The polarization surrounding mask mandates is deepening as some state and local officials spar on how to approach face coverings protocols in schools, a debate unfolding as more children contract Covid-19.
In Florida, which as the second-highest rate of new cases per capita after Louisiana, children’s hospitals and staff are “overwhelmed,” said Dr. Aileen Marty, an infectious disease expert at Florida International University.
“The numbers of cases in our hospitals in children and our children’s hospitals are completely overwhelmed,” Marty told CNN’s Jim Sciutto on Friday evening.
“Our pediatricians, the nursing, the staff are exhausted, and the children are suffering. And it is absolutely devastating. … Our children are very much affected. We’ve never seen numbers like this before,” she said.
Marty noted that Nicklaus Children’s Hospital in Miami is at 116% occupancy for Covid-19 patients.
The Covid-19 surge fueled by the rapid spread of the Delta variant of the coronavirus across the US is happening as millions of children are returning to schools, reigniting the conversation on mitigation measures that aim to lower virus transmission so students can safely be in the classroom.
But officials on the state and local levels have not streamlined their back-to-school mask wearing strategy, prompting local districts to create their own rules.
In Texas, the Houston Independent School District will move to mandate masks upon students’ return on August 23, despite GOP Gov. Greg Abbott’s executive order prohibiting counties, public school districts, public health authorities and government officials from requiring mask wearing.
“I will propose a mask mandate,” HISD Superintendent Millard House said in a video posted on Twitter. “This mask mandate will be for our students, staff, and visitors at all of our schools, buses and facilities.”
The mask mandate measure will become effective when the school board approves it next week, House said, adding that the move comes after local officials have raised Covid-19’s threat level to red.
And that threat is so intense that an 11-month-old girl with Covid-19 had to be airlifted from Houston to a hospital 150 miles away because of a shortage in pediatric beds in the Houston area. The baby, Ava Amira Rivera, is stable and no longer intubated.
“Now we’re starting to see large numbers of young people pile into hospitals and lots of kids going into pediatric intensive care units. And to me, that’s the game changer. We have not seen kids pile into pediatric ICUs across the South like we’re seeing right now. We didn’t see that nearly as much last summer,” Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, told CNN on Friday.
And as Covid-19 cases continue to climb in Florida, Republican Gov. Ron DeSantis issued an executive order last week, telling the state’s health and education departments to create rules preventing the implementation of local school mask mandates.
His order was in response to “several Florida school boards considering or implementing mask mandates,” the governor’s office said, and is intended to “protect parents’ freedom to choose whether their children wear masks.” Eight attorneys have filed a lawsuit against DeSantis.
On Friday, Orange County Public Schools in Florida issued a mask mandate for all students unless parents choose for their children to opt out, the district said in a news release. Employees, visitors, volunteers and parents are required to wear masks.
Returning to schools safely is possible if mitigation efforts, including wearing masks, are implemented, said Dr. Rochelle Walensky, who heads the US Centers for Disease Control and Prevention.
“The places that are having a problem, the places that are having disease that is transmitted in the schools, are the places that are not taking prevention strategies. The places that aren’t masking. The places where you see kids in the hospital, the places where you see footage of kids in the hospital, are all places that are not taking mitigation strategies to keep our children safe,” Walensky said Friday.
“If you’re masked and you’re doing all of the prevention mitigation strategies, (Covid-19) won’t be transmitted in the school. It will be contained,” Walensky added.
The CDC recommends that everyone – students, teachers, staff and visitors – wear masks in schools.
And while 50% of the total population is fully vaccinated, children under 12 are still not cleared to be inoculated, according to the CDC. In the meantime, health experts, including Hotez and Marty, say the mitigation efforts in schools should be implemented regardless of students’ vaccination status.
“Yes, mask mandates. I think we absolutely need vaccination mandates for our schools if we’re really gonna give kids our best,” Hotez said.
Boosters for people with a weaker immune system could be on the horizon
People who are immunocompromised could soon hear about a possible Covid-19 vaccine booster.
A decision from the US Food and Drug Administration on the booster shot could come before early September, a Biden administration official told CNN.
The Washington Post reported Friday that in the next week or two, FDA officials are expected to review data on additional vaccine doses for immunocompromised people from the CDC. If the data checks out, the FDA will amend the emergency use authorizations of at least two Covid-19 vaccines to allow the additional doses, The New York Times reported.
The move could affect millions of people who may not have had an adequate response to the vaccine.
That includes people taking immunosuppressant medications, some organ transplant patients and those with certain medical conditions. Research published in JAMA Network Open estimates that 6 million people in the US are taking immunosuppressants that could interfere with the vaccine – a number the researchers say is likely an underestimate.
The CDC warned last month that the vaccine may not have been effective for immunocompromised people. The agency said these people should continue to take precautions as if they were not vaccinated.
Meanwhile for others, a booster shot might just be part of the completion process for immunization, not an annual requirement to revaccinate, said Dr. Peter Marks, director of the Center for Biologics Evaluation and Research at the FDA.
“I don’t think that we want to think that these vaccines have somehow failed us,” Marks said at a discussion hosted by the Covid-19 Vaccine Education and Equity Project.
Marks distinguished between two ways of considering third doses: One to aid people without an effective immune response, and another to address continuing circulation of the virus.
“There is the third dose of vaccine as part of the upfront series for people who don’t make a good immune response – that’s one type of third dosing. And then there may be a third dose, or a booster, depending on how you look at it, that will be given to make sure we have good immunity against the circulating strains of Covid-19,” Marks said. “I think we need to make sure we present this correctly.”
Hospitals are strained amid Delta surge
As cases rise, hospitals and staff are facing dire situations day in and day out.
In Louisiana, 2,421 people were hospitalized with Covid-19 on Friday, up by 71 patients from a day prior.
“We broke the all-time record that we’ve had in Louisiana on Tuesday, and each day since then we have gone up. And I can tell you the indications are, we will go up by more than 100 more for tomorrow’s report,” Gov. John Bel Edwards said.
Another 3,939 children have tested positive for Covid-19 in Louisiana since his last news conference Monday.
“That means this week more than 6,000 children tested positive. So in light of that, and the CDC recommendations, the recommendations of the American Academy of Pediatrics, the information that we’ve received here from the Office of Public Health and leading Louisiana pediatricians, and quite frankly, as a parent myself, I have to ask – why wouldn’t we send our kids to school with a mask on?” Edwards questioned.
“Any holistic effort to slow the spread of the virus, which is absolutely paramount right now, in light of all the things we’re seeing across the state of Louisiana, simply has to include these young people,” Edwards added.
Edwards said he does have hope, as over the last month those individuals choosing to receive their first shot of the Covid-19 vaccine is up by more than 300% in the state.
And in Tennessee, the Covid-19 uptick is so high that Republican Gov. Bill Lee issued an executive order that allows hospitals to hire out-of-state health care providers as well as permit retired medical professionals to easily reenter the health care workforce. His order also increased bed capacity for Covid-19 patients.
Elizabeth Stuart, Lauren Mascarenhas, Virginia Langmaid, Rebekah Riess, Christina Maxouris, Rosa Flores, John Couwels, Ray Sanchez and Kay Jones contributed to this report.