Many governors in the USA are insisting that they cannot mandate vaccines or mask usage (as in GA), or are actively obstructing localities that try to do so (FL and TX). Their claims rely on rampant misinformation that kids do not get COVID-19 – or that if they do, they get very mild cases and do not spread it easily, and rarely do they die from it. This was questionable earlier this year with the initial variants and has become very misleading in the last two months as the extremely contagious and ferocious Delta variant has spread to constitute 99% of all cases in the USA.
It is increasingly clear that the Delta can and does seriously infect school children, especially those under 12 who cannot be vaccinated yet. Recent anecdotal stories from Florida have raised alarm and now strong statistical evidence has emerged that reopening schools without mitigation measures may be extremely dangerous to the health and futures of millions of kids while also encouraging the continued spread of the SARS-CoV-2 among all Americans.
The table below from the Florida Department of Health (FL-DOH) weekly report captures the case trend by age group in FL over the period of 7/29 – 8/19, a period when many schools began to reopen in FL. Columns 2-4 show the weekly case counts per 100,000 people for the weeks ending in 8/19, 8/12, and 8/5. These are all extremely high although the over 65 group is below average due to their well-vaccinated status (85%). The last two columns show the percent change from week to week. As expected cases were still soaring in the period from 8/5 – 8/12 for every age group with as high as a 23% increase for the under 12 age group. With schools reopening the virus has continued to surge for that age group – up by 22% for the week 8/12 – 8/19. Middle school and high school student infections grew by 16%. Interestingly, this wave appears to have peaked for everyone else. This is somewhat expected since Delta surges are extremely contagious and fast-growing but they also tend to burn out rapidly after reaching a peak infection of about 100 per 100,000 per day. At this stage, exponential growth stops as it did in the UK.
What about the more dangerous outcome of Delta – how fatal is it? The answer is slowly beginning to emerge as deaths take 2-4 weeks after infection to resolve and then several more weeks to be reported. The following table from FL-DOH shows that the case fatality rate (CFR = deaths/cases) from COVID-19 is highly age-sensitive with a CFR about 100 times higher for the oldest group (>65 yrs old) than the younger groups (<30 yrs old) over the 19-month span of the pandemic in Florida (column 4). However, the strong age dependence has evolved with the arrival of Delta. Death counts and death rates have increased for all age groups but most significantly for the young. For those age16-29 years old, the lagged CFR [=deaths/(cases from 3 weeks prior)] has increased from 0.03% to 0.17%, or nearly 6-fold. For middle-aged adults 30-49 years old, it has more than doubled. Overall CFR has remained near the life-to-date value of 1.4%. We need to accumulate more data to ascertain how much deadlier the Delta is than the original and earlier variants. As more people get vaccinated, we expect the CFR to improve. Unvaccinated kids and young adults will remain big carriers of the disease unless schools adopt stronger mitigation measures and they will also serve to lower the overall CFR.
This early data makes it clear that Florida’s current wave could have peaked already if the governor had not poured more fuel -misleading information – on the fire and supplied more kindling – kids. Moreover, kids are much more likely to die from Delta than from the original SARS-CoV-2. Along with the uncertain but potentially debilitating effects of Long-COVID, this makes the Delta variant a major threat not only to the wellbeing of millions of children but also to every Floridian. Prolonging the contagion increases the possibility of even more dangerous variants developing in millions of Americans that continue to be infected each week.