Young people don’t get a pass with COVID-19

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At a time when a pandemic is sweeping around the globe, it is incongruous to see photos of college kids partying on U.S. beaches during spring break and youthful revelers flocking to Berlin’s trendy nightclubs.

Young people always feel bulletproof to a certain degree but, in this instance, they may have been lulled into greater-than-usual smugness by the mistaken belief that coronavirus is only a worry for the elderly.

It is true that COVID-19 deaths are highest among people over the age of 80. But mortality isn’t the only measure that matters.

COVID-19 causes more grave illness than death, and we don’t yet know the long-term prospects of survivors. Remember, one in four patients who survived SARS had permanent disability due to lung damage.

Research published this week shows that younger adults are not only dying of of COVID-19, but being hospitalized and ending up in intensive care in significant numbers.

The most detailed study was published Wednesday by the U.S. Centers for Disease Control and Prevention.

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Researchers examined 2,449 cases of COVID-19 in the United States from Feb. 12 to March 16, with particular emphasis on 508 patients who had detailed hospitalization data, and the 121 who ended in an intensive-care unit.

The data are sobering, regardless of how young or old you are.

Among all the infected in this study, 5 per cent were under the age of 19, and 6 per cent were over age 85. Twenty-five per cent were aged 65 to 84; 18 per cent were aged 55 to 64; another 18 per cent, aged 45 to 54; and 29 per cent, aged 20 to 44.

But remember that in the U.S., like Canada, very few people with mild illness are being tested.

The 508 patients who were admitted to hospital, most with serious symptoms such as pneumonia and dangerously high fever, merit more attention.

Forty-five per cent were over the age of 65, but 17 per cent were aged 55 to 64; 18 per cent, aged 45 to 54; 20 per cent, aged 20 to 44; and only 1 per cent under 19.

Among ICU patients, the sickest of the sick, 53 per cent were over the age of 65; another 36 per cent were aged 45 to 64; and 12 per cent were aged 20 to 44. (No ICU admissions were recorded in the under-19 group, a rare bit of good news.)

There were only 44 deaths in the sample; 21 per cent in those under 64 and 79 per cent in those 65 and older.

In other words, while four in five deaths occur in older adults, only about half of those hospitalized and in intensive care are seniors. Among young adults who are infected, one in five ends up in hospital, one in eight ends up in ICU, and they account for one in five deaths.

It is this group of seriously ill patients – many of them younger adults – who are going to push the health system to the brink in the coming weeks.

That doesn’t seem to be understood by those chugging Corona beer (presumably ironically) on Florida beaches.

These data have limitations. It’s a small, U.S. sample. But researchers in France and the Netherlands have published near identical numbers. (We can’t yet do this kind of detailed analysis in Canada because provincial officials have a strange allergy to transparency and data-sharing; in two-thirds of 800-plus cases, we don’t even know the age of the person infected.)

There is also important information missing in the U.S. study. We don’t know how many of those hospitalized have underlying health conditions such as COPD, heart disease and diabetes, which make them more susceptible not only to infection, but poor outcomes.

We have to pay particular attention to protecting the vulnerable, including Indigenous peoples, people with disabilities and the frail elderly. To the living, not just the dead.

When people discuss coronavirus mortality, it’s often in a rather cavalier fashion, variations on “old people are going to die anyhow.” However crude it is to say, there is some truth to that; roughly half of all deaths in Canada are people over the age of 80. The corollary is that, in a country such as Canada, very few young people die; fewer than 1 per cent of deaths occur in those aged 1 to 24, and they are almost all from traumatic injuries, such as those suffered in car crashes and falls.

Every coronavirus death may not be preventable, but if we can slow the spread, we can reduce hospitalizations, critical illness and the burden on the health system.

At this point, the only tool we have is preventing infections by social distancing. It has to be practised by all, young and old, for the benefit of all. There is no room for complacency.

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