Michigan has become one of the most pressing hotspots, with an average daily infection now five times higher than six weeks ago.
New data from the Michigan Department of Health and Human Services shows that this dramatic wave is largely due to cases growing among children and teens.
According to state data, as of Feb. 19, the new daily average of COVID-19 cases among children under 10 jumped 230%, more than any other age group. The second largest increase in infections is in the 10 to 19 age group, which saw cases increase by 227%. The trends of these groups exceed that of the state as a whole.
The increase in cases among children has been evident in other parts of the country. In Minnesota, people under the age of 20 accounted for nearly a quarter of cases reported in March, down from 15% in late February. Similar trends have also been seen in other states, including Illinois and Massachusetts. According to the latest data from the American Academy of Pediatrics, more than 64,000 new cases were reported in children nationwide between March 18 and 25, the highest weekly total for a month.
According to Michigan doctors and experts in infectious diseases, much of the increase in pediatric cases may be related to the reopening of schools and youth sports. State data show that more than 40% of new outbreaks (defined as two or more cases related by place and time) have come from K-12 schools or youth programs. But Dr. Natasha Bagdasarian, a senior public health physician with the Michigan Department of Health and Human Services, says social gatherings after youth sports events also contribute to the spread.
“If everyone takes off their mask and goes out to dinner to celebrate a big win, all those precautions come out the door,” he said. “So it really seems like this has driven that increase.”
The state allowed schools to resume contact sports on Feb. 8, but testing was not mandatory for all sports. More than a month later, this policy was amended to require testing for all sports regardless of whether it is a contact or not, a change that will take effect on Friday. Bagdasarian says that, like other mitigation measures, this change has received a boost.
While children in general are less risk of serious cases of COVID-19, some have suffered serious illness. Some children develop a disease called multisystem inflammatory syndrome in children (MIS-C) after infection, a rare condition that can affect the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. As of March 1, more than 2,600 cases had been reported nationwide, with 33 deaths.
Michigan doctors are concerned that the current increase in COVID infections will lead to an increase in this syndrome in the coming weeks and months. Bagdasarian says anecdotally, this is already happening.
Beaumont Health, Michigan’s largest health care system, says it has received an increase in MIS-C cases. Dr Bishara Freij, head of pediatric infectious diseases at Beaumont Royal Oak, says her hospital has had three MIS-C cases in the ICU last month and eight in total this calendar year. He said MIS-C cases are usually delayed in infections by 2 to 6 weeks from their peak, fueling concerns that are more on the way.
One of three patients with MIS-C at Beaumont Royal Oak in March was 4-year-old Juliana Elkhoury, who spent six days in the ICU. His parents said they had little or no information about MIS-C before their son was admitted to the emergency room, adding that the first symptoms looked like a normal headache, until they increased, including a persistent rash.
“It was a really scary experience,” said Michelle, Juliana’s mother, struggling with tears. “It was a hard thing to happen to your child that you just want to always protect and not see them in the ICU with pipes connected everywhere and go through it.” Both parents urged the other to rethink whether a social activity is essential and worth the risk.
In recent days, federal health officials have been constant that while the end of the pandemic may be near, now is not the time to relax restrictions, specifically masking mandates. The recent rise in infections sparked a passionate petition earlier this week by CDC director Dr. Rochelle Walensky, who warned of the feeling of “impending doom.”
“We don’t have the luxury of inaction,” he said.
While officials are concerned about the increase in pediatric cases and their contribution to community outreach, research on COVID-19 vaccines for children is advancing. Preliminary data from Pfizer showing that their vaccine is fully effective in children aged 12 to 15 are a significant sign of hope. All three U.S.-approved vaccines have ongoing trials in children, with hopes that vaccinations in some age groups may begin before the fall school year. Bagdasarian says it is imperative that vaccines be available as soon as possible.
“Getting a vaccine for this pediatric age group is our best chance to achieve herd immunity,” he said.
Freij noted that in the meantime, it is important for adults to overcome any hesitation and decide to fire.
“Our health is tied up. We are together and we fall together,” he said. “And I think people might have to relax into some firm beliefs and maybe try to help those around them.”