Passing COVID-19 from one generation to the next

Like a rock thrown into water, everything indicates that the active transmission raging among young adults is just the first wave of a wave that will soon hit the older segments of the population in Quebec.

Several specialists and experts consulted by The duty express concern about the current rate of infection among 20 to 39 year olds. A reality that does not evolve in a vacuum and which is likely to ignite, in the short term, other layers of the population that are much more vulnerable, as has been seen in the United States.

The study released last week by the US Centers for Disease Prevention and Control (CDC) shows that the wave of contagion that hit young Americans this summer has clearly led to a rise in infections among the most age 60, on average 8.7 days later.

“Leaders must better communicate with young people how essential they are to keep this epidemic under control,” even hammered Tom Inglesby, director of the Center for Health Security at Johns Hopkins Bloomberg School of Public Health, interviewed by the New York Times.

This finding worries, while Quebec is experiencing such an outbreak among young people, says Dre Caroline Quach-Thanh, microbiologist-infectious disease specialist at CHU Sainte-Justine. “This morning, several people from the Ministry of Health asked me to send them the link to this study. It is certain that this influences the thinking underway at the moment, “confided this specialist, even before the government plunged the majority of Quebec into the red zone.

In the week of September 21, nearly 40% of infections affected 20 to 39 year olds, while 0 to 49 year olds accounted for 74% of the total cases.

“We know we have to reduce contact. Young people have a big role to play in this. We must understand that the risk is there, always wear the mask and act with our loved ones as if everyone was infectious, ”says this specialist.

Domino effect in the United States

The CDC study caused a stir in the United States, where experts believe that young people infected between the months of June and August (20% of cases) in the southern states were the vectors of community transmission among Middle-aged Americans, then among the older ones. And this is because of the jobs overwhelmingly occupied by millennials and thirties in many retail businesses, restaurants and health services.

For the Dr Donald Vinh, microbiologist and infectious disease specialist at the McGill University Health Center (MUHC), there is no longer any doubt that the transmission that runs in young people will have a short or medium term impact on the rate of infection in the elderly and the capacity of the hospital system to cope with the situation.

“We are already seeing isolated cases in CHSLDs which could be the embers before the fire,” he says.

“What we are now seeing among young people is extremely worrying. No one has a crystal ball, but we can see the path that could take shape. If the cases continue to increase, there will be exponential contamination. The ripple effect on young people is clear, “believes the microbiologist.

The CDC study also concludes that young people are more resistant to health measures, due to the perception that COVID is an illness of “old people”, having little or no impact on their health.

However, the infection rates of young people should not be of concern to us only because of their domino effect on the elderly, adds this MUHC expert. In his opinion, the serious effects of COVID also threaten young adults, a significant proportion of whom end up hospitalized, and who are at risk of serious complications.

“We can already see it in this second wave, people under 49 are hospitalized and we fear that this figure will increase in the coming weeks,” he said. Among the complications observed: pulmonary embolism, blood clots in the brain which can leave significant sequelae.

According to data from the National Institute of Public Health of Quebec (INSPQ), at least twenty young people under the age of 49 were hospitalized on Monday for complications related to COVID.

In the United States, the surrounding rhetoric about the “mild” effects of COVID on younger people has fueled the recklessness of many of them and encouraged certain risky behaviors. But according to results published recently in the Journal of the American Medical Association (JAMA), COVID has reportedly resulted in a worrying proportion of hospitalizations and intensive care among young Americans.

The review of the medical files of some 3,222 young people aged 18 to 34 hospitalized between 1er April and June 30 this year shows that 21% had to be admitted to the intensive care unit and 10% had to be placed on a ventilator. No less than 3% died, especially of young people with morbid obesity or hypertension. Quebec has so far reported only one death in a young person under the age of 20.

“I believe that there is still a lot to do with young people in terms of communication strategies,” says Marie-France Raynault, Head of the Department of Social and Preventive Medicine at the CHUM. “We’ll have to come back to influencers. The social norm has changed since the start of the pandemic. At first it was glorious to apply the sanitary measures, and now it almost got out of date. Unfortunately, young people, like all other humans, surrender to arguments that allow them to keep doing what they want to do. Now is the time to kick back, otherwise our health care system and all other patient care will take a hit. “

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