Health

(NEW YORK) — With coronavirus cases in the U.S. approaching near-peak levels recorded last winter, pediatric coronavirus infection and hospitalization levels are now surging to their highest point in months.

Last week, nearly 200,000 American children tested positive for COVID-19, up by about 50% since the beginning of December, according to a new report from the American Academy of Pediatrics and the Children’s Hospital Association. Hospitalizations among children have been rapidly following suit.

Across the country, more than 2,100 children are currently hospitalized with confirmed or suspected cases of COVID-19 — up by approximately 800 pediatric patients, compared to just a month ago, according to federal data.

As a growing number of COVID-19 positive children are admitted into the hospital in need of care, health care workers and experts are sounding the alarm about the concerning trend.

“Our most precious commodity in this United States of America is our children,” Dr. Kenneth Remy, associate professor of internal medicine and pediatrics critical care with UH Rainbow Babies & Children’s Hospital, told ABC News. “And right now, we’re on fire.”

Daily pediatric COVID-19 related hospital admissions have more than doubled in the last month, increasing by 110%. Now, an average of more than 300 children are being admitted to the hospital each day.

According to the health experts, a confluence of factors have led to the surge. The initial catalyst was the delta variant, subsequently followed by the recently discovered omicron variant. Further, vaccination rates, particularly among the pediatric population, continue to lag, leaving many children vulnerable to severe illness.

To date, less than a third of eligible children — ages 5 to 17 — have been fully vaccinated.

6 states report more than 100 children hospitalized with COVID-19

At the state level, more children are hospitalized with COVID-19 in New York than in any other state in the country, particularly in New York City, where children appear to be bearing the brunt of the state’s latest surge in pediatric cases.

In less than three weeks, New York City has seen a five-fold increase since the week of Dec. 5, Mary Bassett, the state health commissioner, reported during an update with Gov. Kathy Hochul on Monday.

“There’s just no reason. We have the supply. We have the capacity. We have the staff in place for every child to be vaccinated, who is eligible,” Hochul said, urging parents to use the winter break as a time to vaccinate their children.

Six states – Georgia, Illinois, New York, Ohio, Pennsylvania, and Texas – currently have more than 100 children hospitalized with COVID-19.

In Pennsylvania, the PolicyLab at Children’s Hospital of Philadelphia warned last week that it has seen a “sharp increase in test positivity” among children it has tested in the area.

“These data support the fact that transmission is now increasing disproportionately among children compared to adults,” the group wrote. “We are seeing cases of moderate to severe disease among hospitalized children, including otherwise healthy children, particularly those who have not been vaccinated.”

In Ohio, where more than 200 children are currently hospitalized with COVID-19, Dr. Adam Mezoff, chief medical officer at Dayton Children’s Hospital, told ABC News that he has been concerned to see the recent increase in infected children.

“It seems to be hitting younger age groups, at this time,” Mezoff said, adding that he expects to see more hospitalizations to follow, given the infectivity of omicron. “How sick they become is hard to estimate right now, because we don’t have enough information.”

Preliminary data from South Africa estimates that children had a 20% higher risk of hospitalization in the country’s omicron-driven fourth wave, given the fact that so many children were still unvaccinated, and therefore, unprotected.

“We have to keep an eye on that,” Dr. Anthony Fauci, chief medical adviser to the White House, told ABC’s Good Morning America on Monday. “That’s one of the reasons why we say now that we have the capability and the authority to vaccinate children 5 to 11 that we’re encouraging parents, that if you have a child from 5 to 11, please get that child vaccinated to prevent them from getting anything that even resembles a serious illness.”

Although severe illness due to COVID-19 remains “uncommon” among children, according to the AAP and CHA, experts stress that young people are not immune from the virus, or from severe illness and death.

According to the CDC, children are as likely to be infected with COVID-19 as adults and the virus is now one of the top 10 causes of death for children ages 5 through 11 years.

In Northeast Ohio, Remy said that what is happening in his hospital “is a reflection” of what is happening in the rest of the country for children, further rebutting the misconception that children are unaffected by COVID-19.

“What we’ve seen over the past couple of weeks, sadly, is not even just a slow increase, but a direct shoot upward [trend] of children becoming ill from this disease, and coming into the ICU,” Remy said. “Sadly, we’ve seen children at our institution and others, lose their lives. So we’re in a different situation than we were many months ago.”

Mezoff said he worries that there will be a lot of sick children, and he is also deeply concerned that there will not be enough staff to take care of them.

“The combination of large numbers of children that are sick with challenging staffing numbers does raise a lot of concern for us,” Mezoff said.

Remy added that he and his colleagues fear that more people, including children, will be coming into the hospital in the next few weeks into the intensive care units.

“We’re not just arcing upward. We are going straight upward,” Remy said. “And suddenly over the next couple of weeks, this is going to get worse, and so sadly, too many people are going to lose their lives.”

‘This is a no brainer’

As the virus continues to spread, experts stress that vaccination remains the best tool to not only protect children from getting sick, but also to change the trajectory of the pandemic.

“If I knew that there was a fire outside my house, I would make sure that I had extinguishers. I would make sure that I had a way out and an escape plan for my children,” said Remy, using, once more, his blaze metaphor to explain the current crisis of the unfolding pandemic. “Right now … being on fire, we have something that could actually quench much of those flames.”

Mezoff noted that as of yet, Dayton’s Children’s Hospital has yet to care for a COVID-19 positive child who has been vaccinated.

Getting boosted when eligible and wearing masks also remain key to protect those who are still too young to be vaccinated, Remy said.

“We know that these things will quell those flames and protect our children. So to me, this is a no brainer,” Remy said. “We only have one goal we’ve only had one goal and that’s to improve the lives of children. That means keeping them alive.”

 

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(NEW YORK) — A new study suggests immunocompromised Americans people who are fully vaccinated against COVID-19 are more likely to have breakthrough infections than people without weakened immune systems, but found full vaccination still adds more protection than being partially vaccinated.

Researchers from Johns Hopkins Bloomberg School of Public Health and the University of Washington found people with so-called immune dysfunction, including immunocompromised people like those with HIV or on immunosuppressant medications, had rates of breakthrough cases up to twice as high as those with normally-functioning immune systems.

“People with immune dysfunction conditions have a higher risk for COVID-19 breakthrough infection than those without such a condition, suggesting continued use of nonpharmaceutical interventions (mask-wearing, social distancing, avoid crowd gathering and travel, etc.) and alternative vaccine strategies (additional doses or immunogenicity testing) should be recommended even after full vaccination.” Dr. Jing Sun, corresponding author of the study and an assistant scientist in the department of epidemiology at Johns Hopkins Bloomberg School of Public Health, told ABC News.

For the study, published in JAMA Internal Medicine Tuesday, the team looked at data from the National COVID Cohort Collaborative, which is a central database of COVID-19 data from academic medical centers across the country.

More than 664,000 people were included in the study between December 2020 and September 2021.

Patients were broken into two groups: with and without immune dysfunction. Those with compromised immune systems were broken down even further into patients with diagnoses such as HIV, multiple sclerosis and rheumatoid arthritis as well as people who had undergone organ transplants and bone marrow transplants.

A breakthrough infection was defined as someone who contracted COVID on or after the 14th day following vaccination.

Compared with only being partially vaccinated against COVID-19, being fully vaccinated was linked to a 28% reduced risk of breakthrough infection, regardless of immune system status.

However, those with weakened immune systems were at higher risk for breakthrough infection.

Throughout the study period, patients without immune dysfunction had a breakthrough infection rate of 7.1 per 1,000 person-months.

By comparison, those who had undergone bone marrow transplants had a breakthrough case rate of 8.6 per 1,000 person-months and multiple sclerosis patients had a rate of 8.9 per 1,000 person-months.

HIV patients had a rate of 9.1 per 1,000 person-months and rheumatoid arthritis patients had a rate of 9.3 per 1,000 person-months.

The highest breakthrough case rate was seen among organ transplant patients at 15.7 per 1,000 person-months — twice as high as those who are not immunocompromised.

Researchers believe this is because transplant patients must be on immunosuppressants for the rest of their lives so their bodies don’t reject their new organs. However, this also weakens their immune systems and makes them more susceptible to infection such as COVID-19.

The team said the findings provide further evidence that immunocompromised people may be at higher risk for breakthrough infection and that these Americans — which make up an estimated 3% of the population — should continue to wear masks even after being vaccinated and also should receive a third dose.

The findings have three caveats, with the first being that the study was conducted during the delta wave, before the omicron variant — which appears to be more transmissible — became dominant in the U.S.

Secondly, researchers only looked at the risk of breakthrough infection after a first and second dose of the vaccine and did not study the risk after a booster shot.

Finally, they only looked at certain immunocompromising conditions but not all, like cancers.

Booster shots were approved by the Food and Drug Administration and the Centers for Disease Control and Prevention for immunocompromised people in August and have been shown to boost antibody levels in immunocompromised people after being fully vaccinated.

 

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(NEW YORK) — A new trend on TikTok could lead some teens to believe they have a serious mental disorder, according to some experts.

The app, which has become a community for users to connect and for teens to show off dance moves and share other fun videos, has recently had some trending videos of young people claiming to have a borderline personality, bipolar or dissociative identity disorder, which is spreading like wildfire on the platform.

Posts with the hashtags, “dissociative identity disorder” and “borderline personality disorder” have been viewed hundreds of millions of times. And some of those videos list possible signs to look out for and encourage viewers to self-evaluate.

Samantha Fridley, 18, said these videos influenced her to believe that she was suffering from a mental disorder.

“I remember seeing these videos on my ‘For You’ page of people saying, like, ‘These are signs that you have this disorder,’ bipolar or borderline and all these other weird disorders that I’ve never even heard of before,” Fridley told GMA. “My mind would be like, ‘Maybe I don’t have just depression and anxiety, maybe I have something else.'”

“After working with a therapist for a long time, I started realizing that I don’t have borderline personality, I don’t have disassociated identity, I don’t have bipolar. I just have what I’ve always had, which is depression and anxiety,” she added.

According to the National Alliance on Mental Illness, borderline personality disorder is extremely rare — only 1.4% of the U.S. adult population is estimated to have this condition and it is rarely diagnosed in adolescents.

Mental health professionals say these videos may pose an alarming risk to a potentially vulnerable population.

“If you spend 15 minutes, 30 minutes, 60 minutes viewing people talk about these disorders over and over again, that can make it seem like these conditions are a lot more prevalent than they actually are in the world,” said psychologist Ethan Kross, the author of Chatter: The Voice in Our Head, Why It Matters, and How to Harness It.

To help teens on TikTok, experts are urging parents to maintain an open line of communication with their kids about mental health.

“Take the time to empathetically hear them out,” Kross said. “How intense are these symptoms? How long are they lasting? Does it seem like they’re interfering with your child’s ability to live the life that they want to live? Again, if the answer to those questions is yes, that’s a cue to then take the next steps to get a formal diagnosis.”

In a statement to ABC News, TikTok said, “We care deeply about the well-being of our community, which is why we continue to invest in digital literacy education aimed at helping people evaluate and understand content they engage with online. We strongly encourage individuals to seek professional medical advice if they are in need of support.”

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(NEW YORK) — Amidst growing pressure as COVID-19 cases surge across the country, the U.S. Centers for Disease Control and Prevention (CDC) has now announced that it will shorten the recommended isolation time for asymptomatic people who test positive for COVID-19, and update guidance for people who have been exposed to the virus.

“The Omicron variant is spreading quickly and has the potential to impact all facets of our society. CDC’s updated recommendations for isolation and quarantine balance what we know about the spread of the virus and the protection provided by vaccination and booster doses,” CDC Director Dr. Rochelle Walensky said in a statement on Monday.

The change in guidance is based on data which shows that “the majority of COVID-19 transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and the 2-3 days after,” according to the CDC.

Guidance for asymptomatic individuals differs greatly depending on one’s vaccination status.

Here’s what you need to know:

Anyone COVID-19 positive should quarantine for at least five days

Anyone, regardless of vaccination status, who tests positive for COVID-19 and is asymptomatic, should isolate themselves for at least five days, the CDC said.

If you continue to have no symptoms after five days, the CDC states that you may leave isolation if you “continue to mask for five days to minimize the risk of infecting others.”

However, if symptoms, such as a fever, are present, you should continue to stay home until your fever, or the other symptoms, resolve. If your symptoms resolve after five days, and you are without fever for 24 hours, the CDC said you are free to leave your house with a mask on.

According to the CDC, an isolation period of five days, followed by wearing a well-fitting mask around others, will minimize the risk of spreading the virus to others.

What to do if you are exposed to COVID-19, and unvaccinated or not boosted

If you are exposed and unvaccinated, or not fully vaccinated, the CDC now recommends that you quarantine for five days, followed by “strict mask use” for five days after your quarantine. This guidance also applies to people who are more than six months out from their second mRNA dose of the vaccine — or more than two months out from their Johnson & Johnson Vaccine — but not yet been boosted.

However, if a five-day quarantine is not feasible, the CDC said it is “imperative” that an exposed person wear a well-fitting mask at all times and when around others, for 10 days after exposure.

Fully vaccinated, but still not eligible for a booster

If you were fully vaccinated with either the Pfizer or the Moderna vaccine within the last six months, or you completed the primary series of the Johnson & Johnson vaccine within the last two months, the CDC said you do not need to be quarantined after an exposure; however, you should still wear a mask for 10 days, following the exposure.

No need to quarantine if you are boosted and asymptomatic

If you have received your booster shot, you do not need to quarantine after an exposure, but should wear a mask for 10 days following the exposure.

If symptoms do occur, the CDC stressed that you should immediately quarantine, until a negative test confirms that the symptoms are not due to COVID-19.

All individuals who have been exposed are recommended to get a COVID-19 test around five days after exposure.

The CDC pointed people to preliminary data from South Africa and the United Kingdom, which demonstrates that vaccine effectiveness against infection for two doses of an mRNA vaccine is approximately 35%, while a COVID-19 vaccine booster dose restored vaccine effectiveness against infection to 75%.

“These updates ensure people can safely continue their daily lives. Prevention is our best option: Get vaccinated, get boosted, wear a mask in public indoor settings in areas of substantial and high community transmission and take a test before you gather,” Walensky said.

 

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(WASHINGTON) — As the “extraordinarily contagious” omicron variant surges across the United States, Dr. Anthony Fauci warned that COVID-19 cases will likely continue to climb.

“Every day it goes up and up. The last weekly average was about 150,000 and it likely will go much higher,” Fauci told ABC This Week co-anchor Jonathan Karl.

While Fauci said studies show omicron is less severe in terms of hospitalizations, he stressed, “we don’t want to get complacent” because “when you have such a high volume of new infections, it might override a real diminution in severity.”

“If you have many, many, many more people with a less level of severity, that might kind of neutralize the positive effect of having less severity when you have so many more people,” he explained. “And we’re particularly worried about those who are in that unvaccinated class … those are the most vulnerable ones when you have a virus that is extraordinarily effective in getting to people.”

On Tuesday, President Joe Biden announced a plan to distribute 500 million free at-home rapid tests to Americans beginning in January. The tests will be delivered by mail to Americans who request them. A website to request the tests will launch in January, according to the administration.

But the omicron surge created a massive rush for tests as Americans prepared to see relatives for the holidays, and they instead faced empty pharmacy shelves and massive test lines.

On Wednesday, ABC News’ World News Tonight anchor David Muir, asked Biden if that was a failure.

“I don’t think it’s a failure,” Biden replied in the exclusive interview. “I think it’s — you could argue that we should have known a year ago, six months ago, two months ago, a month ago.”

“I wish I had thought about ordering” 500 million at-home tests “two months ago,” he told Muir.

Biden added “nothing’s been good enough” when it comes to the availability of at-home tests.

When Karl asked about the comments, Fauci admitted to This Week he is frustrated with at-home test availability and said “we’ve obviously got to do better.”

“The beginning of the year, there were essentially no rapid point of care home tests available. Now, there are over nine of them and more coming,” Fauci said. “The production of them has been rapidly upscaled, and yet because of the demand that we have, which in some respects, Jon, is good, that we have a high demand because we should be using testing much more extensively than we have.”

“But the situation where you have such a high demand, a conflation of events, omicron stirring people to get appropriately concerned and wanting to get tested as well as the fact of the run on tests during the holiday season — we’ve obviously got to do better,” he continued. “I think things will improve greatly as we get into January. But that doesn’t help us today and tomorrow.”

Karl also asked about the FDA last week granting emergency authorization to both Pfizer and Merck’s antiviral pills to treat COVID-19.

“Is this really the breakthrough that you’ve been waiting for?” Karl questioned.

“That’s part of the comprehensive approach to this outbreak. Vaccines and boosters, masks and now very importantly, a highly effective therapy is really going to make a major, major difference,” Fauci replied. “We’ve just got to make sure that there’s the production of enough of that product that we can get it widely used for those who need it as quickly as possible.”

“I assume that will be a top priority going forward, right? I mean, possibly including Defense [Production] Act … and the like?” Karl pressed.

“Absolutely, Jon, absolutely,” Fauci said. “We’ve got to get that product into the mouths of those who need it.”

Only 61.7% of the U.S. population is fully vaccinated against COVID-19, according to CDC data. Many Americans remain against COVID-19 vaccines over one year into their use.

The omicron surge doesn’t appear to sway unvaccinated Americans. According to a Kaiser Family Foundation poll this week, just 12% percent of unvaccinated Americans polled said the variant makes them more likely to get a vaccine.

Former President Donald Trump showed his support for vaccinations, who has spread conspiracy theories about vaccines and didn’t get vaccinated publicly, showed his support for COVID-19 vaccines in a Wednesday interview with The Daily Wire’s Candace Owens, saying, “The results of the vaccine are very good. … People aren’t dying when they take the vaccine.”

Karl asked Fauci whether Trump’s supporters might listen to that message.

“I think that his continuing to say that people should get vaccinated and articulating that to them, in my mind is a good thing. I hope he keeps it up,” Fauci responded.

Fauci also said he was surprised when Trump was booed by some of his supporters in Texas last weekend after the former president revealed he’d gotten his booster shot.

“I was stunned by that,” Fauci said. “I mean, given the fact of how popular he is with that group, that they would boo him, which tells me how recalcitrant they are about being told what they should do.”

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(NEW YORK) — For weeks now, as public health experts have warned about the COVID-19 omicron variant and its incredible ability to infect people, they’ve followed the bad news with good: booster shots available to every adult in the U.S. drive protection against omicron back up.

One of a few glimmers of scientific optimism in the omicron era is that the variant can be held at bay or kept to a very mild infection when people get a boost. And yet, just four in 10 eligible Americans have gotten a booster shot.

Among the most vulnerable Americans — those over 65 years old — it’s slightly higher, but still low: Just over 60% have gotten their booster shots, according to White House data presented last week.

Despite the demand for other pandemic tools, like at-home rapid tests or new treatment pills from Pfizer and Merck, many experts point to booster shots as the best method to actually prevent sickness — and they’ve been there, widely available, for weeks.

“The booster is exponential. It’s not just a little bit different. It’s a lot different,” said Janet Hamilton, an epidemiologist and the executive director at Council of State and Territorial Epidemiologists, a group that works closely with the Centers for Disease Control and Prevention.

“I don’t know that we have really communicated that effectively enough for people to say, ‘I really need to get this, this is a big deal,'” she said.

Why are the rates so low?

Public health directives can take a long time to circulate and have historically reached marginalized populations even slower.

But when it comes to boosters, that message was particularly muddled.

“The recommendation for the booster has come out in bits and pieces, and the most recent recommendation for everyone to get a booster is pretty new still,” Hamilton said.

The confusion began after President Joe Biden and his administration called for boosters for everyone eight months after their second dose. But experts at the CDC and Food and Drug Administration didn’t jump onboard, instead spending the summer months debating if there was a need for boosters for the whole population or only the most vulnerable.

By the time boosters were recommended in November — a recommendation that applied to all adults who’d been fully vaccinated for six months — the data was strongly backed by most in public health.

But, as Hamilton noted, “it takes time for people to hear the information.”

Unfortunately, the country didn’t have the luxury of time. It took just a few weeks for omicron to gather steam in the U.S. By Dec. 18, it was nearly 75% of all cases in the U.S., and nearing 90% along the East Coast and Midwest, the CDC found.

And because the variant evades vaccine immunity — whittling down protection from the first shot to somewhere between 30-40%, according to a study out of the U.K. — the booster shot, which brings protection up to nearly 70-80%, became an urgent public health missive.

Among nursing home residents

In nursing home patients, the CDC released data last week that showed the highest COVID cases were among the unvaccinated, but cases were also increasing among fully vaccinated patients without a booster.

Meanwhile, fully vaccinated and boosted nursing home patients had a 10 times lower rate of getting COVID, the CDC found.

“We’re sitting on an enormous vulnerability right now,” said Dr. Ali Khan, a primary care physician and executive medical director at Oak Street Health, a practice in Chicago.

MORE: Fauci says omicron can evade vaccine protection, but boosters help
Khan, who treats patients at nursing homes, said he thinks omicron has shed new light on booster urgency — but only in certain areas.

“I think it’s leading to increases in booster enthusiasm around relatively privileged populations,” he said.

“But we have a lot of work to do in people receiving those messages like nursing home residents, like minority communities that may have had more complex reactions to vaccines in the first place, to really say, ‘Hey, this is super crucial’,” he said.

Disparities in messaging

Dr. Jay Bhatt, an internist also practicing in Chicago, said among his patients on the city’s Southside, largely low-income people of color, the reasons about half have rejected a booster shot is because of “changing messages.”

Patients say they “lost trust in government,” and the different timelines on when to get a booster led to feelings that it was optional.

“They feel like they can wait longer before they get it,” Bhatt said.

But the doctors noted that the same investments the country made in the initial vaccine rollout can be made on boosters, with positive results.

“I’d say most of my patients, if they’ve already been vaccinated and we can reach them, they’re often very willing to do what’s right to protect themselves and get boosted,” said Dr. Atul Nakhasi, a physician and policy advisor with the Los Angeles County Department of Health Services.

Only a handful of vaccinated patients are hesitant to get a booster, Nakhasi said, and through discussions, he’s able to walk through their concerns — particularly if they’re logistical, like taking off work.

If that effort is not made, Nakhasi warned that disparities that have already manifested will only continue to grow, erasing much of the progress that has been made to close the racial gaps on vaccine uptake.

Outreach is needed

In Los Angeles County, Black and Hispanic people account for 60% of the population, but only 30% of people who have gotten a booster — a much smaller proportion.

“Disparities are again appearing within the data on who is getting the boosters,” Nakhasi said.

And the omicron variant has made it clear that the outreach, especially among communities that already have a shortage of health care, will need to be a long-lasting effort, not a one-and-done.

“I think that goes to the core. We want that closure but unfortunately COVID is not giving it to us,” he said. “So we need to make sure we build long lasting bonds to our communities, because it’s become evident that there’s a need for more than just the initial series.”

Khan, the physician in Chicago, also said outreach has been effective. While more patients have reached out to doctors asking for a booster in light of surging omicron cases, far and away it’s the doctors who are initiating the conversation.

“If we’re prompting them, they’re saying yeah I’ll take it. But only now is that message starting to turn,” Khan said.

“I’m just hoping we’re not too late,” he added.

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(NEW YORK) — COVID-19 has been a major challenge for schools.

From shutting down in March 2020 to reopening and trying to stay open, the task has been varied and in some cases monumental.

This school year — the third since the pandemic began — has presented its own promise and challenges, from vaccines being available to millions of students, to new “test-to-stay” protocols and more transmissible variants. Still, many schools were able to stay open safely with multiple protections in place.

For Elizabeth Stuart, a professor in mental health and health policy and management at the Johns Hopkins Bloomberg School of Public Health, a multi-pronged mitigation strategy has been key to keeping schools safe.

“I think it has been heartening this fall that, in general, schools have been open,” she told ABC News. “Those that had good sets of protections in place, including masks, teacher vaccinations, some sort of symptoms screening, good ventilation, have been able to open successfully with sometimes without very many disruptions.”

But as the omicron variant COVID-19 surges nationwide, schools are reflecting the high rates of community transmission — forcing officials to reassess their protocols and double down on efforts to keep classrooms open in the new year.

“Community transmission rates are just so high right now, that then the school starts to feel it as well,” she said. “That doesn’t mean the schools are contributing to the spread. But when there’s so much virus in the community, of course, the schools are going to be starting to feel that as well.”

Exactly how much COVID-19 transmission there has been in schools is unclear, but studies based on contact tracing suggest that the community transmission plays a larger role in case levels among students, especially where safety protocols are followed.

There are some areas of concern going forward, including winter sports and the unprecedented surge from the omicron variant, but experts are hopeful that the many tools officials have at their disposal can help mitigate the impact of the virus and continue in-person learning.

Recent spikes in cases

Public data on school COVID-19 cases varies, and there is no national data for this school year. However, several Northeast states with comprehensive dashboards are showing sharp increases in recent weeks, as the region leads the nation in new coronavirus cases per capita.

In New Jersey, for instance, which tracks COVID-19 data from over 60% of K-12 public schools, case rates among students and staff started spiking in early November, reaching their highest levels so far this school year. According to the latest data, more than 44,500 student cases have been reported so far this school year, including over 7,700 the week of Dec. 19 alone.

Connecticut has seen a similar growth; for the week ending Dec. 22, the state reported over 3,000 student cases, compared to under 500 the week ending Nov. 3. About two-thirds of the new cases were in students who were not fully vaccinated, the data shows.

Though not as widespread as last school year, closures have also risen in recent weeks. More than 1,000 schools or districts are virtual or closed this week due to rising COVID-19 cases in students and staff and logistical challenges, according to Burbio, a company that monitors COVID-19 policies in over 80,000 K-12 schools. That number is lower than widespread closures in November during the delta surge, though higher than what was tracked in late August, when that surge began. Recent closures are largely concentrated in the Northeast and Upper Midwest, according to its tracker.

Omicron, which has now been detected in all 50 states and has quickly become the dominant variant of new cases here, brings another level of concern. Growing research indicates it spreads more easily than any other variant identified during the pandemic, though it’s too soon to tell if it causes more mild or severe illness.

“[There’s] high level of concern from schools across the country right now,” Dr. Sara Bode, a member of the American Academy of Pediatrics Council on School Health and an author of the AAP’s interim guidance on schools amid the pandemic, told ABC News. “The concern is, as all these students are now back home with their families and in their communities with these high rates of COVID, what’s that gonna mean for the return?”

School vs. community transmission

Outbreaks can and do occur in schools, though multiple studies have shown that transmission in school settings is typically lower than or the same as that of the community when several mitigation measures are in place, such as mask-wearing, testing, ventilation and physical distancing, according to the Centers for Disease Control and Prevention.

“We know that school is not necessarily the driver of COVID transmission, it’s a reflection of the community rates of COVID,” Bode said. “School is probably one of the safest places kids can be.”

But, she continued, “at some point, do we get to such a high rate that it just makes it really challenging to be able to have in-person learning?”

That’s the question some schools are facing now.

New York City, home to the country’s largest public school system, has seen a rapid increase in school cases in recent days, forcing more than 400 out of approximately 48,000 classrooms districtwide to close, according to the latest city data. At least 11 of some 1,600 schools were also closed as of Thursday night; since the school year started, 17 schools total have temporarily closed.

As the number of new COVID-19 cases reported citywide has reached record levels in recent days, city leaders have said they are intent on keeping classrooms open, and that measures including masking, surveillance testing and mandated staff vaccinations have kept COVID-19 rates low.

The New York City school seven-day average COVID-19 testing positivity rate is also just over 2%, according to city data. The school rate has been “higher than what we’ve seen in previous weeks, but it remains relatively low,” Dr. Dave Chokshi, commissioner of the city’s health department, said during a press briefing earlier this week. Citywide, the seven-day average positivity rate is over 11%.

New York City public schools are supposed to randomly test 10% of their unvaccinated student population weekly, per city Department of Education protocols. Some city officials and the teacher’s union have charged that protocol isn’t widespread enough to provide a clear picture of COVID-19 transmission — a notion Mayor Bill de Blasio has pushed back against.

“We’re testing in every school, every week, the results are extraordinarily consistent and show very low levels of COVID,” he told reporters earlier this week. “You have all those health and safety measures in place, you have every adult vaccinated. This is one of the safest places in the city by definition.”

Los Angeles County, which has widespread school testing, has ​similarly found low test positivity rates in students and staff. So far this school year, it has remained below 1%, data from the county’s health department shows.

Spotlight on sports

One area that is “particularly problematic” right now in schools is sports, said Bode. “These are winter sports — they’re indoor, lots of contact.” Mask usage may also vary based on local guidelines.

As the medical consultant for the Columbus, Ohio, school district, Bode has seen high school teams needing to postpone or cancel games this season, much like professional sports, due to positive cases. On some teams, as many as one-third of the team has tested positive, she said.

“That is going to be the other consideration in these winter months — how many cases is too many?” she said. “When do we decide just to take a break from athletics for 10 days for a particular team, if it seems like there’s an outbreak?”

“I think those are other considerations schools are going to be grappling with when they return,” she continued.

Some districts are already doing just that. Springfield Public Schools in Springfield, Massachusetts, this week postponed all winter sports amid a rise in COVID-19 cases in the school and community and the new, highly transmissible omicron variant. School and health department officials plan to discuss restarting the season after the holiday break.

Connecticut this week halted guidance that would have allowed fully vaccinated students to compete without wearing masks, following policies already in place in neighboring Massachusetts and Rhode Island, citing the “the rapid rise in COVID-19 community case rates and the emergence of this more contagious variant.”

Post-winter break

Schools are heading into winter break as pediatric cases continue to surge nationwide.

Since the first week of September, there have been nearly 2.3 million child cases — nearly a third of the total pediatric cases reported since the onset of the pandemic — including approximately 170,000 in the last week alone, according to a new report from the AAP and the Children’s Hospital Association released on Monday. Though children tend to have mild infections, there can be acute cases; over the last month, pediatric COVID-19-related hospital admissions also have increased by 33%, according to federal data. Children could also transmit the disease to more vulnerable people.

Public health officials have pointed to a variety of factors that are fueling the latest COVID-19 surge, including more indoor gatherings during colder weather, relaxed protocols, the Thanksgiving holiday, unvaccinated populations and waning immunity against the backdrop of two highly transmissible variants — delta and omicron.

To limit COVID-19 transmission once students return to the classroom this new year, some leaders are boosting testing. On Wednesday, California Gov. Gavin Newsom announced that the state will be distributing 6 million free rapid tests to school children — about one or two tests per child — “so that they can get those results back quickly and make sure when they go back in person, they’re doing so safely knowing that they have not contracted the disease over the holidays,” he said.

Similarly, in Washington, D.C., the district health department will be distributing 100,000 rapid tests to schools to test children returning from the winter break, city officials announced this week. D.C. public schools will cancel classes for two days to allow for families to pick up the tests, with instruction resuming on Jan. 5.

Public health experts and school leaders are also stressing vaccination amid the latest surge to help limit transmission among children, protect against severe illness and limit disruptions due to exposure. Those ages 5 and up are eligible to get the COVID-19 vaccine, though less than a third of the pediatric population — those under 18 — is fully vaccinated, according to federal data.

D.C. this week joined a small but growing list of cities and school districts to require COVID-19 vaccination in schools for students. Students eligible for a COVID-19 vaccine that’s been fully approved by the Food and Drug Administration will have to be immunized beginning March 1, following regulations from the D.C. Council, with enforcement beginning in the 2022-2023 school year.

“This adds to the safety of our schools,” D.C. Mayor Muriel Bowser said at a press briefing Wednesday. “We urge parents right now to make a plan to have their children vaccinated, even before the deadline, because the benefit is you get the extra months and weeks of protection.”

Bode is optimistic that there we won’t see “mass amounts” of school districts going virtual in the new year, though noted that case counts and other issues like staffing shortages may lead to targeted school closures as needed.

“‘I’m hoping that we’ve learned some good lessons over the time of the pandemic to understand that we can do this, we just have to really double down with our mitigation strategies and be vigilant with the data, have frequent testing, have vaccination and have a plan that can be flexible in these smaller situations,” she said. “I think that’s the most effective.”

Stuart is also confident due to the number of mitigation measures, including vaccination and rapid testing, schools now have at their disposal.

“It feels like a scary time,” she said, “But again, we have to remember that we have a lot more tools in our toolbox, and that schools and school districts can use those tools in smart ways to help schools be open safely.”

ABC News’ Arielle Mitropoulos contributed to this report.

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(NEW YORK) — Gretchen Lee, a third grader in Washington, D.C., was wrapping up her last week in school ahead of Christmas break when the unexpected happen.

A fully vaccinated 8-year-old, Gretchen tested positive at school for the virus that causes COVID-19 — likely the omicron variant that has whipped around the globe with lightning speed.

Within a matter of hours, a long-planned family trip to Seattle to visit a new baby cousin suddenly evaporated. Her parents’ tickets to the new Spider-Man movie went unused. And Gretchen, whose symptoms are mild, is now mostly isolating until her parents can figure out next steps.

“I didn’t think that they would have to separate me from my sister,” Gretchen said when asked about the worst part of getting COVID just days before Christmas.

It’s the Grinch’s dirtiest trick yet. If 2020 was the year we all stayed home, 2021 was supposed to be the year of joyous family reunions and travel splurges.

Instead, the nation has logged more than 1.1 million new coronavirus cases in the last week alone. And many of the cases are children, with 170,000 kids testing positive last week.

The Centers for Disease Control and Prevention says any person infected with the virus — vaccinated or not — should isolate for 10 days. That means staying alone in a bedroom and, if possible, not sharing a bathroom.

It’s a rule that’s never been practical for families living in small spaces or with very young children.

It’s also one that, during Christmas, seems a particularly cruel twist of fate for conscientious parents and their Santa-loving kids.

“We have done everything that we were supposed to do,” said Gretchen’s mom, Gloria Lee, who, like her husband, is both vaccinated and boosted.

Dr. Mark Kline, an American pediatrician and infectious diseases specialist working as physician-in-chief and chief medical officer at Children’s Hospital New Orleans, said there’s no one good answer for how to handle a COVID case in the family.

In lieu of strict isolation, a family could opt for masks in the house, assuming everyone else is fully vaccinated and low medical risk, he said. Upgrading to surgical masks instead of cloth masks is a good idea too. And moving the celebration outdoors or cracking the windows can make it less likely the virus will spread, Kline said.

“These are difficult questions to answer. There’s the ideal, and then there is the pragmatic approach. And I think we have to be pragmatists on this,” said Kline.

Some doctors and disease experts are questioning whether the 10-day isolation rule still makes sense if people are vaccinated. That’s because while a vaccinated person without symptoms can still spread the virus, they probably aren’t contagious for as long as an unvaccinated person.

Dr. Amesh Adalja, a senior scholar at Johns Hopkins’ Center for Health Security, estimates a vaccinated person’s infectious period is about 40% or 50% shorter than the unvaccinated. So, instead of 10 days isolation, they might only need five or six, he said.

“When people get a breakthrough infection, the period of time that they are contagious is truncated, because the immune system jumps into effect very quickly and slams down the viral load,” Adalja said.

One tactic for families, Adalja said, could be to keep doing a rapid test on the COVID-positive person until they test negative. Whereas a laboratory PCR test might still pick up tiny pieces of the virus, the benefit of a rapid test is that it is most likely to register positive while a person is truly contagious.

The approach isn’t foolproof, and families might need to think twice if anyone has a medical condition that makes them vulnerable to a more serious outcome from COVID. But a truncated isolation period for a vaccinated person is already being pushed by the airlines and some health care workers who say it doesn’t make sense to keep vaccinated personnel at home for the full 10 days.

Late Thursday, the CDC relaxed its quarantine and isolation rules slightly for health care workers out of concern that hospitals might face severe staffing shortages next month following the latest wave of omicron cases.

“We have the technology to (avoid) one-size-fits-all isolation periods for everybody. We can use antigen testing to be able to do this,” Adalja said. “If the NFL can do it, why can’t we?”

As for Gretchen, who is asking in vain for a puppy this Christmas, she isn’t too worried about getting sick because she understands the vaccine will protect her.

But her parents say they wouldn’t mind more up-to-date guidance from federal health officials on whether a 10-day isolation period makes sense for a vaccinated person and how to navigate testing other vaccinated members of the household.

“There are obvious downsides to not making memories and missing out playing and being social. Those are real harms,” said Gretchen’s father, Woo Lee.

“But you know, the other side of that is that she could continue to spread this virus,” he said, adding, “Our decisions could affect other people.”

ABC News’ producer Arielle Mitropoulos and Karen Travers contributed to this report.

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(NEW YORK) — The World Health Organization is investigating a mysterious illness in South Sudan that has killed dozens of people.

So far, 97 people have died of the unknown disease in Fangak, Jonglei State, in the northern part of the country.

Fangak County Commissioner Biel Boutros Biel told ABC News on Thursday that the latest fatality occurred in an elderly woman.

Deaths have mostly been reported among the elderly and children ages 1 to 14, according to a statement from South Sudan’s Ministry of Health.

The symptoms of the mysterious illness include cough, diarrhea, fever, headache, chest pain, joint pain, loss of appetite and body weakness, officials said.

Biel said the WHO team that traveled to Fangak has since left, but did not communicate their findings to local officials.

In a statement to ABC News, Collins Boakye-Agyemang, a spokesperson for WHO Africa, said the agency began investigating the outbreak in November but did not provide further details.

According to BBC News, because the area has recently been hit with heavy floods, the WHO tested samples from patients for cholera, which is typically contracted from infected water supplies.

However, the samples returned negative for the infectious bacterial disease, the outlet reported.

Sheila Baya, a lecturer in the College of Medicine at University of Juba in South Sudan, told BBC News that WHO scientists had to reach Fangak by helicopter due to the flooding to conduct testing.

Biel told ABC News that some nongovernmental organizations have delivered medical supplies to Fangak and are in the process of setting up mobile clinics to help treat people.

In a statement last month, international humanitarian group Médecins Sans Frontières (Doctors Without Borders) called the floods a “perfect storm” for disease outbreaks.

“People do not have enough water or options for water storage, and there is no garbage collection, while dead goats and dogs are left rotting in the drainage systems,” the statement read. “With the conditions further worsened by the influx of new arrivals [at camps], people are at higher risk of outbreaks and waterborne diseases such as acute watery diarrhea, cholera and malaria.”

ABC News’ Morgan Winsor contributed to this report.

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The Food and Drug Administration on Thursday authorized Merck’s COVID-19 pill for certain adults.

The authorization is limited to adults who have a high risk of severe illness and for whom alternative FDA-authorized treatment options are not accessible or medically appropriate.

This is the second COVID-19 treatment in pill form after Pfizer’s pills were authorized Wednesday.

This is a developing story. Please check back for updates.

ABC News’ Sony Salzman contributed to this report.

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