While federal officials warn of a potential fourth wave of COVID-19 infections, Michigan has emerged as one of the most urgent critical points, with an average daily infection five times greater than six weeks ago.
New data from the Michigan Department of Health and Human Services show that this dramatic increase is largely due to the increase in cases among children and adolescents.
According to state data, since February 19, the daily average of new cases of COVID-19 among children under 10 years of age has increased by 230%, more than in any other age group. The second largest increase in infections occurs in the 10 to 19 age group, where cases have increased by 227%. The trends in these groups surpass those of the state as a whole.
The increase in cases among children is evident across the country. In Minnesota, people under the age of 20 accounted for almost a quarter of the cases reported in March, down from less than 15% at the end of February. Similar trends have also been observed in other states, including Illinois and Massachusetts. According to the most recent data from the American Academy of Pediatrics, more than 64,000 new cases in children were reported across the country between March 18 and 25, the highest weekly total in a month.
According to doctors and infectious disease specialists in Michigan, 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 linked by location and time) came from K-12 schools or youth programs. But Dr. Natasha Bagdasarian, a senior public health physician in the Michigan Department of Health and Human Services, says social gatherings after sporting events for young people are also contributing to the spread.
“If everyone is taking off their mask and going out to dinner to celebrate a big victory, all of these precautions will be discarded,” she said. “So, really, that seems to have driven this increase.”
The state allowed schools to resume contact sports on February 8, but testing was not mandatory for all sports. More than a month later, she adjusted that policy to require testing for all sports, regardless of whether they are in contact or not, a change that will take effect on Friday. Bagdasarian says that, like other mitigation measures, this change has met with resistance.
While children are usually less risk for severe cases of COVID-19, some suffered serious illness. Some children develop a condition called multisystemic inflammatory syndrome in children (MIS-C) after infection, a rare condition that can affect the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs. On March 1, more than 2,600 cases were reported across the country, with 33 deaths.
Doctors in Michigan 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 his hospital had three cases of MIS-C in the ICU last month and eight in total this year. He said that MIS-C cases usually delay infections 2 to 6 weeks from the peak, fueling concerns that more are on the way.
One of the three patients with MIS-C at Beaumont Royal Oak in March was Juliana Elkhoury, 4, who was in the ICU for six days. 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 cold, until they increased, including a persistent rash.
“It was a really scary experience,” said Juliana’s mother, Michelle, fighting back tears. “It was a hard thing to go through with your child that you just always want to protect and not see him in the ICU with tubes attached everywhere and going through it.” Both parents encouraged others to rethink whether a social activity is essential and worth the risk.
In recent days, federal health officials have said that while the end of the pandemic may be near, now is not the time to loosen restrictions, specifically to mask mandates. The recent rise in infections led to a vehement appeal earlier this week by the CDC’s Director, Dr. Rochelle Walensky, who warned of a sense of “imminent destruction”.
“We cannot afford to inaction,” she said.
While officials are concerned about the increase in pediatric cases and their contribution to the spread of the community, research on COVID-19 vaccines for children is progressing. Preliminary data from Pfizer showing that its vaccine is fully effective in children aged 12 to 15 years is a significant sign of hope. All three vaccines approved in the United States have tests in progress on children, with the expectation 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 of achieving collective immunity,” she said.
Freij noted that, in the meantime, it is important for adults to overcome any hesitation and decide to make the injection.
“Our health is linked. We are together and we fall together,” he said. “And I think that people should perhaps let go of some deeply held beliefs and maybe try to help those around them.”