The long-awaited start of the new school year coincided with a wave of COVID-19 cases driven by the highly contagious delta variant, creating plenty of anxiety over what would happen when millions of California kids gathered in classrooms, many for the first time since March 2020.
So what’s the story with schoolkids since then?
The good news is overall case and hospitalization rates in California and around the country have been declining since a summer peak in late August. But case rates among children have come down more slowly than the adult population, and kids now make up a greater share of infections.
“It is striking that the cases have shifted substantially towards children and adolescents since the beginning of the school year in mid- to late August,” said George Lemp, an infectious disease epidemiologist who has been tracking California demographic trends in the pandemic. “Schools may need to double down on COVID-19 safety protocols.”
Some districts are considering just that sort of step. West Contra Costa Unified’s school board next week will consider requiring all eligible teachers, staff and students 12 years and older to be fully vaccinated, becoming possibly the first in the Bay Area to do so. Oakland Unified will consider a similar requirement.
Here’s a look at the numbers.
Case rates:
Weekly infection rates for all age groups in California hit a low in June, spiked in August to levels not seen since late January, and have fallen since, according to the U.S. Centers for Disease Control and Prevention. Weekly case rates among California adults began a downward trajectory before those among kids, who according to the most recent data still had higher rates than adults, at about the same level as in February.
As of Sept. 11, the CDC reported that California’s weekly infection rates per 100,000 people were 84.7 for children up to age 4, 169.7 for ages 5-11, 176.2 for ages 12-15 and 191.5 for 16-17-year-olds. Those numbers are generally better than the national rates, which were 89.6 for kids up to age 4, 165.7 for ages 5-11, 192.3 for ages 12-15 and 198.8 for 16-17-year-olds.
Lemp, former director of the California HIV/AIDS Research Program at the University of California Office of the President, said his analysis shows that while kids under 18 accounted for about 15% of all state cases in July, that shot up to about 26% last week.
Nationwide, the American Academy of Pediatrics and Children’s Hospital Association reported that the number of child COVID-19 cases added each week hit its highest level the week ending Sept. 2, with 251,781 across 49 states that reported, topping the 211,466 the week ending Jan. 14. That number has since dipped to 243,373 the week ending Sept. 9.
Severe disease:
As delta-driven cases multiplied across the country over the summer, newscasts were filled with images of children in hospital beds with oxygen tubes down their throats and pediatricians sounding alarms. But are more kids really ending up in hospitals?
Hospital rates in kids did rise significantly along with infections over the summer — a Sept. 10 CDC report found hospitalization rates among U.S. children and adolescents rose nearly five-fold from late June to mid-August. But rates have declined since. And unlike infection rates, child hospitalization rates remain far below those of adults, whose risk of serious illness increases with age.
As of Sept. 14, the CDC’s rate of new hospital admissions per 100,000 people in California was 0.16 for kids under 18, compared to 0.25 on Aug. 26. That is much lower than the national rate of 0.47 for kids under 18.
The local picture:
COVID-19 outbreaks have closed some California schools in northern cities with lower vaccination rates, including Oroville, Susanville and Red Bluff. But Bay Area schools and local health officials have reported only small numbers of cases among students and staff since most of the state’s 6 million public school kids returned to classes in mid-August. And most of the infections are believed to have been transmitted outside of school.
San Francisco health officials last week reported that cases among kids under 18 have remained steady — under 20% of total cases throughout the pandemic — even during the latest infection spike driven by delta. Since March 2020, there have been a total of 13 San Francisco kids hospitalized with the disease at city hospitals, and none as of last week.
San Francisco Unified School District last week reported 227 cases out of nearly 52,000 students and 10,000 staff, and city health officials said private, parochial and charter schools reported 61 cases out of nearly 22,500 students and 5,000 staff, the vast majority occurring outside of schools.
“To date, our data demonstrate that cases among San Francisco residents under age 18 have remained low and stable throughout the pandemic and that schools are low-risk settings when the proper safety protocols are followed,” the city’s public health department said in a statement.
Health officials in surrounding counties said they’ve seen much the same since kids headed back to campus. In Alameda County, the case rates per 100,000 people have been falling for all since a late-August peak, though those among children ages 5-14 remain higher than the overall rate.
But there haven’t been many COVID-19 hospitalizations, with fewer than 10 pediatric intensive-care cases at any given time in county-area hospitals. Since June, there have been 25 reported hospitalizations of Alameda County children who have tested positive for the virus, although it’s unknown whether COVID symptoms were the primary reason they were there.
“Hospitalizations have remained low, and are decreasing,” county health spokeswoman Neetu Balram said.
Santa Clara County health officials in an update to the board of supervisors Tuesday said case rates have been falling for all age groups in recent weeks, including children. The current case rate per 100,000 people among kids under 12 who can’t be vaccinated is 15, twice the 7.5 rate among the fully vaccinated. But both are far lower than the 45.4 rate among people age 12 and older who have not gotten the shots.
Dr. John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley’s School of Public Health, said “the fact that this decline has been seen in the face of schools reopening is very reassuring.”
“Still,” Swartzberg said, “delta is a formidable foe and anything that we do to relax our vigilance will likely result in a resurgence.”
Staff Writer Harriet Rowan contributed to this report.