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More children are being hospitalized with Covid-19 as health systems struggle to cope with a surge in new patients and officials race to expand vaccine protection.

The seven-day average number of children reported hospitalized with Covid-19 jumped almost 30% to a new peak of 239 in the week ending August 9. That number is up from the 184 children reported the previous week, according to data from the Centers for Disease Control and Prevention.

Evaluating vaccines for children under 12 is now a top priority for the US Food and Drug Administration, and it is possible that doses could become available to them by the end of the year.

“Make no mistake, the FDA will move quickly on this because they recognize what’s at stake. It’s the health of our children, and there’s really nothing more important than that,” Surgeon General Dr. Vivek Murthy told CNN’s Wolf Blitzer.

The urgency to get more of the population protected by vaccines is growing, said CNN medical analyst Dr. Leana Wen, who noted the worrying spread of the more transmissible Delta variant, adults being less cautious about protection – and more children being admitted to hospitals.

“We have the more contagious Delta variant, we have surges and we have so many adults letting down their guard, not wearing masks, not getting vaccinated,” Wen told CNN’s Wolf Blitzer on Tuesday.

“That’s contributing to this really dangerous environment for children.”

And in the next 48 hours, the FDA is expected to announce it is authorizing a third vaccine dose to help some people who are immunocompromised, according to a source familiar with the discussions.

For people with compromised immune systems, including some cancer patients, those taking medications that suppress the immune system and organ transplant recipients, the two doses of mRNA vaccine or a single dose of Johnson & Johnson may not be enough to develop adequate antibodies, Murthy said.

These people “really never got a good response to begin with,” from their immunizations, so the extra dose is “more of getting them up to what they hopefully had gotten the first time around, but we know because of their immune compromise, they didn’t,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on NBC’s “Today” show on Thursday.

The authorization would apply to less than 3% of adults, CDC Director Dr. Rochelle Walensky said Thursday. The CDC’s Advisory Committee for Immunization Practices will meet Friday to discuss the authorization, Walensky said.

More than 60% of the adults in the US are fully vaccinated, according to data from the CDC. But an ensemble forecast published Wednesday by the CDC projects that new hospitalizations and deaths will likely increase over the next four weeks.

The new school year already upended

For many students, the new school year has just begun – and the fresh surge in cases is already causing disruption.

In Mississippi, more than 4,400 students are quarantining after being exposed to Covid-19 during the week of August 2, according to data from the state’s department of health.

In Lamar County, several schools were forced to switch to virtual learning to combat rising cases. Superintendent Steven Hampton proposed a hybrid schedule during a board meeting on Monday, saying while he believes face-to-face learning is best, a hybrid model would help avoid having all of the schools be virtual.

“Face-to-face learning is the best way for our children to learn but I just don’t feel like it’s safe,” Hampton said.

In Georgia, all 14 cities within the Fulton County Schools jurisdiction are exceeding the qualifications for “High Community Spread,” and the requirement to wear a mask indoors has been extended to all schools within the district effective Thursday, according to an update from the district Wednesday.

In Clayton County, the Kemp Primary School confirmed that students will “operate in a virtual learning environment for the remainder of the week,” and the Glascock County Consolidated School in Gibson, Georgia, will continue virtually until at least August 20, it said.

In Florida’s Palm Beach County, 440 students are quarantined after Covid-19 cases were detected, after just two days of the new school year.

Meanwhile, Virginia Gov. Ralph Northam announced Thursday the state has passed a public health order requiring masks in indoor settings in K-12 schools, according to a news release from his office.

Current prevention guidelines for schools are the “best way” to prevent community transmission in the classroom, Walensky said Thursday.

“(The) best way to keep our schools safe, and we know how to do it, is to vaccinate everyone who can be vaccinated, vaccinate family members of children who cannot yet be vaccinated, and then to follow the mitigation strategies in our school guidance, including masking in schools.”

Understaffed hospitals facing rising patient numbers

Increased protection in the community could also be important in reducing the burden on hospitals across the country.

West Virginia Gov. Jim Justice said that for the first time since February 8, there are more than 100 Covid-19 patients in hospital ICUs across the state.

In Oregon, Gov. Kate Brown said ICU beds are about 90% filled, with some hospitals starting their days with fewer than five available ICU beds.

“Oregon hospitals are facing a crisis that threatens to eclipse the most severe bed shortages they’ve faced at any point in the pandemic,” said Pat Allen, Director of the Oregon Health Authority.

In Alabama, only 5% of ICU beds are available, Dr. Scott Harris, the state’s health officer, said on Thursday, and at the current rate, “we will surpass our all-time high from back in January in the next three or four days.”

“We need Alabamians to understand we are in a very difficult position right now,” Harris said during a Covid-19 update.

In Mississippi, the University of Mississippi Medical Center reported its highest number of Covid-19 patients ever – while citing problems with finding nursing staff as the “biggest pain point.”

There are some medical, surgical and ICU beds unable to open due to low nursing staff numbers, said Dr. LouAnn Woodward, UMMC Vice Chancellor.

Louisiana also has a record number of people hospitalized with Covid-19, the state’s health department tweeted Thursday.

San Francisco to require vaccination proof for some indoor activities

San Francisco residents age 12 and older will be required to show proof they have been fully vaccinated against Covid-19 to enter indoor restaurants, bars, gyms and theaters, as well as large event spaces.

The new mandate, announced Thursday by Mayor London Breed, takes effect next Friday and applies to “high contact” indoor public spaces and events with 1,000 or more people.

The move makes San Francisco the first major US city to mandate proof of full vaccinations for some indoor activities. Earlier this month, New York City implemented a similar mandate but allowed for partial vaccination.

“We know that for our city to bounce back from the pandemic and thrive, we need to use the best method we have to fight COVID-19 and that’s vaccines,” Breed said in a statement.

San Francisco has a high number of fully vaccinated residents, with 78% being inoculated. But the coronavirus positivity rate for the past week of the current surge is 5.6%, surpassing the peak of the winter surge, which was 5.2%.

While businesses are directed to see proof of vaccination for patrons by August 20, employees are also required to be fully vaccinated. The city is giving businesses a bit more time to ensure employees are immunized, setting that deadline at October 13.

The move comes after some San Francisco businesses started mandating proof of vaccination on their own. Last month, hundreds of bar owners said they would require patrons to provide proof of vaccination status or a negative coronavirus test result to enter.

CNN’s Lauren Mascarenhas, Kaitlan Collins, John Bonifield, Cheri Mossburg, Naomi Thomas, Rebekah Riess, Amanda Watts, Maria Cartaya, Mallory Simon, Melissa Alonso, Chris Boyette, Hannah Sarisohn and Keith Allen contributed to this report.

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