Child Hospitalizations on the Rise Weeks into Texas School Year

The number of children hospitalized with COVID-19 has reached an all-time high just weeks after the start of the school year for public schools in Texas, according to data from the Texas Department of State Health Services.

Over the weekend, more than 300 children were hospitalized with COVID-19 in Texas. This uptick represents the highest of any two-day stretch since the onset of the pandemic.

“The delta variant is the most contagious variant to date,” Jim Versalovic, Texas Children’s Hospital pathologist-in-chief and interim pediatrician-in-chief, said in a blog update. “We know that it can spread rapidly, and that’s obviously a major concern for children under 12 who can’t be vaccinated yet. It’s also a concern for the many adolescents that are still in the process of getting vaccinated.”

Versalovic continued, “The delta variant is presenting itself a bit differently in children and adolescents. We are seeing more upper respiratory congestion, congestive features and less prominence of loss of taste and smell, at least initially. Also, similar symptoms that have been apparent throughout the pandemic continue to be the case in children and adolescents, like fever, fatigue, and a variety of upper respiratory symptoms. Any child who has symptoms consistent with an upper respiratory tract infection should be evaluated for COVID-19.”

Among the more than five million students enrolled in Texas public schools, nearly 52,000 cumulative positive cases had been reported as of Sept. 3, according to the Texas Department of State Health Services dashboard. Connally Independent School District located near Waco announced it would resume in-person classes this week after two middle school teachers died days apart from COVID-19 complications. 

Texas’ increase in pediatric COVID-19 hospitalizations tracks closely with a national trend shown in a study released by the Centers for Disease Control and Prevention. The CDC data indicates the highest rate of increase was among teenagers and children four years old and younger.

“Rates of COVID-19–associated hospitalization among children and adolescents increased rapidly from late June to mid-August 2021, coinciding with predominance of the delta variant,” CDC officials said in the report. “With more activities resuming, including in-person school attendance and a return of younger children to congregate child care settings, preventive measures to reduce the incidence of severe COVID-19 are critical. Universal indoor masking is recommended for all teachers, staff members, students, and visitors in kindergarten through grade 12 schools, regardless of vaccination status.”

In comparison to their vaccinated peers in the eligible age group of between 12 to 17 years old, unvaccinated adolescents were 10 times more likely to require hospitalization for COVID-19, according to the CDC. On Monday, just over 80 staffed pediatric intensive care unit beds were available statewide.

To curb the rampant spread of the virus and its variants, the agency recommends implementing preventive measures including vaccination for those who are eligible, universal mask-wearing in schools, and quarantining after exposure to individuals with COVID-19. But the severe rise in pediatric hospitalizations is not necessarily due to the delta variant’s heightened transmissibility, Katelyn Jetelina, an epidemiologist at UTHealth School of Public Health in Dallas, said in a blog update.

“Pediatric hospitalizations have dramatically increased in the past month,” Jetelina said. “Yes, the media is accurately portraying the situation on the ground. And, hospitalizations have increased the most for 0-4 year olds. Importantly, this isn’t because [the delta variant] is likely more severe, it’s because we are transmitting delta in the community and our kids aren’t protected. Your decision not to get a vaccine or implement public health measures in schools or the community is directly impacting the health of kids.”