Coronavirus cases among Oregon children younger than 10 grew fivefold during the month of June, representing the fastest growth rate of new or presumed infections across any age range.
State public health officials said the increase is largely due to unidentified transmission within the community, although outbreaks at day cares also are playing a small role.
The Oregon Health Authority on Tuesday reported 319 confirmed or presumed coronavirus infections among children younger than 10. The number as of May 31 stood at just 58.
Young children still represent the smallest overall share of cases in Oregon. And young children are among the least likely to need hospitalization, with only eight such patients and no deaths.
But the surge is concerning for state public health officials who say that, without correction, it could dim the prospects for having children in school desks this fall.
“I hope that the increasing cases among children will lead people to reevaluate their behavior and to take additional precautions,” said Dr. Melissa Sutton, a senior health adviser for the Oregon Health Authority.
Sutton said the rate of infections in Oregon “certainly endangers the prospect of reopening schools in the fall” and urged residents to maintain social distancing, wash hands and comply with Gov. Kate Brown’s order requiring masks for people age 12 and older in indoor public spaces beginning Wednesday.
“Our actions have real consequences,” she said, “and that might impact reopening schools.”
The somber message comes as Wednesday marks the 100th day since Brown announced a sweeping stay-at-home order that sent the state’s economy sputtering but worked to slow the spread of the virus. Brown began easing those restrictions May 15 and infections subsequently surged, more than doubling to 8,656 to close out June.
Brown on Tuesday extended her state of emergency through September and said Oregon is at a crossroads, with recent modeling warning of exponential growth in new cases.
“Oregon, you have a choice,” Brown said in a statement. “You can help to save lives again. What happens next is up to all of us.”
The rapid surge in new cases among children from newborns up to age 9 has gone relatively unnoticed – in part because of a lack of transparency by state agencies. Neither public health officials nor day care regulators have previously reported outbreaks at day cares, and they declined multiple requests from The Oregonian/OregonLive this week to quantify cases, saying information would be released Wednesday.
The young age group has now nearly caught up to the infection totals among Oregonians ages 80 and over, the group that has been most likely to die from COVID-19.
While vulnerable seniors have largely remained isolated from the outside world, many other Oregonians – including children – have resumed some semblance of daily life. That has enabled the virus to spread more readily among younger people, including parents in their 20s or 30s, Sutton said.
Health officials on Tuesday were not able to say how many children with confirmed or presumed infections live in households where a parent or sibling has also tested positive. But Sutton said infections in children generally have not been traced to another source, noting that community transmission is the “driving force.”
Young kids went from having almost no exposure, following the unprecedented shutdown of schools in March, to now returning to activities that include day camps, sports and trips to the playground.
“I don’t think there’s ever been a time in recent history where children have been so sheltered,” Sutton said of the early months of the pandemic.
Part of the increase may be due to more testing among children, she added. But testing alone does not explain the jump.
Coronavirus symptoms among children with infections generally include cough, fever, nausea, diarrhea and sore throat, Sutton said. Oregon has reported only one case of multisystem inflammatory syndrome in children, a seemingly rare condition that appears to strike sometime after a coronavirus infection.
The mere mention of the condition can be cringe-inducing for some parents. It causes inflammation in key organs, such as the heart and brain, and doctors don’t know what causes it, according to the Centers for Disease Control and Prevention.
It remains unclear precisely how many of Oregon’s new coronavirus cases among young children can be traced back to day cares.
“I think a small proportion of it can be linked to child care outbreaks,” Sutton said. “The vast majority of it is simply due to social mixing.”
The Oregon Health Authority on Monday and Tuesday would not provide figures requested by The Oregonian/OregonLive about the total number of outbreaks at day cares statewide or associated infections. Nor would the Office of Child Care, which regulates providers.
Jonathan Modie, a spokesman for the Oregon Health Authority, said the agency would begin including information in weekly reports released each Wednesday.
Officials plan to disclose day cares with at least five infections and an enrollment of at least 30 kids. But they aren’t planning to differentiate infections between children and workers.
Modie on Tuesday declined to say how many distinct outbreaks would be reported, although it apparently will be only a handful.
At least one outbreak to be reported is at the KinderCare in Lake Grove.
The day care notified parents June 14 that someone tested positive, according to records obtained by The Oregonian/OregonLive.
The center told parents on June 25 that eight children tested positive out of 69 enrolled, according to records. In the same message, KinderCare said 12 teachers also tested positive.
Some parents expected an outbreak eventually amid the pandemic, despite what appeared to be best efforts among staff. Some families were encouraged to seek testing if their children spent time around an infected teacher.
The incident left some on edge, awaiting results.
“It’s worrying that we don’t have a lot of data about children, especially those who can’t speak for themselves yet and can’t articulate what they’re feeling,” said one parent, who requested anonymity to speak about the outbreak for fear of retribution against their child.
KinderCare on Tuesday declined to identify the number of cases at the Lake Grove facility or if the company had outbreaks at other Oregon locations.
“As soon as we learned of the positive diagnoses in Lake Grove, we partnered with the Clackamas County Health Department and closed the center for 14 days to allow for a professional deep cleaning, retraining on our protocols and re-testing of our staff before we reopen,” spokeswoman Emily Snyder said in a statement. “We’re also taking the extra step of retraining all of our Oregon center staff to ensure we’re delivering against the highest standards possible.”
State officials have long been aware of the fact that day cares could become sources of coronavirus spread. In March, a Hillsboro day care worker tested positive, a fact that the Office of Child Care confirmed at the time.
Melanie Mesaros, a spokeswoman for the agency, said in an email Tuesday that it is misleading to compare that decision to the agency’s stance now to defer to the state health authority. That’s because officials disclosed the information in March, prior to an executive order by Brown that required coronavirus reporting be made to the health authority, she said.
Oregon officials have been slow to disclose outbreaks at nursing homes, workplaces and now day care facilities, often deciding to release broader information only after news reports.
State officials would not say Tuesday whether they should have been reporting outbreaks at day cares sooner, stressing that they have been working to find the right balance between public disclosure and individual privacy.
Modie, the health authority spokesman, said officials could use their new disclosure plan for day cares and apply it to schools this fall, should outbreaks occur.
-- Brad Schmidt; bschmidt@oregonian.com; 503-294-7628; @_brad_schmidt
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