August 5, 2021

'Younger, sicker, quicker': How providers see delta striking younger patients

Daily Briefing

    In areas where the delta variant is leading to rises in Covid-19 cases, providers report seeing much younger, otherwise healthy patients than in previous waves—and those patients appear to be getting much sicker much faster, Roni Caryn Rabin reports for the New York Times.

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    'Younger, sicker, quicker'

    According to CDC data, half of all patients hospitalized with Covid-19 at the end of January were ages 65 and over, and just 22% were under age 50. Now, people ages 18 to 49 make up 41% of those hospitalized for Covid-19, while older adults make up just over 25%.

    And while evidence does not yet suggest that the delta variant targets young people differently, providers have anecdotally spoken to how young people seem to be "younger, sicker, quicker" in this delta-driven surge, the Times reports.  

    "Something about this virus is different in this age group," Catherine O'Neal, CMO at Our Lady of the Lake Regional Medical Center in Louisiana, said. "We always saw some people who we just said, 'Why the heck did this get them?' But that was rare. Now we're seeing it more commonly."

    "I think it is a new Covid," she added.

    Separately, Cam Patterson, chancellor of the University of Arkansas for Medical Sciences (UAMS), said the average age of patients hospitalized at UAMS Medical Center has dropped from 60 years old in the winter to 40 now.

    "Our sense is that younger, healthier people are more susceptible to the delta variant than those that were circulating earlier," Patterson said.

    According to the Times, the first Covid-19 case caused by the delta variant detected at UAMS Medical Center arrived on May 1. By June 17, nearly all Covid-19 cases at the hospital were caused by the delta variant.

    "The transition we saw toward younger patients and toward people getting sick more quickly coincided almost precisely with the emergence of delta here in Arkansas," Patterson said. "This to us feels like an entirely different disease."

    And Angie Honsberg, director of the ICU at University Medical Center in Las Vegas, said her younger Covid-19 patients are getting sicker much faster.

    "My suspicion is that the delta variant probably does behave somewhat differently," she said. "This is a much more equal-opportunity virus now."

    Similarly, Terrence Coulter, director of critical care at CoxHealth, also said Covid-19 patients at the hospital are younger and sicker than they were in the previous wave. "They thought in the first round that young patients and kids would get it and not even know they had it, or have mild disease," Coulter said. "With the delta variant, it's not like that. It's much more severe, without a doubt, than the original variant."

    Coulter added that while a number of patients hospitalized with Covid-19 have underlying health conditions such as diabetes or obesity, some of the younger Covid-19 patients don't have any.

    "That's what really frightens me," Coulter said. "It's hitting younger healthy people that you wouldn't think would have such a bad response to the disease."

    Why is the delta variant hitting young people so hard?

    According to the Times, experts are cautious about ascribing the blame for this situation solely to delta, though a recent CDC document suggests the variant is more contagious—and "may cause more severe disease"—than prior variants.

    "I don't think there's good evidence yet about whether it [the delta variant] causes more severe disease," said Adam Ratner, associate professor of pediatrics and microbiology at the New York University Grossman School of Medicine.

    Instead, Ratner hypothesized the cause of the surge, particularly among young people, "may be behavioral—a combination of the fact that we're opening things up, and in some places they're wide open and there are no masks, which is different from a year or 15, 16 months ago."

    Some experts added that younger patients may be more severely affected by the delta variant because they're less likely to be vaccinated than older patients, the Times reports.

    "I haven't seen evidence that delta selectively is targeting kids and adolescents and young adults," Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, said. "My impression has been that this virus is so highly transmissible that anyone who is unvaccinated is getting swept up in this, and that includes younger people."

    According to CDC, as of Sunday, more than 80% of Americans between the age of 65 and 74 have been fully vaccinated, but just under half of those between the ages of 18 and 39 have. (Rabin, New York Times, 8/3)

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