The Marin County, Calif., elementary school had been conscientious about following covid-19 protocols. Masks wererequiredindoors, desks were spaced six feet apart, and the students kept socially distant. But the delta variant found an opening anyway.
On May 19, one teacher, who was not vaccinated against the coronavirus, began feeling fatigued and had some nasal congestion. She dismissed it as allergies and powered through. While she was usually masked, she made an exception for story time so she could read to the class.
By the time she learned she was positive for the coronavirus two days later, half her class of 24 had been infected — nearly all of them in the two rows closest to her desk — and the outbreak had spread to other classes, siblings and parents, including some who were fully vaccinated.
“The mask was off only momentarily, not an entire day or hours. We want to make the point that this is not the teacher’s fault — everyone lets their guard down — but the thing is delta takes advantage of slippage from any kind of protective measures,” Tracy Lam-Hine, an epidemiologist for the county, said in an interview.
The case study, published by the Centers for Disease Control and Prevention and highlighted by CDC director Rochelle Walensky during a briefing on Friday, highlights the potential danger for children under the age of 12 — the only group in the United States ineligible for coronavirus vaccines as a hyper-infectious variant tears across the country.
Just this month in Brevard County, Fla., 1,623 children were infected and more than 8,000 students were quarantined. And in the Atlanta area, thousands of positive cases were confirmed in schools with 23,000 students and staff have been quarantined. The situation has turned the nation’s schools into ideological battlegrounds — with one angry parent ripping off a mask from a teacher’s face in a Texas school this month, and parents both for and against masks filing lawsuits against their children’s school districts.
Without concerted efforts to curb delta’s transmission, things are likely to get worse in coming months. A simulation posted this month by a CDC-funded lab predicted that in elementary schools without either masks or regular testing, more than 75 percent of children might be infected with the coronavirus in the first three months.
The delta variant-fueled surge has put new pressure on the Food and Drug Administration to authorize the vaccine for younger children as soon as possible. It has thrown school reopening plans into disarray, with some officials scrambling to impose vaccine mandates for staff, as well as universal mask mandates. And it has frightened and bewildered many parents, unsure how to protect their kids.
“It’s hard to put our heads around this,” said Julie Swann, an expert in mathematical modeling at North Carolina State University who leads the team that published the school transmission study and a mother to a 10-year-old. “As parents, we are having to wrestle with these really hard notions of expected risk.”
Vaccines for children ages 5 to 11 had been widely expected to be available in the early fall, but to the surprise of many, federal regulators asked vaccine companies in late July to double the number of trial participants to include several thousand more children. The FDA is seeking to better understand the vaccines’ link to a rare but potentially serious inflammation of the heart muscle known as myocarditis and pericarditis that has predominantly affected younger males, and to learn whether it might affect younger children as well.
National Institutes of Health Director Francis Collins and vaccine makers have indicated that the expansion of the pediatric testing means a vaccine for younger children is unlikely before the end of the year, or perhaps even early 2022.
That forecast has spurred alarm among some public officials and health providers, with more than 180,000 new child covid-19 cases confirmed in the week ended Aug. 19 — an up to 20-fold increase over weeks in June when summer breaks began.
The American Academy of Family Physicians warned that “the risk for severe and long-lasting impacts on health outcomes in unvaccinated children is increasing.”
And the American Academy of Pediatrics has urged the FDA to use a two-month follow-up time frame for safety studies rather than six months, which would “significantly hinder the ability to reduce the spread of the hyper infectious covid-19 delta variant among this age group.”
“In our view, the rise of the delta variant changes the risk-benefit analysis for authorizing vaccines in children,” AAP President Lee Savio Beers wrote in a letter, urging the agency to make the shots available for younger children “as swiftly as possible.”
The FDA said it could not comment on its discussions with manufacturers but stressed that it is working to “ensure the number of participants in clinical trials are of adequate size to evaluate a product’s safety and effectiveness in the intended population.”