Virus Outbreak Colorado Schools

Students in masks queue up to enter the building for the first day of in-class learning since the start of the pandemic at Garden Place Elementary School Monday, Aug. 23, 2021, in north Denver. All students, visitors and staff are required to wear face coverings while in Denver Public Schools regardless of vaccination status with the start of the school year.(AP Photo/David Zalubowski)

Colorado is experiencing a "rapid rise" in pediatric COVID-19 case rates, a top state health official said Tuesday, with infections for younger children hitting their highest rates of the pandemic thus far.

The highest case rate in the state is among 6- to 11-year-olds, who are not yet eligible to be vaccinated, according to Rachel Herlihy, the state's epidemiologist. While they're eligible for vaccination,  12- to 17-year-olds have Colorado's the second-highest case rate.

Though there's been a slight increase in pediatric hospitalizations for COVID-19, Herlihy said the numbers remain relatively small. Ten children younger than 11 were hospitalized Tuesday, plus seven more between 12 and 17 years old. Pediatric hospital capacity remained stable, said Scott Bookman, the state's incident commander for COVID-19. 

Students across the state returned to schools amid some battles over mask mandates. Gov. Jared Polis resisted new classroom restrictions, but the state Department of Public Health and Environment has recommended masks.

A lengthy saga in the Adams, Arapahoe and Douglas counties - which were placed under an optional school mask order by the Tri-County Health Department - took a turn Monday night after the agency moved to require masks. Douglas and Adams counties had previously opted out, following hours of opposition to masking, though for different reasons: Douglas County commissioners felt the order unnecessary, and their Adams counterparts were upset the opt-out provision existed at all.

A Gazette examination of data published by the state last week indicates that nearly every new K-12 school outbreak in Colorado was in a district that had no mask mandate. A broad coalition of health care organizations in Colorado have come out in support of masking in schools, and Glen Mays, of the Colorado School of Public Health, urged using masks in schools and other high-risk settings.

"The current surge is not yet showing signs of abating," he said of cases rising generally across Colorado, not just in children. "Our best tools in fighting the virus continue to be vaccines, masks and social distancing. At this point in the pandemic, the most effective response is to implement requirements for vaccination and for mask-wearing in indoor settings – particularly for high-risk settings such as schools, healthcare, and long-term care settings."

The beginning of pediatric case jump predates the return to school, Herlihy said, and can be attributed tosummer activities. But the case rate for 6 to 11 year olds has spiked sharply in the past two weeks, above adult case rates. 

"We do know that transmission, especially with a more transmissible delta variant that we have across the state right now, in schools is possible and that could be contributing to the amount of transmission we're seeing in children, especially in unvaccinated children," she said.

There are multiple converging health problems affecting children right now, Herlihy said. RSV, a common but sometimes serious respiratory infection, spiked several months before its typical emergence, she and pediatric health officials have said, which is contributing to a jump in pediatric hospitalizations and intensive care admissions. Children's Hospital Colorado told the Gazette earlier this month that RSV was more prominent in causing hospitalizations than COVID-19. Officials at other pediatric facilities said they were experiencing a similar trend. 

It's not known why RSV is spiking now, so far ahead of its typical peak. Herlihy said part of the reason is likely because there were such low rates of RSV during the 2020-21 season, which might've left more children susceptible to the illness. She warned that may also be a warning to what the flu season will bring.

The spike for younger Coloradans coincides with an overall increase statewide. Cases have dipped slightly in recent days, but the state is still averaging more cases per day than at nearly any other point in months. Hospitalizations have also hit their highest point since January.

Herlihy acknowledged that cases have dropped somewhat, but she said that could be explained by the data lag that often follows weekends. 

The increase in hospitalizations statewide is concerning, said Jon Samet, the dean of the Colorado School of Public Health.

"This is a worrisome steep rise and further evidence that current transmission control and the level of vaccination are not sufficient," he said in an email. "The Delta variant is an important part of the story as well; its level of transmissibility finds the weaknesses in our efforts to control the pandemic."

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