WASHINGTON — As the school year draws near, children and teens represent a ballooning percentage of COVID-19 cases in the U.S. as the youngest Americans increasingly venture outside their homes and are able to get tested.
While the U.S. Centers for Disease Control and Prevention has long maintained on its website that those younger than 18 make up only 2% of cases, state data paint a much less rosy picture. California and Mississippi, for instance, are recording rates nearing 10% of overall cases. Florida has found that about a third of all children tested there are infected.
In response to questions from Bloomberg, the CDC cited a chart this week with data from the states showing children make up 6.4% of those infected, though information isn’t included on almost 1 million cases. The numbers are rising, epidemiologists say, as testing has become more available to those with mild or no symptoms, encompassing many of the pediatric cases, and as those under 18 are increasingly involved in social activities.
At the same time, there is enormous pressure building to reopen in-class schooling from parents who need to return to work, childhood development specialists and the Trump administration, which sees it as a linchpin for the economy in an election year. Others remain skeptical.
“I think we need to understand why that’s happening and what it means for the risk of this virus in kids,” said Jennifer Nuzzo, a senior scholar at the Johns Hopkins Bloomberg School of Public Health’s Center for Health Security. “Our understanding for how it affects kids is evolving.”
Virus data aren’t reported in a consistent manner across states. But publicly available databases show that in many cases the numbers are vastly different than what the CDC continues to say on the portion of its website meant to provide COVID-19 information to pediatric healthcare providers, a site that hasn’t been updated since May 29.
Regional authorities are also seeing the surge. Harris County, Texas, where Houston is located, is an epicenter of the recent rise in U.S. cases. There, those younger than 20 made up 11.4% of about 49,000 cases, according to the county’s public health department. Children up to age 9 represented 4.1%.
Studies have found that children tend not to suffer from severe coronavirus symptoms as often as adults, but there remain unknowns. They include the potential long-term effects of a COVID-19 infection, and at what rate students can transmit the virus to each other while in the classroom, as well as the effect on their teachers.
“Just because somebody doesn’t die from this doesn’t mean that something bad doesn’t happen to them,” said Jason Salemi, an epidemiologist at University of South Florida’s College of Public Health. “Think about cancer. A cancer could have a tumor developing over 10 to 20 years, and you don’t know.”
Florida’s schools are slated to reopen in the fall despite the surge of cases there and state reports that 31% of children tested there were positive.
Salemi, who helps run the CovKids Project, which collects data on cases in children and teens, said he supports schools reopening responsibly with robust plans in place to keep children safe, something he doesn’t think Florida is capable of right now.
The project has tracked 769 pediatric intensive-care unit admissions related to the virus across the U.S. since mid-March, and 66 deaths in those younger than 20. Some of the severe cases have resulted in a condition similar to Kawasaki disease, which can cause heart and circulatory problems.
Age data collected from state health departments by Bloomberg show that the oldest Americans now represent a lower percentage of infections than they did at the start of the outbreak. The surge in recent cases is led by the group most likely to have school-aged children, those in their 20s, 30s and up to their 50s in some states.
At the same time, the prevalence in children has risen as testing has become more available to those with mild or no symptoms.
“Without the testing, we were blind,” said Margaret Aldrich, director of infection control for the Children’s Hospital at Montefiore in the Bronx. Aldrich’s hospital has its own lab so it tests every child admitted and is able to turn around results in about six hours, a much different experience than the long wait times at testing sites around the country.
