(CNN)As Michigan grapples with a surge of Covid-19 cases and hospitalizations, state officials have expanded the mask mandate to include children as young as 2.
The mandate, which went into effect Monday, requires children ages 2 to 4 to wear face masks while in public spaces, including day care and camps. Before Monday, the mandate only extended to children ages 5 and older.
The change comes as the state is in the midst of one of the nation's worst Covid-19 outbreaks, even as vaccination numbers rise across the country.
Driving the outbreak are coronavirus variants, as the state has tracked more than 2,200 cases of variant infections, Dr. Joneigh Khaldun, the state's chief medical executive, said earlier this month.
Hospitals are now at critical capacity levels as a result. Beaumont Health's eight hospitals in two Detroit-area counties are 90-95% full, and the number of their Covid-19 patients jumped from 129 in late February to more than 800 patients now, system officials said this month.
"Our Covid-19 numbers are climbing higher and faster and it's very troubling and alarming to see this," Beaumont Health CEO John Fox said in a news release. "We need everyone's help immediately."
And the surge has affected children, too. Covid-19 cases among children are rising in the state, reaching a record high April 20 with 70 pediatric patients, according to the Michigan Health & Hospital Association. In November, during the fall and winter surge of the virus, there were only 35 pediatric patients, a spokesperson at the association said.
"If kids are at school, at day care, playing with each other, that's a way they can take the virus from one place, transport it back to a household where there might be vulnerable people," Dr. Justin Skrzynski, a Beaumont internal medicine physician, told CNN affiliate WXYZ regarding the surge.
The US Centers for Disease Control and Prevention has recommended that children older than 2 wear a mask to curb the spread of the virus. Michigan's mandate is in effect until May 24.