Author: Nick McGregor
Last month, when the number of cases of the coronavirus disease 2019 (COVID-19) started to grow in the United States, recommendations for caution focused on older adults and those with underlying health issues. Many young, healthy people dismissed the threat and didn’t take COVID-19 seriously, congregating on Florida beaches for Spring Break and in bars and restaurants across the United States before stay-at-home and physical distancing orders went into effect to try and slow the spread of the disease.
Now, statistics show that young, healthy people are at risk:
- Between February 12 and March 16, the Centers for Disease Control and Prevention (CDC) reported that American adults between 20 and 44 accounted for nearly 30% of positive COVID-19 cases, while 40% of hospitalizations occurred in patients aged 20 to 54
- In South Korea, which has been testing broadly for COVID-19 and therefore has less skewing of data as to who is infected, around 30% of positive cases occurred in those aged 20 to 29
- In California, Governor Gavin Newsom recently announced that nearly half of the more than 6,000 people who had tested positive for the virus were aged 18 to 49
- According to Philadelphia's health commissioner, more than 50% of their COVID-19 cases are occurring in people under 40 years old
- According to Gov. Andrew Cuomo, in New York City, now considered a global epicenter of the disease, 54% of COVID-19 patients are between the ages of 18-49 years old — and only 8% are those aged 75 or older
Further Evidence
On a more anecdotal level, these numbers bear out:
- The first known case of COVID-19 in the United States was a Washington State man in his 30s who tested positive after returning from China
- A 17-year-old California boy whose death was linked to the coronavirus last month may be one of the youngest victims of the outbreak in the United States
- In Georgia, a 12-year-old girl with no known health conditions was placed on a ventilator last month
- In Kentucky, a young person who attended a “coronavirus party” organized by healthy adults has tested positive
- In Utah, 27-year-old Rudy Gobert and 23-year-old Donovan Mitchell, star basketball players for the Utah Jazz, were two of the first people to test positive for COVID-19
- In South Africa, 31-year-old Cameron van der Burgh, a gold medal-winning Olympic swimmer, has been battling COVID-19 for several weeks
- In France, a 16-year-old recently died from COVID-19
The problem is that even healthy adults who don’t show any symptoms of COVID-19 can be carriers of the disease, which has an incubation period of anywhere from two to 14 days. (The common cold and influenza both have incubation periods of only one to four days.)
Mild Symptoms? COVID-19 Could Still Affect You
In early February, Jane Yee, MD, a global health fellow in the Division of Emergency Medicine at University of Utah Health, authored a paper for the Journal of the American College of Emergency Physicians about the emergence of COVID-19 and its implications for emergency care. Studying the spread of the disease in Wuhan, Hubei Province, China, Yee worried that “transmission [of COVID-19] may be possible during the incubation period or by patients with mild disease.”
It’s easy to imagine how a person with mild symptoms of a disease with a larger window of infectivity going about their daily activities in the community can unknowingly and rapidly spread the disease to someone downstream. “Unfortunately, the lack of widespread testing in the United States means we don't yet have a good idea about whether younger patients are in the clear,” Yee says. “Yes, most of the patients hospitalized, admitted to the ICU, or deceased are older. But keep in mind that hospitalization is not benign. There is no telling how long you will be hospitalized for, how long you might need oxygen, if you will get worse, or even if the disease will have a lasting impact on your lung function.”
The Only Way to Slow the Spread Is to Stay Home
Recommendations from public health officials are clear: the only way to slow the spread of COVID-19 is to stay home. That means no social gatherings, working and studying from home whenever possible, and maintaining a physical distance of at least six feet when you do leave the house for groceries or other essentials.
Photo: Getty Images
The goal is to “flatten the curve” in the growth of cases, which continue to explode in the United States. Positive COVID-19 cases in hard-hit areas like New York City and New Orleans are doubling every two days, a rate similar to Italy, where hospitals have been overwhelmed and approximately 10% of patients testing positive for the disease have died.
“COVID-19 has tested our health care systems in unprecedented ways,” Yee says. “We know how to treat fever, dehydration, and low oxygen levels, but when there is a surge of patients, there is not enough medications or equipment to meet the needs. If we ever reach that magnitude, then difficult decisions to ration care will have to be made.”
Personal protective equipment (PPE) is also an issue, Yee says. “At the moment, we do not have a local shortage, but that can become a reality if we do not take measures to slow the growth in cases,” she says. “As many as 20% of health care workers in Italy and 14% in Spain have been infected with COVID-19. When health care workers become infected, it exposes their patients and families and may put them out of commission. Unlike ventilators, which can keep running if plugged in, or face shields, which can be manufactured, health care workers need to rest—and take years to train. A loss of the workforce would diminish our ability to fight this disease and protect patients.”
Young People Have a Unique Responsibility
Physical distancing and stay-at-home practices are the best measures to slow the spread of COVID-19, Yee adds. “If unchecked, the natural course of the disease is to spread,” Yee says. “Since COVID-19 is primarily spread by respiratory droplets generated from coughing and sneezing, it makes sense that putting distance between those who are infected (recognized or not) and those who are not sick reduces the chance of infection. Young people have a unique responsibility to stop the spread, as those walking around with trivial, non-obvious symptoms will continue transmission. Young and healthy people have an important role in protecting the community and health care workers by staying at home.”
Early signs about the impact of physical distancing are promising. In Westchester County, New York, and the suburbs surrounding Seattle, Washington, early spikes in COVID-19 cases led to strict stay-at-home measures that, according to preliminary data, have begun to slow the spread.
Even if you’re young and healthy, you can make a difference by staying home and remaining six feet away from other individuals when you do go out. In the face of COVID-19, that simple act can save lives.
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