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With school year underway, COVID-19 cases and hospitalizations rising for Illinois kids

Newly released federal and state data shows COVID-19 cases and hospitalizations climbing among Illinois children, along with outbreaks tied to schools, as the state tries to balance limiting the virus’s spread while keeping kids in class.

Since July, in all regions of the state, the number of confirmed infections for school-age children has climbed at least through early September, the most recent data available. Downstate regions have seen the biggest spikes. And childhood COVID-19 hospitalizations in Illinois — although still relatively rare — are nearing the levels seen at the peak of past surges.

Researchers caution that we don’t know for sure how much of the rise in cases is from more testing, vs. more spread, and we don’t know how much transmission is occurring in schools or elsewhere.

“I think it’s too soon to say, especially without good case investigation (or) outbreak tracing,” said Jaline Gerardin, a Northwestern University assistant professor of preventive medicine who works on virus modeling. “We certainly know that with vaccination, masking, ventilation and regular testing, going to in-person school doesn’t have to end in infection or exposure.”

The rising cases and hospitalizations come as Illinois reopens schools while battling the highly contagious delta variant. Districts have said they’re trying to keep students masked and in class, where they learn best, while quarantining exposed children as needed and keeping a wary eye on rising case counts.

“It’s just a tough time; that’s all I can tell you,” said Superintendent Brian Karraker, of New Athens Community Unit School District 60, southeast of St. Louis. His district had to close one of its buildings temporarily this school year because of an outbreak. “We’re doing all we can to keep kids in school.”

Chicago reported that 117 schools — about a fifth of its district-run buildings — had at least one COVID-19 case as of Wednesday. The Chicago Teachers Union said it believes the number is higher.

As of Friday, the Illinois Department of Public Health had traced another 128 outbreaks to schools across the state, a 58% rise from the figure it reported the week before. Among those added to the list was Indian Grove Elementary School in northwest suburban Mount Prospect, where a district spokesperson said 75 students across all grade levels were in quarantine Friday. That’s roughly 1 in 6 students.

It’s difficult to assess in real time the pandemic’s toll on Illinois kids and their schools. Case data for Chicago children is less detailed than the information provided for the rest of the state, and the data that is released is delayed and sometimes incomplete.

From all available data, here’s what we know:

Youths leading in new cases

For much of the pandemic, the rate of new COVID-19 infections among people younger than 20 trailed the rates for other age groups. But that’s changed. In the most recent week’s worth of data, those under 20 experienced the highest rate of new infections.

For the week ending Sept. 4, Illinoisans under 20 saw more than 300 new cases per 100,000 people in that group. That’s 22% higher than the state average, which is near 245 per 100,000 residents.

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IDPH also breaks out data for children ages 5 to 11 and those 12 to 17, at least for those living in the suburbs and Downstate. (Neither IDPH nor the Chicago Department of Public Health publishes the same data for kids in Chicago, for reasons not explained.)

The state data shows that cases are climbing for both school-age groups, but in different ways in different places. Those trends largely mirror the predominant theme of this surge: less-vaccinated Downstate regions seeing case spikes, while the more-vaccinated Chicago area sees more subdued growth.

For the seven-day period ending Sept. 4 — the start of the Labor Day break — the weekly new case rate for children ages 5 to 11, per 100,000 kids in that group, was nearly 930 for the region covering east-central Illinois, according to a Tribune analysis of state and federal data. That’s four times as high as the lowest rate, around 240, for DuPage and Kane counties.

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The spread was even more extreme for the group of kids who can get vaccinated: those ages 12 to 17.

The state’s southern region topped 1,320 weekly new cases per 100,000 kids that old — or six times the rate of that age group in Lake and McHenry counties. The good news, for the southern region, is its latest figures were slightly lower than the prior week, stopping what had been a steep climb since mid-August.

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Kids hospitalized near record high

Case counts are an imperfect measure of the pandemic’s trajectory because many people with the virus do not get tested. Complicating matters for children: They may not get tested much or at all over the summer, but then be tested more during the school year.

One school on the outbreak list is the Illinois Mathematics and Science Academy, a residential high school in Aurora that has seen a total of seven COVID-19 cases among students and staff, two of them linked, according to a school spokesperson. It’s also a school that has been testing students and colleagues twice a week, with less than 1% of tests coming back positive.

A more sobering indication of the pandemic’s effect on children may be seen in hospitalization data kept by the federal Centers for Disease Control and Prevention, which shows the number of pediatric admissions tied to COVID-19 has increased notably statewide in recent weeks.

Hospitalizations can be measured in two ways: the number of cases confirmed upon admission or the larger number of confirmed and suspected cases. (At the time of admission, test results may not be back yet for kids showing COVID-19-like symptoms). By either measure, the figures are nearing the highest levels of the pandemic.

The average number of kids admitted each day in Illinois with confirmed cases of COVID-19 has risen from less than one a day in July to about six now. When adding in suspected cases upon admission, the number increases to nearly 44 kids a day, on average, which is about as bad as the spring 2021 surge and close to levels of last fall’s surge.

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Even with the growth in Illinois’ pediatric hospitalizations, however, hospitals across the state have yet to report filled pediatric wards, as has occurred in some other states.

And deaths of children from COVID-19, although tragic, remain extremely rare, particularly compared with deaths from other causes. In Cook County, the medical examiner has reported 12 deaths of children tied to the coronavirus, most with preexisting health conditions. In the pandemic’s past 18 months, about 100 kids died in accidents and 110 from homicide.

What’s traced to schools?

When children test positive, health officials try to trace the cases to see if there’s any connection to schools they attend. The state defines a school outbreak as at least two COVID-19-positive people, from different households, with a shared experience on school grounds.

It’s not a perfect science. The state relies on local health officials to do contact tracing, which has been spotty at times in Illinois. Even in well-traced cases, data can be delayed as officials attempt to determine whether people crossed paths in schools.

Some known cases also aren’t listed, such as CUSD 60’s New Athens High School. The small, rural school went to remote learning Aug. 30 after more than two dozen students tested positive for the virus. But the school wasn’t listed in the state’s update on Sept. 3, or the one released Friday. Nor is it named in a separate state listing of schools where people had potential contact with someone infected.

When asked why, an IDPH spokesperson said the agency was checking with local health officials, who report outbreaks to IDPH, but in general reports can be delayed as they’re processed and evaluated.

Within those limitations, state data show local health officials had confirmed 128 outbreaks in schools as of Friday. That’s up from 81 a week earlier and 26 the week before. (One school can have multiple outbreaks.)

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A separate Chicago website lists schools with “actionable cases,” which it said are people who visited a Chicago Public Schools building while deemed contagious. Also listed is the number of close contacts, or people who were, for at least 15 minutes, within 6 feet of someone deemed contagious with COVID-19.

On Wednesday, during its weekly update, CPS reported 161 actionable cases tied to its schools, leading to nearly 3,000 close contacts, between Aug. 29 and Wednesday.

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The Chicago Teachers Union has complained that the district appears to be undercounting cases, and the union started its own online “tracker” tallying far more cases at far more buildings.

And in a sign of how confusing the information can be, IDPH began reporting Friday on Chicago school outbreaks but listed only two school outbreaks citywide, then referred people to CPS’ website for more information. One of IDPH’s two listed Chicago outbreaks was at a CPS school the district hadn’t listed on its website as of Friday.

What does it mean?

In some ways, researchers say, it’s not surprising that known cases are skewing younger than they were before vaccines came along. Older age groups tend to be more vaccinated, and those under 12 can’t even get the vaccine yet.

Kids also are more susceptible in general to respiratory diseases, and may be more active now than other times during the pandemic, said Sarah Cobey, a University of Chicago associate professor of ecology and evolution who used to help the state model the spread of infections.

“Elementary school-age kids and young teenagers tend to drive flu infections in the community, for instance,” she said. “This is probably because they’re both more susceptible, and they tend to have more contacts.”

A tougher question to answer: What effect is in-person school having?

Chicago’s health commissioner, Dr. Allison Arwady, has argued schools aren’t a major cause of infection spread, pointing to the city’s experience last year, when some schools held class in person and others shifted to virtual learning.

“We didn’t find that being in school was itself a risk factor for COVID,” she said in a Thursday Facebook Live event. “In fact, both the students and the staff that were (at an) in-person school — with the masking, with the distancing, with the things in place — actually had lower rates than those who did not.”

Cobey, however, said she’s not so sure. There just isn’t enough data, even 18 months into the pandemic, to know precisely who’s getting sick and how, particularly with kids in school.

That means districts should be quick to shut down an activity or area traced to an outbreak, said Mercedes Carnethon, vice chair of preventive medicine at Northwestern University Feinberg School of Medicine.

“In some cases, that may be the entire school — particularly where transmission can definitively be traced to a policy or action that could be changed in the future,” Carnethon said. “In other cases, it may mean shutting down an extracurricular activity that is risky. We need to have a low threshold for pausing and reevaluating safety procedures so that we can provide as much education in person as safely as possible.”

jmahr@chicagotribune.com

kcullotta@chicagotribune.com

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