While federal officials warn of a potential fourth wave of COVID-19 infections, Michigan has emerged as one of the most pressing hotspots, with average daily infections now five times higher than six weeks ago.
New data from the Michigan Department of Health and Human Services shows that this dramatic increase is largely due to growing cases among children and adolescents.
According to state data, since February 19, the new average daily cases of COVID-19 among children under 10 have increased by 230%, more than any other age group. The second highest increase in infections is in the age group 10-19, which saw cases with 227%. The tendencies of these groups exceed that of the state as a whole.
The increase in the number of 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, up from less than 15% at the end of February. Similar trends have been observed in other states, including Illinois and Massachusetts. According to the latest data from the American Academy of Pediatrics, more than 64,000 new cases in children were reported nationally between March 18 and March 25, the highest weekly total in a month.
According to doctors and experts in infectious diseases in Michigan, much of the increase in pediatric cases may be related to the reopening of schools and sports for young people. State data show that more than 40% of new outbreaks (defined as two or more cases related to place and time) came from either K-12 schools or youth programs. But Dr. Natasha Bagdasarian, chief public health physician at Michigan’s 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, then all those precautions come out the door,” she said. “So, indeed, this seems to have driven this growth.”
The state allowed schools to resume contact sports on February 8, but testing was not mandatory for every sport. More than a month later, it changed this policy to require testing for every sport, whether contact or non-contact, a change that will take effect Friday. Bagdasarian says that, like other mitigation measures, this change has received a push.
While children are generally at lower risk for severe cases from COVID-19, some suffered serious illness. Some children continue to develop a condition 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 have been reported nationwide, with 33 deaths.
Doctors in Michigan are worried 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 his hospital had three MIS-C cases in the ICU last month and eight in total this calendar year. He said MIS-C cases normally delay infections by 2 to 6 weeks from the peak, fueling concerns that more are on the way.
One of the three MIS-C patients at Beaumont Royal Oak in March was 4-year-old Juliana Elkhoury, who was in intensive care for six days. Her parents said they did not have much information about MIS-C before their child was admitted to the emergency room, adding that the early symptoms looked like a normal headache until they grew up, including a persistent rash.
“It was a really scary experience,” said Julella Michelle’s mother, fighting back tears. “It was a hard thing to do with your child that you just want to always protect and not see in the ICU with tubes connected everywhere and going through it.” Both parents urged others to rethink whether a social activity is essential and worth the risk.
In recent days, federal health officials have been convinced that while the end of the pandemic may be near, now is not the time to loosen restrictions, especially masking warrants. The recent rise in infections has led to a passionate plea earlier this week from CDC Director Dr. Rochelle Walensky, who warned of feelings of “imminent condemnation.”
“We don’t have the luxury of inaction,” she said.
While officials are concerned about the growing number of pediatric cases and their contribution to the community, research on COVID-19 vaccines for children is making progress. Preliminary data from Pfizer showing its vaccine are fully effective in children between the ages of 12 and 15 is a significant sign of hope. All three vaccines approved in the US have ongoing studies in children, with the expectation that vaccinations in some age groups can begin before the fall school year. Bagdasarian says it is imperative that vaccines become available as soon as possible.
“Getting a vaccine for that pediatric age group is the best chance of achieving immunity from the herd,” she said.
Freij noted that in the meantime, it is important for adults to overcome any hesitation and decide to receive the shot.
“Our health is linked to each other. We sit together and fall together,” he said. “And I think people should relax with some strong beliefs and maybe try to help those around them.”