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Child COVID-19 Cases, School Outbreaks Spike in Run-up to Fall

In the last few days, school districts in Georgia and Indiana have been forced to quarantine more than 1,000 students following outbreaks of the novel coronavirus, and a new report from the American Academy of Pediatrics suggests this may be only the beginning as schools begin to reopen amid high community infection levels of the virus that causes COVID-19.

The AAP and the Children's Hospital Association analyzed data on COVID-19 infection rates in 49 states, New York City, Washington D.C., Puerto Rico, and Guam. They found that of the more than 380,000 total COVID-19 cases reported so far among children, nearly 180,000 have been reported from July 9 to August 9—a 90 percent jump within a month. That represents an infection rate of 501 for every 100,000 children.

In more than half of states, at least 1 in 10 people with COVID-19 is a child or adolescent.

These results come with some big provisos. For one thing, children still only made up 3 percent to 12 percent of all those tested for COVID-19 in the states. That may help to explain why children accounted for only 2 percent of all COVID-19 cases in April, but 7 percent by the start of July and more than 9 percent of all cases now. 

And states are nowhere near on the same page with how they define and collect data on child infection rates. While a majority of states consider those 18 and under as "children," Utah and Florida count only those ages 14 and younger, while Alabama counts those up to 24. Moreover, Texas only has age information for about 8 percent of its cases, and New York only includes age for cases in the Big Apple. Both California and Florida have had testing problems, due to computer issues in the Golden State and hurricanes in the Sunshine State. 

Uncertainty Over Child Infectiousness

In Georgia, where more than 900 students were sent into quarantine this week after a coronavirus outbreak in Cherokee County school district, the state health department reports that older adolescents and college-age students had the highest cumulative number of cases, but middle and high school students had nearly as many total positive cases of COVID-19 as 70-somethings, as the chart below shows:

Georgia.JPGYet, in Georgia and nationwide, K-12 and college-age students are the least likely age groups to experience severe symptoms from the disease, including hospitalizations and deaths. The AAP found that even as the percentage of child coronavirus cases rose from spring to summer, the percentage of child COVID-19 cases that led to death fell, from .06 percent in May to .02 percent in August. Only 1.6 percent of all child coronavirus cases required hospitalization.

Of course, child infection and illness isn't the only calculation for school reopening, particularly when a third or more of teachers fall in higher-risk groups for coronavirus infections. Evidence has been mixed about how easily children can transfer the disease, though recent studies have suggested high school-age students may be more likely to pass along the virus than elementary-age students. 

Chart Source: Georgia Department of Health

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