While federal officials warn of a possible fourth-wave 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 Department of Health and Human Services in Michigan shows that this dramatic increase is mainly due to cases among children and teens.
According to state data, the average daily new COVID-19 cases have risen 230% since February 19 since February 19, more than any other age group. The second highest increase in infections is in the age group 10 to 19 years, where cases increased by 227%. The trends in these groups exceed those of the state as a whole.
The increase in cases among children is evident elsewhere in the country. In Minnesota, people under the age of 20 accounted for nearly a quarter of reported cases in March, up 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 latest data from the American Academy of Pediatrics, more than 64,000 new cases were reported in children nationwide between March 18 and March 25, the highest weekly total in a month.
According to doctors and experts of infectious diseases in Michigan, a large part of the increase in cases of children can be linked 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 place and time) come from K-12 schools or youth programs. But dr. Natasha Bagdasarian, senior public health physician at the Department of Health and Human Services in Michigan, says social gatherings after youth sporting events also contribute to the spread.
“If everyone removes their mask and goes out to eat to celebrate a great victory, all the precautions will go out the door,” she said. “It seems to have driven this boom.”
The state allowed schools to resume contact on Feb. 8, but tests were not mandatory for every sport. More than a month later, it adjusted its policy to set tests for each sport, whether contact or non-contact, a change that takes effect Friday. Bagdasarian says that this change, like other mitigation measures, has been pushed back.
While children are usually at less risk of serious cases of COVID-19 some suffered serious illness. Some children 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 were reported nationwide, 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, it’s already happening.
Beaumont Health, the largest healthcare system in Michigan, says it has seen an increase in MIS-C cases. Dr. Bishara Freij, head of 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 usually delay infections by 2 to 6 weeks from their peak, causing concern that more are on the way.
One of the three MIS-C patients in Beaumont Royal Oak in March was 4-year-old Juliana Elkhoury, who was in the ICU for six days. Her parents said they had little or no information about MIS-C before their child was admitted to the emergency room, adding that early symptoms look like a normal cold, until they escalate, including a persistent rash.
“It was really a scary experience,” Michelle, Juliana’s mother, said, fighting back her tears. “It was a difficult thing to go through with your child that you always want to protect and not want to see in the ICU with tubes tied up everywhere and going through this.” Both parents encouraged others to reconsider whether a social activity is essential and worth the risk.
In recent days, federal health officials have been adamant that while the end of the pandemic may be near, now is not the time to weaken restrictions, especially mandates. The recent increase in infections earlier this week led to a passionate plea from dr. Rochelle Walensky, director of the CDC, who warned of a sense of impending doom.
“We do not have the luxury of idleness,” she said.
Although officials are concerned about the increase in cases of children and their contribution to the spread of the community, research on COVID-19 vaccines for children is progressing. Preliminary data from Pfizer showing that the vaccine is effective in children aged 12 to 15 years is an important sign of hope. All three of the vaccines approved in the U.S. have undergone trials with children, with the expectation that vaccinations in some age groups could begin before the fall school year. Bagdasarian says it is essential that vaccines be available as soon as possible.
“Getting a vaccine for that pediatric age group is our best chance of achieving herd immunity,” she said.
Freij noted that in the meantime, it is important for adults to overcome any hesitation and decide to get the chance.
“Our health is all stuck together. We stand together and fall together,” he said. “And I think maybe people should relax some strong beliefs and try to help those around them.”