COVID and North Carolina Kids: What’s the Latest?

Blog | September 30, 2021

By Michelle Ries, MPH

Throughout the COVID-19 pandemic, children have fortunately not suffered high rates of severe disease. However, the Delta variant has led to increased cases among children, and infectious disease experts and policymakers have been closely monitoring this increase, as well as the impact of the return to in-person school for most children. As we look to another fall and winter of COVID, this two-post series examines the current state of the disease in North Carolina’s children, the status and impact of school-based policies, vaccination rates for adolescents, and what we can expect regarding a vaccine for younger children.


Cases, Hospitalizations, and Deaths


Since the start of tracking in March 2020, there have been more than 215,000 COVID-19 cases in North Carolina children aged 0-17, approximately 16% of the overall COVID cases in North Carolina. Most of these cases have been in school-aged children (age 5-9: 52,084 cases; age 10-14: 71,380 cases; age 15-17: 54,463 cases). A disproportionate number of these cases have occurred in recent weeks: more children aged 0-17 tested positive during the week of August 29 than at any other point during the pandemic.

graphic showing cases by age for north carolina
Source: North Carolina Department of Health and Human Services, NC COVID-19 Dashboard, Cases Demographics.


Fortunately, severe disease remains rare among children in North Carolina. Demographic data for COVID hospitalizations show that children make up around 1-3% of hospitalized patients on most recent days. Seven children under age 18 have died from COVID since March 2020 in North Carolina.


School-Based Policies


At the start of the traditional school year in late August, many counties were in the midst of making policy decisions to address the potential spread of COVID-19 in schools back at full capacity. In July, Governor Cooper, under guidance from the North Carolina Department of Health and Human Services, announced that school districts should require masks for all students and staff in school settings, regardless of vaccination status. Responsibility for issuing mask requirements would be at the local level. As of late September, all but three counties in the state (Avery, Lincoln, and Union) required masks for all students, teachers, and staff. Approximately 95% of North Carolina students attend schools where masks are required, an increase from mid-August, when mask mandates applied to 64% of students.


While Governor Cooper is not issuing vaccination mandates for school staff at this time, several districts have done so: Orange County, Chapel Hill-Carrboro City Schools. and Warren County have mandated vaccination for all school employees.


Child Care and School Clusters


NC DHHS collects data on COVID outbreaks and ongoing clusters within schools. According to NC DHHS, “in a child care or school setting, a COVID-19 cluster is defined as a minimum of five positive cases identified through a positive molecular (PCR) or positive antigen test result with illness onsets or initial positive results within a 14-day period and plausible epidemiologic linkage between cases. A cluster is considered over if there is not evidence of continued transmission within the setting.”


The most recent data, released on September 28, 2021, indicate 40 ongoing clusters within child care facilities, and 248 ongoing clusters in K-12 schools across the state. Since the start of tracking clusters in child care facilities and schools, NC DHHS has identified 7,025 cases and 3 deaths related to these clusters.


Look out for part two of this series - about emerging data on the impact of masking in schools and more - early next week.