Games have been canceled and many schools are moving classes online only, if for a few days, in attempts to control the spread of COVID-19 among children in North Texas.
Doctors and districts are finding outbreaks could have possible links to out-of-school events and activities.
Krum ISD officials said that the North Texas Fair and Rodeo and Halloween parties have likely been a "huge contributor" to the current spike in positive cases. Three campuses at the district are now learning completely online.
The Texas Education Agency allows only districts to switch online for five days.
Grapevine-Colleyville ISD said contact tracing shows that outbreaks came from non-school events that were held without masks.
Dr. Nicholas Rister of Cook Children's said that most cases among children are linked to family gatherings, sports activities and community spread.
Tarrant County Judge Glen Whitley said Tuesday that he wished youth sports could be suspended. He said the sporting events are contributing to the spike in cases in Tarrant County. The county reported a record number of new COVID-19 cases this week.
At Cook Children's Hospital in Fort Worth, the seven-day rolling average for positive pediatric cases has been increasing since early September. It reached a high this week with 7.8%. At Children's Health in Dallas, pediatric cases have also been increasing. There was a 6% positivity rate reported last week.
Rister, along with the infectious diseases team at Cook Children’s, does not feel schools are a huge driver in the COVID-19 numbers at this point.
"Schools have done a great job trying to manage this, and we haven't seen the balloon in spread that we were worried about," Rister said. "But even if there was no spread within a school, which is almost certainly there will be, we know children will get these infections from their families."
On Tuesday, Grapevine-Colleyville ISD sent a letter to parents that said that the district has seen a sharp increase in new cases of COVID-19 among students and staff members.
"If the virus spread continues to increase, we might have to close individual schools," the letter said, which urged for everyone's help to keep schools open.
Through contact tracing, Grapevine-Colleyville ISD has learned that the biggest sources of an outbreak are occurring from events without masks and social distancing that were held outside school settings.
Keller ISD said Tuesday that Timber Creek High School will be closed for five days and all learning will be online-only, starting Wednesday.
And Eagle Mountain-Saginaw ISD is moving all students and staff at Chisholm Trail High School to fully online starting Tuesday. There were 450 people who needed to quarantine due to 26 active positive cases.
The Tarrant County health department says that online-only learning is recommended for schools in the county.
"Younger patients are also getting sicker," said Dr. Kishor Gangani, who works at Texas Health Arlington Memorial Hospital.
Gangani deals with COVID-19 patients every day. He says contact sports should be put on hold for some time until there is clarity on cases.
"I know I'm sure they are doing what they're supposed to be doing with precautions," he said. "But despite that, there will be someone who is not going to be completely careful at some point and it's going to create a breakout."
Positive cases and exposures at Fort Worth ISD have slowly been increasing week-over-week. Last week, there were 534 positive cases and close-contact exposures in students.
Overall, most have been in pre-K students, followed by first graders, second graders and third graders.
Dallas ISD has 10,259 students on campus as of Sept. 28, according to the TEA. There were 54 additional cases reported on Tuesday and 195 additional cases so far in November.
The district doesn’t display cases over time through its dashboard. There have been 738 cases so far this year.
At Children's Health in Dallas, pediatric hospitalizations reached a high during the week of Sept. 27 at 34%. For the week of Nov. 1, hospitalizations were at 25%.
The Dallas County health department says there is a provisional total of 693 confirmed and probable cases of COVID-19 in school-aged children, ages 5 to 17, in the week ending on Oct. 24.
Reporter Tiffany Liou contributed to this report.