The young Covid victims
‘Not everyone shrugs off this virus’
Keith Lynch explains how seven days in England demonstrated the Covid-19 risk to younger people.
Adriana Takara was a young business student. She wanted to get vaccinated but was not able to get the jab in time. She died in Sydney, aged
38, of Covid-19.
John Eyers was a ‘‘fit and healthy’’
42-year-old. Weeks before contracting the virus, he was climbing mountains in Wales. He died after his organs failed.
He had refused to be vaccinated. These are not necessarily the people you think of as vulnerable to
Covid-19. Since the pandemic began, there have been reports of people in their 20s, 30s and 40s dying. These stories are, of course, unsettling but relatively speaking they are outliers – somewhat unusual.
For example, according to statistics from United States public health agency the Centres for Disease Control (CDC) there have been 7218 deaths involving Covid-19 among people aged 30 to 39 and 19,000 in the 40-to-49 age group. For some context, there have been 135,308 deaths among people aged 65 to 74. There have been 35 million cases in the US.
Research from December last year also outlined the exponential relationship between age and Covid19’s infection fatality rate (IFR) in OECD (Organisation for Economic Cooperation and Development) countries. There has been bad news and good news since then.
The now dominant Delta variant is much more infectious. The vaccines have been rolled out to huge numbers of people – seemingly warping the relationship between case numbers and subsequent deaths in Britain, for example.
So let’s explore the risk to younger people right now. Has anything changed? And what can we learn from what is going on in England?
It is more than deaths, isn’t it?
You contract Covid-19. What happens next is not necessarily black and white – it is not as simple as you live or you die. There is a range of outcomes in play. Sure, the virus has the potential to be mild but it could also land a person in a hospital bed for days, even weeks.
A very recent paper, which has yet to be peer-reviewed, explored not just how likely someone was to die of
Covid-19 but how likely they were to end up suffering severe (bad) or critical (very bad) disease.
The authors found an exponential relationship between age and all three outcomes: The older you are, the more dangerous Covid-19 is.
However, as the authors note, the ‘‘rate of increase in the risk of severe and critical disease outcomes with age is less marked than the rate of increase in lethality’’. This example, from the study, explains it well: ‘‘According to our estimates, people in the 20-to-25 years old range are on average 836 [391-1668] times less likely to die from Covid-19 than 70-to75-year-old people, 146 [72-277] times less likely to develop critical disease, and 41 [23-65] times less likely to develop severe disease.’’
At age 38, Adriana Takara, according to this work, faced a minuscule chance of death and slightly less than 1 per cent chance of severe illness.
Tell me about this one week in England
There are obviously limitations to reading too much into one week of a pandemic. And, yep, there are lags between infections, hospitalisations and deaths. Taking all that into account, there are so many cases in England that the raw data from a seven-day period does offer some real-world perspective on the risk Covid-19 poses.
First, the seven-day period(s) we are looking at happened about two weeks ago. A touch out of date, yeah, but the dataset is nice and complete.
OK. So, according to Office of National Statistic (ONS) numbers, for the week ending July 24, 2021, it was estimated one in 65 people had Covid19 in England.
The time frame for deaths is slightly different. The ONS numbers are for the week ending July 23. Over that period there were 308 deaths involving Covid-19 in England. Most were in people aged 75 or older. Twenty were in people aged 20 to 44.
What about the hospitalisations rates?
Again older people are much more likely to end up seriously ill but to the week ending July 25 (I know, I know . . . again a different end to the week), the hospitalisation rate in the 25-to-44 age group was almost the same as the 65-to-74 age group.
Once you dig a little deeper into the hospitalisation data, there are some quirks. As hospital admissions peaked in mid-January in England, the ONS defined hospitalisation rates at that point in time as ‘‘100 per cent’’ across all the age groups it measures.
Of course, 100 per cent of people were not in hospital but it is a useful way to illustrate when Covid-19 was at its worst and whether things have become better or worse since.
To the week ending July 25, hospitalisation rates have fallen significantly for every age group above 45-year-olds.
What is happening then?
It appears to be fairly simple, really. Almost all older people are fully vaccinated and there are gaps in the coverage of younger people. On July
23, more than 90 per cent of people in England aged over 65 had received two doses of a Covid-19 vaccine, according to the official United Kingdom Government website. Yet the same date, 23 per cent of people aged 25 to 29 had received both doses of the vaccine, 31 per cent of 30 to 34 years and 44 per cent of 35 to 39 years.
Only 18 per cent of people aged 18 to 24 had been fully vaccinated.
If the UK’s vaccination rates were not as high, it is likely the numbers of elderly people dying would be exponentially higher, way more out of whack with that of younger people. The overwhelmingly high number of inoculated older people also explains why there have been periods of time in the UK where more vaccinated people have died than unvaccinated people. Older people are still at significant risk from Covid-19 and almost all older people are vaccinated.
So are young people more at risk?
As Auckland University associate professor and microbiologist Dr Siouxsie Wiles points out, the deaths among young people may just be more noticeable now as they are not necessarily being drowned out by hundreds, or even thousands, of deaths among the elderly.
Remember Joseph Stalin’s quote ‘‘a single death is a tragedy, a million deaths are a statistic’’.
Last month, an excellent Financial Times analysis also outlined how the vaccine had made Covid-19 less dangerous in different age groupings.
For example, it suggested a fully vaccinated 70-year-old now has a slightly greater chance of dying than an unvaccinated 40-year-old.
This suggests the vaccine may well be introducing a sort of equity of Covid-19 outcomes: Unvaccinated people in their 30s and 40s may well be facing similar risk to vaccinated people older than them.
Mathematics professor Michael Plank says that recent study exploring how age affects death, serious and critical illness appears to be consistent with what the ONS data shows.
‘‘Vaccines have done an amazing job of preventing deaths in the older age groups and the bulk of cases has shifted into younger age groups where the risk of death is very low.
‘‘But nevertheless, these younger groups do still have a small but significant risk of needing hospital or intensive-care treatment and this is showing up in significant numbers of hospital admissions in the young and middle-age groups.’’
Wiles adds that many young people think they will ‘‘shrug the virus off’’. The reality: Not all of them do.