Young people are also dying from COVID-19, though many engage in denial

MILWAUKEE – Dangerous fiction has made its way through social media and American politics, the idea that COVID-19 is only really a danger to the elderly or those with severe chronic illness.

“Those who are in excellent shape, are young and have no previous illness can, in fact, become seriously ill from COVID,” said Nina Shapiro, professor at UCLA’s David Geffen School of Medicine and author of the book, “HYPE: A Doctor’s Guide to Medical Myths, Exaggerated Claims, and Bad Advice.”

“Many have died and many will die. In addition, healthy people continue to unknowingly transmit COVID to the elderly, who in turn become very ill and are at higher risk of death.”

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To those young adults who doubt their vulnerability to the pandemic, “I would invite them to visit our intensive care unit and see the multiple tragedies of young people infected with COVID,” said Daniel S. Talmor, president of the anesthesia, intensive care and pain medicine at Beth Israel Deaconess Medical Center in Boston.

© Mike De Sisti / Milwaukee Journal Sentinel
Johnnie Hodges, of Milwaukee, on his way to register to vote, walks through an island of empty chairs at the New Milwaukee COVID-19 Memorial on MacArthur Square in Milwaukee on Tuesday. The memorial consists of nearly 600 empty chairs to represent the lives lost due to the Covid-19 pandemic.

“I think people are willing to believe that they are safe because they are young and healthy, but that is a very dangerous and mistaken belief.”

The continued rejection of the pandemic as a typed virus that primarily kills the elderly and those already seriously ill has undermined the public health message that ‘we’re all in the same boat’.

Plus, when young and healthy people underestimate the danger, it opens up new opportunities for the virus to spread, especially at a time when many Americans have grown bored after months of wearing masks, cancellation of birthday parties and reduction of weddings and funerals.

The result has been all too predictable: reckless behavior and cases skyrocketing, with Wisconsin ranking among the highest rates of COVID cases in the country.

College parties are believed to have sparked epidemics at Notre Dame, the University of New Hampshire and the University of North Carolina at Chapel Hill. Even riskier was the 10-day motorcycle rally in Sturgis, South Dakota, which drew nearly half a million people in August. The rally has been linked to COVID outbreaks in South Dakota and Minnesota, and cases in a dozen states.

Now Americans face a moment of peril, but also of promise. Public health officials fear that at a time when the first vaccines appear to be weeks away from emergency use, people will ignore the warnings and gather for the holidays.

“The tragic thing is that we are now very close to having a solution available, if people just want to stick with it for a few more months,” said Nasia Safdar, medical director of infection control at UW Health in Madison. “We don’t have to see the devastation of health care systems and the people dying from them.”

Safdar and others say that while age definitely increases the likelihood of a patient suffering from a more serious illness from COVID-19, there is no foolproof protection for young people.

“This concept that young people don’t get extremely sick and die from COVID-19 is just plain wrong,” said Jakob I. McSparron, associate director of critical care medicine at Michigan Medicine in Ann Arbor.

“The majority of the patients in our intensive care unit are currently under 60. There are three patients in their 20s.”

McSparron said the myth that young people have little to fear from COVID has also led to people unknowingly infecting friends and relatives, who later died. An infected person may not show symptoms of the disease, but they can still pass it on to others, a phenomenon doctors call “asymptomatic spread.”

“We had a very young man with a chronic illness who was very scared of acquiring COVID,” McSparron said. “Unfortunately, someone visited him at home who did not know they had COVID. The young man ended up having COVID and died of COVID.”

A grim record

The death toll of Americans under 40 from COVID-19 – 3,571 – has now exceeded the total death toll from the September 11 terrorist attacks.

The idea that COVID-19 was primarily a disease of the elderly arose early in the pandemic when screening capacity was limited and largely directed at residents of nursing homes and people with symptoms.

By the summer, the United States had expanded its testing for the new coronavirus.

“We found younger and younger people infected,” said Frank Esper, a pediatric infectious disease specialist at the Cleveland Clinic Children’s Hospital.

Esper said the median age of hospital patients with COVID-19 across the country now hovers around 40.

“I have seen a lot of children without any underlying health issues having issues with COVID and becoming very sick and needing oxygen,” Esper said.

McSparron said healthcare workers are “enraged” by how many Americans have let their guard down on mask wearing and social distancing, not taking the pandemic seriously.

“I think there is a feeling we have a better way to deal with this,” McSparron said. “We have improved and the results are better than they were months ago. However, we do not have a quick fix.”

Remdesivir, plasma, steroids, and placing patients on their stomachs to increase their oxygen intake have all helped save the lives of patients with COVID-19. But there are still many cases where none of these treatments work.

Millions of people have additional risk factors

Another fact often downplayed is the number of Americans who suffer from conditions that put them at a higher risk of serious illness from COVID-19. While some adults undoubtedly suffer from more than one risk factor, the total number with at least one is probably 100 million or more.

Obesity alone – listed in several recent studies as a risk factor for severe COVID-19 – affects an estimated 85 million adult Americans.

Other risk factors listed by the Centers for Disease Control and Prevention include: chronic kidney disease (37 million Americans); smoke (34 million Americans); Type 2 diabetes mellitus (30 million Americans) and chronic obstructive pulmonary disease (16.4 million Americans).

This does not include the number of people whose immune systems are weakened by cancer treatments or organ transplants.

Currently, the largest number of COVID-19 cases are in the 18-29 age group.

“It’s really quite striking,” said Lew Kaplan, president of the Society of Critical Care Medicine, a nonprofit medical organization. “What’s worse is that they are young enough to have parents and grandparents. The asymptomatic rate of spread is very dangerous for everyone around them.”

Kaplan said the high rate of spread by young Americans “belies the social contract we have in which we care for each other.”

Like all of the experts interviewed for this story, Kaplan stressed that to bring the pandemic under control, Americans must practice wearing masks and social distancing and accept the idea that “we’re in the same boat.”

“It’s absolutely essential,” he said. “Membership makes everything work. Lack of membership puts everyone at risk.”

Follow Milwaukee reporter Mark Johnson on Twitter: @majohnso.

This article originally appeared on Milwaukee Journal Sentinel: Young people are also dying from COVID-19, though many engage in denial