The last two weeks of July saw nearly 100,000 new cases in school-age kids and teens.

The last two weeks of July saw nearly 100,000 new cases in school-age kids and teens.

Enlarge/ NEW YORK CITY – AUGUST 08: A kid wears a face mask while riding a bicycle in Madison Square Park.
107 with 77 posters participating
View more stories
The US is currently debating if and how schools can be reopened safely during the COVID-19 pandemic while dealing with a cloud of presidential misinformation. The debate is made difficult by a mix of ambiguous data about how much children contribute to the spread of the virus and some dramatic instances of the pandemic spreading within schools. Given the confusing and sometimes anecdotal evidence, it can be difficult to get a decent picture of how children are affected by SARS-CoV-2 and COVID-19.
Fortunately, the American Academy of Pediatrics and the Childrens Hospital Association have decided to provide some perspective. The two groups have been gathering state-level data on a number of stats in children and compiling it to produce a national picture. While there are definitely limitations to the data, the picture it paints is one in which the national surge in infections is being paralleled by a surge in cases in children, with nearly 100,000 new cases in the last two weeks of July.
Data and its limitations
The American Academy of Pediatrics and the Childrens Hospital Association have been analyzing childhood infections at weekly intervals, allowing researchers to track the pandemic’s progression in the United States. Their most recent report covers up to July 30, and they have data going back to mid-April.
That data, however, comes from individual states, which don’t follow a standardized system for reporting. As a result, there are quirks aplenty, and the quality of the data may vary depending on the question being asked.
For symptomatic COVID-19 cases, the data is quite good: 48 states report the age of affected individuals. Texas only provides data on a portion of its population (about 8 percent), while New York doesn’t provide data. New York City, on the other hand, does, which means nearly half the Empire State’s citizens are included. Things go downhill from there, however. Only 44 states and New York City report the age of people who died of COVID-19, 20 states plus NYC report the age of hospitalized patients, and just eight states report the age of those who receive a positive test for the virus.
The complications don’t end there, however, as states differ in how they break down their age categories. Most put the dividing line between adult and child somewhere that’s a close approximation of the end of public schoolingtypically at 17, 18, or 19 years of age. Florida and Utah, however, divide cases as younger or older than 14 years, while South Carolina and Tennessee place a divider at 20 years of age. The impact of this appears to be mixed. Florida, which ranks second in total confirmed SARS-CoV-2 tests, also ranks second in childhood COVID-19 cases, despite its relatively young cutoff. The two states with the older cutoffs (South Carolina and Tennessee) are outside the top-10 states with the most positive tests, but they do rank within the top 10 in terms of childhood cases.A surge in cases
Focusing on the higher-quality data first, the report says that since mid-April, the United States has seen a total of about 340,000 childhood cases, with half of the 50 states having at least 5,000 cases. This means that children account for 8.8 percent of all US cases. As had been seen elsewhere, children don’t often get very severe COVID-19 symptoms. Twenty states reported no COVID-19 deaths in children, with children accounting for only 0.06 percent of the total deaths due to COVID-19that’s 86 deaths total.
The report compares the number of cases reported now to where we were at two weeks prior to the current data. It finds that there have been over 97,000 new childhood cases in that period. That was enough to drive the total number of childhood cases as a percentage of all COVID-19 cases from 8.0 to 8.8 percent, continuing an ongoing trendfour weeks earlier, children accounted for only 7.1 percent of the cases, while in early June they were only 5.2 percent.
From there, however, we get into less reliable data. Information on hospitalizations is only available from 20 states and New York City. This data shows that the rate at which children with COVID-19 symptoms are hospitalized has been dropping steadily, from a high of 3.8 percent in May to a 2 percent rate at present. But again, the growing population of children with COVID-19 symptoms means that an increasing percentage of the total hospitalizations are kids. All told, we know of nearly 2,700 children that have been hospitalized due to COVID-19 symptoms, with that number rising by 600 over the past few weeks.
With so few states offering age data on testing, the results were extremely variable. On the low side, West Virginia saw a positivity rate in childhood tests of only 3.6 percent. On the other end of the scale, Arizonawhich is suffering from a major outbreaksaw a positivity rate of nearly 18 percent in children.
State-by-state
There was a lot of state-by-state variation in symptomatic cases, as well. Cumulatively, most of the states with high childhood cases are the ones that saw major outbreaks, like California, Arizona, and Florida. But in terms of recent developments, states like Oklahoma and Missouri saw the highest percentage increase in symptomatic childhood cases over the last two weeks. These differences emphasize that the pandemic remains a dynamic problem, one where local conditions can cause dramatic changes.
The big picture from this report is at least partly consistent with what we’ve heard previously. Children remain a small fraction of the most severe cases; with over 160,000 dead in the US, less than 100 are known to be children. But that certainly doesn’t mean children are immune to COVID-19, and the boom in total cases has been accompanied by an increase in the total fraction of cases that affect those under 20 years old. And all of that is taking place before most schools have opened, a situation that could put a much larger fraction of children at risk.
The final point this report underscores is that the current data-tracking system in the US is badly hampered by state-to-state variations in reporting. If we want to have a clearer picture of what’s going on with the pandemic in the childhood population, we’re going to have to start with standardizing the tracking of diagnoses and outcomes.

Share