In the US, the number of COVID-19 cases increased more than eight-fold throughout the summer, from an average of a little over 11,400 new daily cases for the week of June 12 to an average of more than 153,400 new daily cases the week of September 12, according to GlobalData. This increase corresponds with an increasing proportion of cases attributed to the Delta variant. The Centers for Disease Control and Prevention (CDC) reports a seven-day rolling average of more than 99% of Delta confirmed cases, compared to a little over 25% on June 12, 2021. As school begins throughout the country, this trend is significant given recent increases in Delta variant-related COVID-19 disease in school-aged children. Increases in the prevalence of COVID-19 in this population may exacerbate transmission to high-risk groups, like adults living in nursing homes, this fall and winter.

Although recent statements by the CDC director indicate minor differences in the severity of illness among children infected with the Delta variant versus other COVID-19 variants, asymptomatic individuals and individuals with mild illness may still transmit the virus. Therefore, the increasing number of children with the virus may increase the likelihood of transmission to other individuals at higher risk for severe disease. One such group is adults 65 and older living in nursing homes; according to GlobalData epidemiologists, this group accounts for more than 1.27 million individuals in 2021. The elderly in nursing homes are at particular risk because age increases the likelihood of hospitalisation and death among the unvaccinated, and COVID-19 vaccines may have waning effectiveness in older age groups. In addition, the high population density and enclosed spaces in nursing homes make transmission much more likely in this population.

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Moreover, many children are under 12 years old and cannot yet be vaccinated, which increases the risk of infection and subsequent transmission. According to the CDC, children are less likely to be tested, indicating that the pediatric COVID-19 prevalence is likely underreported. Therefore, the risk of children transmitting the virus may be even higher than anticipated. Thus, to help prevent the spread of the Delta variant to these groups, it is imperative to reduce its prevalence in children. Unfortunately, in the US, preventative measures to mitigate the transmission of the Delta variant are mainly dependent on state legislatures and vary widely on a state-to-state basis. However, despite the lack of uniform precautions, parents and children should still opt to use evidence-based COVID-19 prevention strategies such as facemasks and social distancing, particularly during this period as fall and winter have historically increased COVID-19 transmission. Doing so will not only reduce transmission among their immediate peers and family members but also to vulnerable groups such as older adults living in nursing homes.