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June 29, 2020

The 'disturbing' surge in Covid-19 cases among young Americans

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    America's coronavirus epidemic has hit a new peak, and public health officials say nearly half of newly reported cases are occurring among adults in their 20s, 30s, and 40s. Now, experts are encouraging young Americans to socially distance—warning that Covid-19 poses serious risks even for young and healthy people.

    Coronavirus cases surge among young people

    The United States' daily number of newly reported coronavirus cases has now grown for more than a week and has surpassed America's previous peak of the epidemic. U.S. officials in recent days have reported consecutive record-high single-day increases in new cases, and nearly 30 states have seen their average daily numbers of newly reported cases rise over the past 14 days.

    The spikes in new cases have been most significant in states that were among the last to implement stay-at-home orders, business closures, and social distancing policies, or among the first to relax those measures. Alabama, Florida, Oklahoma, South Carolina, Montana, Texas and Utah last week all reported their highest single-day totals of new coronavirus cases.

    Public health officials report that many new clusters involve patients who had eased their social distancing practices: visiting bars, restaurants, and other businesses; visiting churches; attending large social gatherings; and taking part in other events where the risk of coronavirus transmission is high. In addition, officials have found that many newly reported cases are among younger adults—a striking change from the country's early outbreaks, which primarily hit older communities and nursing homes.

    For example, in Arizona, residents between the ages of 20 and 44 accounted for almost 50% of new cases last week. In Florida, the median age of people who tested positive has declined from 65 in March to 35 as of last week, the New York Times reports.

    And in Texas, people under 40 made up the majority of newly reported cases in multiple counties. Texas Gov. Greg Abbott (R) earlier this month said, "There are certain counties where a majority of the people who are tested positive in that county are under the age of 30, and this typically results from people going to bars."

    And the Los Angeles Times reports that, in California, 56% of people who've tested positive as of Wednesday were between the ages of 18 and 49, while people older than 65 accounted for 15% of the state's positive cases as of Wednesday.

    Joseph McCormick, a professor of epidemiology at UTHealth School of Public Health, said, "What is clear is that the proportion of people who are younger appears to have dramatically changed. … It's really quite disturbing."

    Robert Griffin, research director for the Democracy Fund's Voter Study Group, said young people are less likely to social distance because they perceive themselves to be at lower risk of developing severe cases of Covid-19. According to a new survey from the Democracy Fund + UCLA Nationscape Project, respondents ages 18 to 29 were the most likely, at 45%, to report they had socialized with people they do not live with while not maintaining social distancing in the past week.

    "We're kind of in this knotty situation where these folks are probably engaging in this stuff because it is less dangerous to them personally," Griffin said.

    Younger populations face serious risks from Covid-19

    Research does indicate that younger people are less likely to develop severe cases of Covid-19. For example, CDC data on U.S. coronavirus cases from Jan. 22 to May 30 shows that adults in their 20s accounted for 13.3% of confirmed coronavirus infections but fewer than 4% of hospitalizations.

    However, states' recent reports suggest those proportions could be rising, and evidence has shown that younger patients can experience serious and sometimes life-threatening symptoms and complications.

    Maria Van Kerkhove, head of the World Health Organization's emerging diseases and zoonosis unit, said countries have seen "more and more younger individuals who are experiencing severe" cases of Covid-19. "We've seen some data from a number of countries across Europe where people of younger age have died."

    CDC on Thursday updated its guidance regarding who is at high risk of developing severe cases of Covid-19 to reflect that "among adults, risk increases steadily as you age, and it's not just those over the age of 65 who are at increased risk for severe illness." The agency said, "As more information becomes available, it is clear that a substantial number of Americans are at increased risk of severe illness—highlighting the importance of continuing to follow preventive measures."

    Jay Butler, incident manager for CDC's Covid-19 response, said, "Younger people are in no way completely immune to the effects of [the new coronavirus] nor are they at zero risk of severe manifestations," particularly if they have "underlying illness or health conditions, including things like diabetes or obesity."

    For instance, providers have reported increasing rates of Covid-19 patients in their 30s and 40s experiencing severe strokes, including among some patients who weren't even aware they had contracted the new coronavirus. Over the course of three weeks, doctors at Thomas Jefferson University Hospitals and NYU Langone Health identified 12 patients who had Covid-19 and experienced strokes. Of those patients, 40% had few or no risk factors for stroke and were under 50 years old.

    And even though young Americans' overall risk of developing a severe case of Covid-19 still appears to be low when compared with older Americans, CDC Director Robert Redfield on Thursday emphasized that younger people can spread the disease to more vulnerable populations.

    While the coronavirus' effects in younger patients "may not be highly associated with hospitalization and death," young people still "act as a transmission connector for individuals that could in fact be at a higher risk," Redfield said.

    Judith Malmgren, an epidemiologist in Seattle, echoed Redfield, adding, "Just because you're in an age group that is less likely to die from coronavirus does not mean that you live alone" (Bosman/Mervosh, New York Times, 6/26; Karlamangla, Los Angeles Times, 6/26; Morin, USA Today, 6/26; Rau/Lawrence, Kaiser Health News, 6/25; CDC Morbidity and Mortality Weekly Report, 6/19).

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