CDC analysis shows coronavirus poses serious risk for younger people

Early data analyzed by the Centers for Disease Control and Prevention (CDC) shows that younger Americans are at substantial risk of experiencing serious medical problems from the coronavirus sweeping the globe.

That data runs counter to some of the early messaging from public health officials in other parts of the world.

new CDC analysis of more than 2,400 cases of COVID-19 that have occurred in the United States in the last month shows that between 1 in 7 and 1 in 5 people between the ages of 20 and 44 in the sample of those who are confirmed cases require hospitalization, a level significantly higher than the hospitalization rates for influenza. The true percentage of young people who require hospitalization is likely much less, because many remain asymptomatic.

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Between 2 percent and 4 percent of confirmed cases among people that young are admitted to intensive care units. The fatality rate is low, only 0.1 percent to 0.2 percent.

Health outcomes are much worse among those who are older and those who have underlying health conditions. The early estimates show that a fifth to a third of those between the ages of 45 and 65 who contract the disease are hospitalized. Among those over 75 years old, hospitalization estimates range from 30 percent to more than 70 percent.

Among the oldest cohort, those over the age of 85, somewhere between 10 percent and a quarter of all patients die. The data show adults over the age of 65 account for 80 percent of the deaths associated with the coronavirus.

  

But younger Americans are contracting the virus at the same rates as those who are older. The initial round of data actually found more people between the ages of 20 and 44 who landed in the hospital than those over the age of 75 who wound up in treatment, even though mortality rates were lower for the younger set.

"Lots of young people are getting hospitalized, a lot more than we’re messaging, and, yes, maybe you don’t die, but living with a damaged lung or damaged organ is not a good outcome," said Prabhjot Singh, a physician and health systems expert at Mount Sinai Health System and the Icahn School of Medicine.

Deborah Birx, one of the Trump administration's top experts on its coronavirus task force, said Wednesday that early data from France and Italy, both dealing with thousands of coronavirus cases, seemed to underscore the threat to younger people.

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"There are concerning reports coming out of France and Italy about some young people getting seriously ill and very seriously ill in the ICUs," Birx said at a White House briefing. She did not offer further details.

The data, Singh said, shows the importance of government messaging to millennials and members of Generation Z that the virus poses a substantial risk no matter someone's age. And even if someone does not show serious symptoms, they can still spread the disease to friends, neighbors or relatives who will.

"We’re talking to young people about doing their part and being good millennials because they could be asymptomatic spreaders," Singh said. "That’s true, but it’s also true that some high number of them will also get sick enough to be hospitalized, and many of them may have lasting consequences."

The survey of the 2,449 cases in the United States for which outcomes are known offers only an initial glance at the havoc the virus has created in American hospitals, explaining why the ranges are so broad. 

The World Health Organization has said the mortality rate from the COVID-19 disease could be up to 3.4 percent, the top end of a range that CDC's data agrees with. The CDC pegs the mortality rate among cases in which the outcome is known at between 1.8 percent and 3.4 percent — though that figure does not count what are likely tens of thousands of other people who had more mild or no symptoms at all.

The CDC warned that the 49 million Americans who are over the age of 65 should maintain a monthlong supply of necessary medications and stay home as much as possible.

Another survey released Wednesday by the CDC shows that a substantial number of the victims of the coronavirus at a nursing home near Seattle had underlying conditions such as hypertension, cardiac disease, kidney disease or diabetes. Of the 129 people connected to the facility who contracted the virus, more than 40 percent had hypertension, nearly 40 percent also had cardiac disease, and more than a quarter had either kidney problems or diabetes.

"This isn’t being megaphoned enough. In plain language, anyone who has high blood pressure or heart problems is at significantly increased risk. People often don’t think about that as being a chronic condition or underlying health problem like diabetes for some reason," Singh said.

The data echoes expert concerns that as many people could die because of the coronavirus as from it — especially if the number of COVID-19 cases overwhelms the health care system and delays treatment or medicine for those who have some other malady.

"As this pandemic expands, continued implementation of public health measures targeting vulnerable populations such as residents of long-term care facilities and health care personnel will be critical," the report says. 

UPDATE: This story has been updated to clarify the study sample included in the CDC's survey. The number of confirmed cases is almost certainly well below the number of actual cases, meaning the percentage of young Americans who contract the coronavirus and require hospitalization is likely much lower. A previous version of this story was unclear about the difference between confirmed cases and actual case numbers.