Practical advice
Why no one should think they’re safe from the coronavirus
It is a typical, slightly selfconscious selfie. Chloe Middleton stares, soulfully, into the camera – with piercing blue eyes, and cherubic pout, she looks much like any pretty young woman her age. And, in many ways, she was.
But, tragically, last week the 21year-old care worker from High Wycombe, Buckinghamshire, became the youngest British victim of the coronavirus pandemic sweeping the world, her family have said.
‘My beautiful, kind-hearted niece Chloe passed away from Covid-19,’ wrote her ‘shattered’ aunt Emily Mistry on social media, adding, terrifyingly: ‘She had no underlying health conditions.’
On paper, at least, Covid-19’s worst effects are felt by those over the age of 50 and, in particular, people with other health problems, including heart disease and diabetes.
Early studies from Wuhan, China, where the disease was first identified in December last year, suggested 80% of all deaths were in those over the age of 65, with the worst outcomes for patients in their 80s.
Younger people were much more likely to suffer a ‘mild’ illness, or no symptoms at all.
And this is part of the reason the virus has spread so fast, say experts. People often don’t know they’ve got it, so go about their normal lives, unknowingly infecting others.
However, 15% of patients suffer a severe illness – and emerging evidence suggests this is not just a worry for the elderly. And, undoubtedly, there will be more – perhaps many – tragic cases like that of Chloe Middleton.
Over the past month, reports have emerged of youngsters in many countries ignoring advice to practise social distancing. Such is the concern, World Health Organisation boss Tedros Adhanom Ghebreyesus last week warned young, healthy people they would not be ‘invincible’ during the pandemic.
‘Although older people are hardest hit, younger people are not spared,’ he said.
The most recent US figures show just that. While fatalities are highest in those over 85, one study found that out of 500 hospitalisations, 18% were aged 45 to 54, and 20% were 20 to 44.
One in 10 ICU admissions – the most perilously ill – were in this youngest age bracket.
Professor Stephen Griffin, virus expert at Leeds Institute of Medical Research, warns: ‘Everyone, potentially, is at risk. Yes, the odds get worse as we get older. But each time a person is infected, a struggle begins between the virus and that person’s immune system. And you can’t say, with any certainty, which will win – because genetics, and many other factors we don’t yet understand come into play.
‘So, while it’s true that eight in 10 patients who die will be over 65, two will be younger. And when you multiply that on the huge scale, as is the case with Covid-19, that is a lot of young people who could be killed by this virus.’
Dr Nathalie MacDermott, a paediatric infectious diseases specialist at King’s College London, agrees, saying: ‘We have seen people in their 20s and 30s die from this virus.
‘Some had underlying medical conditions, others didn’t. Why did they have a severe infection, when a lot of other young people are relatively unscathed? That’s a question we need to answer.
‘But just because a person is young or fit, doesn’t mean they’re going to be fine.’
Another patient who knows all too well what it’s like being on the unlucky side of the statistics is Michael Prendergast.
The ‘fit, healthy, gym-going’ 28year-old, from Co. Kerry, began to suffer a headache a fortnight ago, shortly after coming back from a trip to London.
Within 24 hours, the symptoms came on with brutal speed: a soaring temperature, uncontrollable shaking, and sudden, extreme breathlessness.
‘There is a misconception that this is just a cold or flu,’ said Michael, in a video he recorded from his hospital bed. ‘It is not. It is harrowing. It feels like you’re not far from death. I’m young, sporty and go to the gym. I never would have imagined I would be so sick.’
His mother Joan, 61, adds: ‘He kept calling me from hospital saying he was terrified he’d die alone.
‘It was horrible because I wasn’t allowed to go in the ambulance or to the hospital, in case I was infected, too.’
Thankfully, only a handful of people in Kerry have been infected – and, crucially, hospital staff had the time to give Michael their full attention.
‘He needed all the experts around him doing constant checks because he was having sporadic attacks of breathlessness,’ Joan says. ‘And it took five days in a hospital bed to get him stabilised. It terrifies me to think of what might have happened had they been overwhelmed, like hospitals elsewhere.’ Michael returned home on Tuesday. But he has not yet recovered.
‘He is still having periods of total breathlessness and the unbearably high temperature,’ says Joan. ‘He can’t eat anything, so he’s losing weight. I’m leaving drinks and prescribed nutrition supplements outside his room. He’s anxious that he won’t get better. I feel so powerless – I can’t even go into his room in case he passes it to me. I use FaceTime and texts to check he’s OK.’
Meanwhile, Joan is still awaiting her own test results, having been screened last Friday. She says: ‘At the beginning of the week I had a runny nose, a slight dry cough and some muscle aches, but they’ve reduced now. So, if I have had it, it’s extremely mild – nothing compared to what Michael has been through, and I’m twice his age.’
It has been almost three months since the Chinese government alerted the WHO about the outbreak of severe illness caused by a new coronavirus – subsequently named SARS-CoV-2, or Covid-19.
And, since then, scientific understanding of the virus and the way in which it causes illness, has been growing at breakneck speed.
But one important question remains unanswered: why do some people become severely unwell with Covid-19, while others – the majority – experience few, if any symptoms. One answer may lie in the amount of Covid-19 an individual is exposed to in the first instance – the ‘infectious dose’. Once a virus enters the body, it colonises cells and begins to replicate.
And some think the higher the infectious dose at the beginning, the worse the subsequent illness. This is seen with flu.