Got questions about kids, school and delta variant? Here are some answers.

The start of school is just around the corner, and the timing doesn’t favor Florida schoolchildren.

The delta variant, a more contagious strain of COVID-19, is fueling a fourth wave of infections. Florida leads the nation in infections and hospitalization rates — for both adults and children.

Kids will soon pack into schools, classrooms and school buses as delta spreads. Vaccinations have proven effective against the variant but may offer schools limited protection. Those ages 12 through 19 have the lowest vaccination rate of any age group in the state, and kids 11 and under are not eligible to receive the vaccine.

That means the vast majority of Florida elementary school children will not yet have been vaccinated.

Parents and their kids have plenty of questions about what this means for them, what risks they may face, and what they can do to keep their kids and families safe. Here are some answers.

UPDATE: The Hillsborough County School Board voted to require students, teachers and staff to wear masks for 30 days in response to rising infections. Students can only opt out of the policy for medical reasons. Hillsborough joins the Miami-Dade and Broward School Boards in defying Gov. Ron DeSantis’ recent order trying to bar mask mandates in schools.

What does the coronavirus situation look like for Florida kids?

Florida leads the nation in the hospitalization rate of kids who have been infected with COVID-19. There are 0.76 kids being hospitalized per 100,000 residents, according to the Centers for Disease Control and Prevention. That’s about 32 per day from July 24 to 30.

The Florida Department of Health reported 13,596 new COVID-19 infections among children who are not eligible for the vaccine, age 11 and under, from July 30 to August 5. Those eligible for the vaccine, 12 to 19, saw 13,858 new cases.

That’s an average of more than 3,922 new cases per day that week in ages up to 19.

A total of 228,188 children have been diagnosed with COVID-19 in Florida — about 9 percent of the population — as of July 29, according to the American Academy of Pediatrics.

How much worse for children is the delta variant compared to previous strains?

The delta variant is not considered deadlier than previous strains. But it is twice as transmissible as the alpha variant and the driving factor behind the recent COVID-19 surge among children, said Dr. Christina Canody, director of pediatric services for BayCare Health System.

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While the state does not keep track of total patients infected with the delta variant, hospital officials say the vast majority of recent COVID-19 cases being treated at Johns Hopkins All Children’s Hospital and St. Joseph’s Hospital are because of the new variant.

The CDC estimates that 82 percent of COVID-19 cases diagnosed nationally from July 4 to 17 are delta variant cases.

How does “long COVID” affect children, and how many are getting it?

Some may experience symptoms such as cough, shortness of breath, fatigue, chest pain, and difficulty in concentrating for weeks after getting COVID-19, a condition often referred to as “long COVID.”

While long COVID cases are more common in adults than children, 4.4 percent of infected kids have symptoms that last four weeks or longer and 1.8 percent have symptoms that last eight weeks or longer, according to a new study of more than 1,700 British children.

In rare cases, infected children can also develop multisystem inflammatory syndrome, an autoimmune disease that targets school-aged kids and can occur two to six weeks after a coronavirus infection. Symptoms include fever, rashes, red eye, diarrhea, and vomiting. If left untreated, the illness can be fatal or leave permanent heart damage, said Dr. Allison Messina, chairman of the Division of Infectious Disease at Johns Hopkins All Children’s Hospital.

How many Florida kids have gotten sick and died during the pandemic?

Since the first cases were diagnosed in March of last year, 444,315 people under age 19 have been infected with COVID-19, according to the Florida Department of Health.

The state has reported eight deaths among children under 16.

The youngest child to die in Tampa Bay was 6-year-old Astrid Reyes of Tampa, who passed away Aug. 19, 2020 at Johns Hopkins All Children’s Hospital. The youngest victim in the state is a 4-year-old Hardee County girl who died in March, the state said.

The most recent child to die is an unvaccinated 16-year-old who had no underlying health conditions died of COVID-19 . She died Thursday at Wolfson Children’s Hospital in Jacksonville, the Florida-Union Times reported.

How many Florida children ages 12 and up have been vaccinated?

The state reports that 41 percent of children ages 12 through 19 have been vaccinated — the lowest vaccination rate of any age group. This age group makes up 10 percent of those eligible to be vaccinated and nearly 9 percent of the total state population.

“Until we see vaccination rates above 70 percent,” Canody said, “we’re going to continue to see this pandemic circulate.”

But only 53 percent of Floridians 12 and up are fully vaccinated while 62 percent have received at least one dose, according to the latest state data.

Florida is in the middle of the pack in child vaccinations. Only 16 states have vaccinated more than 50 percent of youths ages 12 to 17, according to the CDC.

When will children under 12 be eligible to get vaccinated?

Pfizer will likely apply for emergency authorization from the Food and Drug Administration to offer the vaccine to children ages 2 through 11 in September, Canody said.

She expects the vaccine to be available for children as young as six months by the end of this year.

Do vaccines pose risks to children 12 and up?

Vaccines do not pose unique risks to children, Canody said. Kids can expect the same vaccine side effects common among adults: low-grade fever, fatigue and soreness in the arm that received the shot.

Individuals with a history of severe allergic reactions may have a higher chance of a severe reaction, Canody said, but in general the vaccines have been shown to be safe and effective.

Dr. Claudia Espinosa, pediatric infectious disease expert at the University of South Florida, said that the vaccine has shown to be nearly 100 percent effective in preventing infections among children.

Do children ages 12 and up need parental permission to get vaccinated?

Florida is one of 41 states that requires parental consent for those under 18 to get vaccinated.

How contagious are unvaccinated children who catch the delta variant?

Unvaccinated children infected with the delta variant are just as contagious as unvaccinated adults, said Dr. Joseph Perno, vice president of medical affairs at Johns Hopkins All Children’s Hospital.

The CDC recommends that anyone who experiences COVID-19 symptoms should immediately quarantine and get tested. Most infected people can resume being around others after quarantining for 10 days from symptom onset and having gone 24 hours without a fever.

How can vaccinated family members and unvaccinated children live together safely?

Young children are most likely to become infected through a household member, Canody said, so parents with children not eligible for the vaccine should reduce the chances of bringing the virus into the home by wearing masks and practicing social distancing in indoor public spaces.

“Masks are going to be (parents’) first line of defense for protecting younger children,” Canody said, “especially those who are too young to mask.”

Dr. Nishant Anand, Baycare’s executive vice president and chief medical officer, has a vaccinated 13-year-old, but his 11 and 8-year-olds are still too young for the shot. The doctor started wearing a mask in early July when he saw the uptick in delta-driven cases, weeks before the CDC updated its masking guidelines and again recommended masking while indoors.

“I would hate to be vaccinated and be fine myself but then have exposed my children to the virus,” Anand said.

How risky is it for unvaccinated children to visit vaccinated grandparents and older relatives?

If vaccinated family members wear masks and practice social distancing while in public, Canody said, the risk of them spending time indoors with unvaccinated children should be relatively low.

What is the latest mask guidance for children?

The CDC updated its guidelines on July 27 and now recommends that fully vaccinated people wear masks indoors if they live in parts of the country where cases are surging (such as Florida).

The guideline for unvaccinated children remains the same: wear a mask while indoors, except for those under the age of 2.

Will Tampa Bay schools require masks and implement social distancing?

The Hillsborough County School Board requires students, teachers and staff to wear masks for a 30-day period ending Sept. 18.

The Diocese of St. Petersburg imposed a temporary mask mandate at its 46 schools and early childhood centers in Pinellas, Hillsborough, Pasco, Hernando and Citrus counties. Parents can opt out of the new policy.

Masks will be voluntary in Pinellas, Pasco and Hernando county public schools for students, teachers and campus visitors. Those districts add that face coverings are strongly recommended indoors while on campus. All four districts will have a supply of masks on hand if people request them.

Social distancing will take place, but on a more relaxed basis than last year. The districts differ slightly in some of their messaging. Hillsborough, for example, will continue to maintain seating charts on buses for contact tracing purposes. Pasco and Hernando schools will encourage social distancing “where possible.” Pinellas says its schools will have some social distancing “while also ensuring collaboration.”

Protocols like frequent sanitizing of buses, restrooms, classrooms and common areas in schools will continue. For the most part, the plexiglass shields that adorned many classrooms will go away. However, many teachers may still elect to put them up, and their use is likely to continue in many common areas.

The districts detail their protocols here: Hillsborough; Pinellas; Pasco; Hernando.

Will Tampa Bay schools require proof that students and staff are vaccinated?

Generally, no. You won’t need proof of vaccination to attend or work in a school. However, you may be asked to voluntarily show your vaccination status in certain situations.

Anyone deemed to have had significant close exposure to the virus will be required to show proof of full vaccination to avoid being quarantined, providing they have no symptoms. That means unvaccinated students and staff are subject to quarantine if exposed.

Those who are exposed and have COVID-19 symptoms, whether vaccinated or not, will be required to quarantine. Quarantine decisions in each district will be made in consultation with the local health department.

What are Tampa Bay school districts doing to get eligible students vaccinated before school starts?

All four local school districts held vaccination events over the summer, mostly in June, offering the Pfizer vaccine, which is the only shot approved for those 12 and older. No plans have been announced for additional events.

Will Tampa Bay school children be allowed to wear masks if that’s what they or their parents want?

Yes. Masks will be optional in Pinellas, Pasco and Hernando schools and required in Hillsborough schools, unless those parents opt out in writing.

What do school districts plan to do when there are COVID-19 outbreaks in schools?

As was the practice last year, cases will be reported to county health departments, which will determine how many people were potentially exposed, whether a quarantine is warranted and the extent of the quarantine.

What can children do to stay safe in school?

First and foremost, eligible children should get vaccinated as soon as possible, Perno said. The vaccine is the most effective way to prevent virus spread and the only way to end the pandemic for good.

The American Academy of Pediatrics and the Centers for Disease Control and Prevention also urge students, teachers and staff to wear masks while indoors in schools.

That may be difficult to enforce in Florida, where Gov. Ron DeSantis last week issued an executive order seeking to ban school mask mandates, after the Broward and Gadsen county school districts announced plans to require masks this fall. School board lawyers question whether the governor can do so.

What should children do to stay safe on a school bus?

Children should wear a mask and practice social distancing if space allows, Perno said.

What about immunocompromised children at school?

The level of risk associated with returning to school varies for each immunocompromised child, Perno said. Families should discuss the decision whether to resume in-person instruction with the child’s physician.

For immunocompromised students who go back to school, the same rules apply: Get vaccinated, wear a mask, and practice social distancing if possible, Perno said.

Other students should keep in mind that mask wearing not only protects them from the virus but also prevents infecting their immunocompromised classmates who are at greater risk.

What are helpful sites for parents on the latest mask and vaccine guidance?

Check these online resources:

The Centers for Disease Control and Prevention: cdc.gov/coronavirus

The American Association of Pediatrics: aap.org

The Florida Department of Health: floridahealthcovid19.gov

Times staff writers Ian Hodgson, Jeffrey S. Solochek, Marlene Sokol and Thomas C. Tobin contributed to this report.

• • •

Tampa Bay Times coronavirus coverage

DELTA VARIANT: The contagious variant has changed what we know about staying safe from COVID-19. Here’s what you need to know.

KIDS AND COVID: Kids are back in school, but COVID-19 is still a problem. Here’s what parents and kids need to know.

BOOSTER: Officials say you’ll need another shot for protection.

VACCINES: The best way to stay safe from COVID-19 is to get vaccinated. Here’s a primer on the coronavirus vaccines.

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