The dramatic rise in COVID-19 cases and hospitalizations due to the more transmissible Delta variant is significantly impacting all age groups, particularly Americans ages 11 or younger who are not yet eligible to receive vaccinations.
More than 500,000 children tested positive for COVID-19 in the US from August 5 to August 26, according to state data collected by the American Academy of Pediatrics. At least 203,962 of those cases were reported in the week of August 19 to August 26; In late June, one weekly reported number was just shy of 8,500.
With concerns building over safely allowing children to return to in-person learning at schools, health experts agree that mask mandates are an effective tool in stemming infections.
"The virus is raging in all these children who are unvaccinated, which is why in schools mask mandates are so important," CNN medical analyst Dr. Jonathan Reiner told Jake Tapper last week, pointing out that inoculation rates are also low among adolescents who are eligible. "They have no other protection. They're literally sitting ducks."
More states and school districts across the country are imposing mask and vaccine mandates, while others are working to limit COVID-19 exposure among the unvaccinated. New York Gov. Kathy Hochul announced on Tuesday plans to implement mandatory weekly COVID-19 testing for state school staff who are not vaccinated.
"We all need to remain vigilant to protect each other - and that means coming in to get your shot and booster shot, wearing masks in indoor spaces, and exercising basic safety measures that we are all familiar with by now," Hochul said.
For teens ages 12 and up attending classes, it remains imperative for them to receive vaccinations to help curb the spread of COVID-19, officials say. And vaccine mandates, while unpopular to some, may be a necessary step.
"I believe that mandating vaccines for children to appear in school is a good idea," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN this week, noting that this would not be a radical idea to impose.
"This is not something new. We have mandates in many places in schools, particularly public schools, that if in fact you want a child to come in -- we've done this for decades and decades requiring (vaccines for) polio, measles, mumps, rubella, hepatitis," Fauci said. "So this would not be something new, requiring vaccinations for children to come to school."
Officials expect additional vaccine data soon
Cognizant of the anxiousness felt by some parents and guardians sending their children back to school unvaccinated, health officials say they are working expediently to review whether the age of vaccine eligibility can be lowered.
If authorized, the CDC would move quickly to recommend the use of COVID-19 vaccines in younger children, agency director Dr. Rochelle Walensky said.
"Everybody is looking at this with urgency. Everyone recognizes how important it is for those children to have access to vaccines," Walensky said during a National Parent Teacher Association town hall Wednesday.
The US Food and Drug Administration (FDA) must approve or authorize the vaccines in younger children first, Walensky noted. And the vaccine makers must make the case to the FDA with clinical trial data.
"My understanding of the timeline is pretty consistent with what is being said -- the middle of fall is my understanding, early fall is when we will anticipate seeing the data -- and then it will lie with the hands of the FDA. And I'm hopeful for the end of the year," she said.
Pfizer/BioNTech's vaccine has been fully approved by the FDA for Americans 16 and older, and emergency use authorization has been granted for those 12 and up. The Moderna and Johnson & Johnson vaccines are under emergency use authorization only for adults 18 and older.
Moderna announced last week that it had completed its submission to the FDA for full approval, and has also filed with the FDA for an emergency use authorization for its vaccine in people age 12 and older.
Clinical trials of vaccines for children under the age of 12 are ongoing.
Fauci said Wednesday that the FDA should have the data to consider authorizing a COVID-19 vaccine for children under 12 by the end of September.
"We should have enough of the data to examine and make a decision as we get into late September, the beginning of October," Fauci said. "Then the data will be presented to the FDA, and the FDA will make a determination whether they will grant that under an emergency use authorization or some other mechanism."
When asked whether a COVID-19 vaccine will be authorized for young children before Thanksgiving, Fauci said he hopes so, but does not want to get ahead of the FDA.
Group says nursing shortage is a 'national crisis'
With the rise in hospitalizations felt nationwide, a health care industry that is exhausted and consistently exposed to COVID-19 infection has sometimes resulted in fewer employees. States and networks have clamored for greater levels of staffing at a critical time of the pandemic.
The American Nurses Association has called on the US Department of Health and Human Services to declare the nation's shortage of nurses a "national crisis," according to a letter the group sent to HHS Secretary Xavier Becerra.
"The nation's health care delivery systems are overwhelmed, and nurses are tired and frustrated as this persistent pandemic rages on with no end in sight. Nurses alone cannot solve this longstanding issue and it is not our burden to carry," association president Ernest Grant said on Wednesday.
Hospital staff remain at risk for COVID-19, researchers reported on Wednesday. Due to a combination of waning vaccine protection and the Delta variant, coronavirus infections have steadily risen among vaccinated healthcare workers in San Diego, Dr. Jocelyn Keehner and Dr. Lucy Horton of the University of California San Diego Health wrote in a letter to the New England Journal of Medicine.
They note that their findings support arguments for using masks more frequently as well as potentially offering booster doses of vaccine if similar evidence is gathered elsewhere.
The strain placed on health care systems is likely to continue into the near future, but there are signs that the situation could start to improve.
For the second week in a row, an ensemble forecast from the CDC has projected that new COVID-19 hospitalizations are likely to remain stable or have an uncertain trend over the next four weeks. Before last week, the forecasts had projected increasing hospitalizations since mid-July.
Yet despite the potential news that the surge could soon ease, the CDC urges caution with the data since actual numbers have fallen outside the range of previous predictions. CDC's latest forecast predicts 550,000 to 1,600,000 new cases likely to be reported in the week ending September 25.
In the short term, Fauci told CNN's Wolf Blitzer that it will help for people to practice mitigation measures, like masking and avoiding congregate settings.
"In the intermediate and longer term, it's going to be vaccines that are going to solve this problem," Fauci said.