A teacher leads her students to an elementary school in the Brooklyn neighborhood of New York on Tuesday, September 29, 2020 as hundreds of thousands of elementary students return to the city’s classrooms and learn in person again amid the coronavirus pandemic. The coronavirus is infecting an increasing number of American children and adolescents in a trend that authorities say is being driven by school openings and resumption of sports, play dates and other activities. (AP Photo / Mark Lennihan)

After being heavily chased by the elderly in the spring, the coronavirus is increasingly infecting American children and teenagers in a trend fueled by school openings and resumption of sports, game dates and other activities, according to authorities.

Children of all ages now make up 10% of all US cases, up from 2% in April, the American Academy of Pediatrics reported Tuesday. And the Centers for Disease Control and Prevention said Monday that the incidence of COVID-19 in school-age children began to rise in early September as many teens returned to their classrooms.

According to the CDC report, about twice more teenagers were infected than younger children. Most infected children have mild cases; Hospital stays and death rates are much lower than those of adults.

Dr. Sally Goza, president of the American Academy of Pediatrics, said the rising numbers are a big problem and underscore the importance of masks, hand washing, social distancing and other precautions.

“While children generally don’t get as sick with the coronavirus as adults, they are not immune and there is a lot to learn about how easily they can spread it to others,” she said in a statement.

The CDC report did not specify where or how the children were infected.

Public health experts say the increase likely reflects the spread of the virus across the wider community. While many districts require masks and other precautions, some prevalence is believed to occur in schools as well. But experts also say that many school-age children who get sick may not get infected in classrooms.

COVID-19 cases in U.S. children rise as schools reopen

Students arrive in New York for in-person classes outside of school on Tuesday, September 29, 2020. The coronavirus is infecting an increasing number of American children and adolescents in a trend that authorities say is being driven by school openings and resumption of sports, play dates and other activities. (AP Photo / John Minchillo)

Just as cases in college students have been linked to parties and bars, school kids can contract the virus during play dates, overnight stays, sports, and other non-precautionary activities, said Dr. Leana Wen, a public health specialist at George Washington University.

“Understandably, there is quarantine fatigue,” Wen said. Many people feel that if schools reopen, other activities may resume, “but in fact the opposite is true.”

Global school studies suggest that face-to-face learning can be safe when transfer rates are low in the larger community, the CDC report said.

Mississippi is among the states where multiple outbreaks of students and teachers have been reported since resumption of face-to-face teaching in July and August.

Kathy Willard said she had mixed feelings about her grandson’s fourth grade being sent home for two weeks in Oxford after several teachers and a student tested positive for the virus. The family does not have internet access at home, which makes distance learning a challenge.

“It was an emergency. There is always a concern that he will fall behind or not get access to what he needs for school,” Willard said. “But at the same time I am glad that the school is doing everything it can to protect our children.”

COVID-19 cases in U.S. children rise as schools reopen

In this September 3, 2020 file photo, students keep social distance as they walk to their classroom in Highwood, Illinois. The coronavirus is infecting an increasing number of American children and adolescents in a trend that authorities say is being driven by school openings and reopening, resumption of sports, game dates and other activities. (AP Photo / Nam Y. Huh, File)

Students in their district are required to wear masks and receive temperature tests, and students and teachers who come into contact with the virus will be placed in quarantine.

In Alcorn County, Mississippi, where hundreds of cases have been reported in the community, including dozens among teachers, staff and students, parents Kimberly Kilpatrick-Kelley keep their 15- and 17-year-olds at home for virtual learning.

The Corinthian mother said the family always wears masks when they leave home and practice social distancing and she is concerned that her children will get sick and infect their parents.

“Personally, I don’t want to take the risk,” she said.

Dr. Yvonne Maldonado, director of the American Academy of Pediatrics’ Infectious Diseases Committee, said the big question is what will happen when schools that started online learning return to face-to-face teaching.

“It will really depend on how well you can mask and distance yourself in a school,” she said.

COVID-19 cases in U.S. children rise as schools reopen

In this Aug. 28, 2020 file photo, a sign reading “Social Distance Maintain 6 ft” is posted on the lockers of students at a school in Baldwin, NY. The coronavirus is infecting a rising number of American children and adolescents, according to a trend agency say seems driven by the reopening of the school and the resumption of sports, game dates and other activities. (AP Photo / Mark Lennihan, File)

New York City, the largest school district in the country with over 1 million students, resumed learning for elementary school children Tuesday. Higher grades will resume on Thursday.

According to the CDC report, more than 277,000 children, ages 5-17, were confirmed infected between March and September 19, with an increase in September after a peak and a decrease in summer.

The agency acknowledged that this may be underestimated, partly because tests are most often done on people with symptoms and children with the coronavirus often don’t have any.

The CDC reported 51 deaths among school-age children, most of them between the ages of 12 and 17. Less than 2% of infected children were hospitalized, and teenagers who are black, Spanish or have underlying medical conditions fared worse than white children.

The results complement other data showing that the pandemic is increasingly affecting younger age groups after older Americans were initially hit hard.

In a separate report on Tuesday, the CDC said weekly COVID-19 cases in people aged 18-22 have increased by 55% nationally. The gains were greatest in the Northeast and Midwest and were not just due to increased testing, according to the CDC. About a third of US cases affect adults aged 50 and over, while a quarter occur in 18 to 29 year olds.

COVID-19 cases in U.S. children rise as schools reopen

Students wait at socially distant intervals when they arrive for personal classes outside of a school in New York on Tuesday, September 29, 2020. The coronavirus is infecting an increasing number of American children and adolescents in a trend that authorities say is being driven by school openings and resumption of sports, play dates and other activities. (AP Photo / John Minchillo)

The AAP study is based on reports from health departments in 49 states, New York, Washington, DC, Puerto Rico, and Guam. New York State does not provide data by age. Most states count cases of children up to the age of 19, although some use different age groups.

As of September 24, the AAP counted nearly 625,000 cases in adolescents under the age of 20, an increase of 14% over the past two weeks. The death toll was 109, far less than 1% of all COVID-19 deaths in the United States

As of Monday, the CDC counted over 435,000 cases in children ages zero to 17 and 93 deaths. The totals for the groups differ as they span different ages and periods.

A total of 7 million Americans have been confirmed infected and 205,000 have died.

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