As federal officials warn of a possible fourth wave of COVID-19 infections, Michigan has become one of the most urgent hot spots, with an average daily infections five times higher than six weeks ago.
New data from the Michigan Department of Health and Human Services shows that this dramatic increase is due in large part to the increase in cases among children and teens.
According to state data, since February 19, the daily average of new COVID-19 cases among children under 10 years of age increased 230%, more than in any other age group. The second largest increase in infections occurs in the age group 10-19 years, in which cases increased by 227%. The trends in these groups exceed those 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 made up nearly a quarter of the cases reported in March, down from less than 15% at the end of February. Similar trends have also been seen in other states, including Illinois and Massachusetts. According to the most recent data from the American Academy of Pediatrics, between March 18 and March 25, more than 64,000 new cases were reported in children nationwide, the highest weekly total in a month.
According to Michigan doctors and infectious disease experts, much of the increase in pediatric cases may be related to the reopening of schools and youth sports. State data shows that more than 40% of new outbreaks (defined as two or more cases linked by place and time) 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 sporting events are also contributing to the spread.
“If everyone takes off their mask and goes out to dinner to celebrate a great victory, then all those precautions are going out the door,” he said. “So really, this seems to have driven this increase.”
The state allowed schools to resume contact sports on February 8, but testing was not required for all sports. More than a month later, it changed that policy to require testing for all sports, regardless of whether it is contact or non-contact, a change that will take effect on Friday. Bagdasarian says that, like other mitigation measures, this change has been rejected.
While children are generally inof COVID-19, some have suffered . Some children develop a condition called multi-system 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 across the country, with 33 deaths.
Michigan doctors are concerned that the current increase in COVID infections will lead to a rise in this syndrome in the coming weeks and months. Bagdasarian anecdotally says that is already happening.
Beaumont Health, Michigan’s largest health care system, says it has seen an increase in MIS-C cases. Dr. Bishara Freij, head of Pediatric Infectious Diseases at Beaumont Royal Oak, says his hospital has had three cases of MIS-C in the ICU last month, and eight in total this calendar year. He said MIS-C cases typically delay infections 2-6 weeks from their peak, fueling concerns that more are on the way.
One of the three MIS-C patients at Beaumont Royal Oak in March was Juliana Elkhoury, 4, who was in the ICU for six days. His parents said they had little to no information about MIS-C before their son was admitted to the emergency room, adding that the first symptoms looked like a normal cold, until they escalated, including a persistent rash.
“It was a really scary experience,” Juliana’s mother Michelle said, fighting back tears. “It was hard to move on with his son who just wants to always protect and not see him in ICU with tubes hooked up everywhere and going through this.” Both parents urged each other to rethink whether a social activity is essential and worth the risk.
In recent days, federal health officials have insisted that while the end of the pandemic may be near, now is not the time to loosen restrictions, specifically to mask mandates. The recent surge in infections sparked a passionate plea earlier this week from CDC Director Dr. Rochelle Walensky, who warned of a sense of “imminent death.”
“We cannot afford inaction,” he said.
While officials are concerned about the increase in pediatric cases and their contribution to community spread, research on COVID-19 vaccines for children is progressing. Pfizer’s preliminary data showing that its vaccine is fully effective in children ages 12-15 is a significant sign of hope. All three vaccines approved in the US have ongoing trials in children, with the expectation that vaccines in some age groups may begin before the fall school year. Bagdasarian says it is imperative that vaccines are available as soon as possible.
“Getting a vaccine for that pediatric age group is our best chance to achieve herd immunity,” he said.
Freij noted that in the meantime, it’s important for adults to overcome any hesitation and decide to get vaccinated.
“Our health is linked. We stick together and we fall together,” he said. “And I think people should maybe drop some very strong beliefs and maybe try to help those around them.”