MIAMI – Over the past two weeks, Florida’s health department has reported a downturn in new cases of COVID-19 among nearly every adult age group while hospitalizations for the infectious disease also have declined — positive indicators that the state may have turned the corner on the latest wave of the pandemic.
Still, new cases and hospitalizations in Florida are at their highest since last winter, and for at least one group of Floridians, the pandemic is still surging: People under 20, who made up nearly 1 in 3 of all new COVID-19 cases during the week ending Aug. 26.
Overall, new cases among adults older than 20 were 13% lower for the week that ended Aug. 26 when compared with the week ending Aug. 12, according to the Florida Department of Health’s COVID-19 weekly situation report. But among Floridians ages 12 to 19, cases were up 45%, and for those younger than 12, cases rose a significant 58% during the same time period.
People under 20 made up nearly 1 in 3 of the 151,749 new COVID-19 cases reported in Florida for the week ending Aug. 26 compared with 1 in 5 of all new cases during the week ending Aug. 12.
Dr. Patrick Kenney, an infectious disease specialist with Cleveland Clinic Florida, said the rise in cases among young Floridians is “concerning because you know people are going back to school.”
Kenney said he has followed the rise and fall of caseloads throughout the pandemic, and that he is heartened by the recent 10% decline in the number of patients admitted daily to Cleveland Clinic Florida with COVID-19.
“This is encouraging,” he said.
But Kenney added that young Floridians have a low rate of uptake for the vaccine, which is not approved for children younger than 12. The vaccination rate among people 12 to 19 years old in Florida is less than 50%. Only one of the three vaccines, the one made by Pfizer-BioNTech, is approved for children 12 to 17 years old.
Schools starting, more testing
Kenney said he’s worried that with schools and colleges reopening, young people will become a key vector for transmission in households — one of the most likely places for spreading the virus that causes COVID-19.
“These individuals can go home and potentially spread the virus to their unvaccinated parents, grandparents, to younger siblings, or other children,” Kenney said. “And I have a fear that even though we’re seeing a decline now that in the coming weeks we could be seeing an increase in cases, most likely either in the unvaccinated or in the immune-compromised.”
Part of the reason for the increase in cases among young Floridians is the resumption of school and a rise in testing for COVID-19 among all age groups, said Jason Salemi, an epidemiologist with the University of South Florida. Parents whose children are quarantined due to exposure at school are likely to have their children tested, he said.
Because of the increase in testing, “Maybe cases we wouldn’t have picked up a month and a half ago, we’re picking up now,” Salemi said.
But even with an increase in cases among young Floridians, Salemi said, young people are at lower risk than older adults of developing severe illness and dying from the disease.
Still, Salemi noted that pediatric hospitalizations for COVID-19 increased slightly in Florida at the same time that hospitals reported a decline in inpatients and new admissions for the disease among adults.
As of Thursday, however, Florida had more patients hospitalized with COVID-19 than any other state, according to the Department of Health and Human Services’ hospital capacity dashboard, which showed 14,949 inpatients with a confirmed or suspected case of the disease.
Pediatric hospitalizations very high
The state’s pediatric hospitals reported 232 inpatients with confirmed or suspected COVID-19 on Sept. 2, second only to Texas, where hospitals reported 364 pediatric inpatients with the disease. But Florida led all states in the number of pediatric patients admitted with confirmed COVID-19 on the prior day — 70 on Sept. 1.
Kenney, the infectious disease specialist, said pediatric hospitalizations for COVID-19 are rising in many Southern states, not just Florida, and especially among children with chronic medical conditions. He attributes that rise to the delta variant, which the Centers for Disease Control and Prevention says is more than twice as contagious as previous variants of the virus.
He said the medical community is still learning about the virus that causes COVID-19 and about children’s vulnerability to the disease. Like the virus itself, the thinking has evolved.
“In the beginning of the pandemic, there was that notion that children do not get this, that they’re ‘immune’ to it,” Kenney said. “Honestly, what we’re seeing now is that kids, especially with the delta variant, they’re so much more contagious. Kids are out and socially interacting with more kids, and they’re potentially spreading this very rapidly.
“So we’re seeing these kids who have compromised immune systems or pulmonary issues like asthma,” he added. “They’re really, really not doing well.”
The best way to protect young people from COVID-19, Kenney said, is vaccination, if they’re eligible.
“People are staying out of the hospital and they’re not dying from this disease because of the vaccine,” he said.
Clinical trials are now underway to test the Pfizer-BioNTech vaccine in children younger than 12 as researchers study whether kids need different doses and sequencing of the shots. The Pfizer trial, which has enrolled 4,500 participants, is not scheduled to be completed until September 2023, though it’s not clear if or when the Food and Drug Administration could provide emergency use authorization for the vaccine in young children.
Until a vaccine is approved for kids under 12, Kenney said, the best protection will be difficult for adults to enforce, particularly in schools: social distancing, masking and frequent hand washing.
“Kids are going to be kids. They’re going to play. They’re going to socialize, and the amount of supervision that it requires to keep kids safe is high,” Kenney said.
As Florida hospitalizations begin to turn downward from a very high point, public health experts have begun to wonder whether the state’s pandemic wave has crested.
“We might be coming off a peak,” said Mary Jo Trepka, an epidemiologist with Florida International University. “If we didn’t have schools reopening and colleges reopening, I suspect we would continue to go down.”
Trepka said she will be watching the next month’s COVID-19 data very carefully. Labor Day is coming up, and many colleges have reopened or will be doing so soon. College football is also back, and more people will be gathering to watch sporting events.
“There’s a lot of opportunity for transmission” of the virus, Trepka said.
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