Is virus spread due to protests? Bars?
What we know about rise of cases in 20-somethings
Researchers from the Centers for Disease Control and Prevention in Atlanta arrived in Winnebago County on Monday to investigate a problem that’s now replicating itself across the nation: Since June 1, nearly three-fifths of the area’s new coronavirus cases have been people in their 20s.
At the end of May, county health officials started to see a worrying trend that turned into the sixth-fastest growing outbreak in the nation. Cases tripled in a matter of weeks, and young people were behind much of that growth.
The CDC team, which will be in Winnebago County through at least July 7, plans to help investigate some of the social factors driving young people to get together and risk infection.
“It may be difficult for us to stop,” county health officer Doug Gieryn said Tuesday. “We really want to get a better handle on this before school starts in the fall.”
And he’s not alone. Wisconsin residents in their 20s are testing positive for the coronavirus nearly twice as often in the last 10 days as they were in the 50 days before that. Data from the Department of Health Services show that before June 22, this age group made up about 20% of the state’s total positive tests. Since then, they’ve made up 40%.
Wisconsin hasn’t seen a major surge like other U.S. states, like in the South. But daily case totals in the state growing. The seven-day average of new cases has grown from under 270 in midJune to 475 on Tuesday, and the percentage of tests that return positive has been climbing along with it.
“It’s been, for some people, three months or longer of being very careful,” said UW-Madison epidemiologist Patrick Remington. “People are letting their guard down.
The question is, where is the disease being spread? And why are 20somethings bearing the brunt of new cases?
Are protests driving coronavirus growth? It doesn’t seem so.
As mass gatherings have unfolded in Madison, Milwaukee and dozens of other municipalities across Wisconsin to protest the death of George Floyd and police brutality against Black people, some might think the answer to where more people are getting infected is clear.
But a new working paper from the National Bureau of Economic Research and the Center for Health Economics and Policy Studies at San Diego State University suggests that’s not the case.
Researchers found no evidence that COVID-19 transmission had overall increased in the weeks following protests in 315 large U.S. cities.
It’s possible there was spread among those who attended the protests, they wrote, but protests may have made others more reluctant to leave their homes.
If the protests are perceived to be dangerous (because of property destruction, violent response from police or potential for infection), that can cause people who do not attend to increase their social distancing and sheltering-at-home behaviors, said Dhaval Dave, a professor of economics at Bentley University in Massachusetts and co-author of the study.
But even rates of infection among protesters who got tested in pop-up clinics is proving to be low, Dave said, suggesting that many are using effective protective measures like wearing masks and attempting to social distance as much as a person is able.
“What our findings suggest is (gatherings) do not necessarily have to mean an increase in infection rate, if the people in that population continue to be cognizant of the risk,” Dave said.
As quarantine fatigue sets in, officials worry about packed bars
If protests share little of the blame for the surge in cases, the reopening of bars and other popular gathering places may be a different story.
We know now how and when the virus spreads: close, sustained contact with an infected individual, particularly indoors, particularly if a person coughs, sneezes, shouts or sings. When the state shut down for a month and a half, that naturally happened less. But now, things are different.
In La Crosse County, where a recent surge in cases has been roughly half people in their 20s, the health department released a list of establishments where an infected person had been, including several downtown bars. Other restaurants in the area have temporarily re-closed, according to the La Crosse Tribune.
Dane County public health leaders ordered bars closed and restaurants to limit indoor dining to 25% capacity to help curb a recent spike in cases. In their weekly data snapshot, they reported that 49% of the county’s 614 new cases in the last week were between the ages of 18 and 25, and 45% of the people interviewed said they attended a gathering or party with people outside their household.
On Monday, UW Health Chief Quality and Safety Officer Jeff Pothof said contact tracers are finding that a high percentage of newly infected people have been in large gatherings at bars and taverns.
Further data analysis in Winnebago County found it wasn’t just 20-somethings, but 19- to 23-year-olds, in particular, who were driving the county’s spike.
Gieryn, the county health officer, visited service industry establishments where younger people are more likely to congregate and work, and even went to a Tavern League meeting to ask for their help.
Though their new case rate has dropped, Gieryn is still concerned that busy establishments reopening, coupled with young people being more likely to take risks, will be a problem for his community.
Brown County officials also sounded the alarm about people ages 21 through 30, saying they need to play a bigger role in stopping the spread.
“We get a confirmed case and we’re asking, well, what were you doing? And what we’re learning is, ‘Well, I had a wedding, I went to a bar, I went to a restaurant, I went to a graduation party, I went to a gathering at my family’s house,” county Health Officer Anna Destree said on a call with reporters Monday.
Consider the true risk of being infected with the coronavirus, experts say
Along with feeling quarantine fatigue, Remington said, young people have always been and will continue to be more inclined to take a risk. And because early data has shown young people are less likely to die of COVID-19 – in Wisconsin, for example, people ages 2029 account for just 1% of the state’s death count – people believe it’s worth the risk now in exchange for some social interaction.
The problem with that attitude is two-fold: First, although young people are less likely to get seriously ill, some still will, and some will die, Remington said.
More serious illness and death typically lags a few weeks behind initial spikes. But from June 21 to this Monday, for example, 27 more people in their 20s were hospitalized with the virus, two more were in the intensive care unit and one more died, according to DHS data.
Second, a person risks transferring the virus to someone more susceptible to serious consequences.
“You’ve got to realize that someone gave you that virus and chances are you’re going to give it to somebody else,” Remington said. “Your individual behavior is harming others. You’re now a step in the epidemic in a community.”
A county health department in Washington state found 14 cases associated with a large party someone had thrown in early June, which led to 15 more cases related to those 14 – which then spread to 31 employers as infected people went in to work.
With the CDC team in Winnebago County, Gieryn is trying to make another message clear as well: Especially in the fall, as students return to UW-Oshkosh with the potential to pack full bars and house parties, he wants them to understand just how much we don’t know about the virus yet.
Even the people who contracted it first have only been living with it for six months. In comparison to what we know about diseases that have been with us for decades, that’s not much time to assess what effects it could have on young people in the long run, even if their initial illness is mild.
“It’s still far better to avoid this illness if you can,” Gieryn said. “Until we learn more, it may not be as absent-of-risk for young persons as they feel it is.”
Risky behavior from young people only tells part of the story
Easy as it may be to pass judgment on young people partying and socializing, Remington cautioned that for every patron, there are employees on the other side of the bar who need to go back to work to make money.
And as the protest researchers cautioned, the small and visible minority – say, the long line of college-age people standing outside the Kollege Klub in Madison – don’t represent the full group’s intentions.
That’s true for Maryellen Pawley and her boyfriend CJ Zabat, both 23 and living in Madison. The pair will soon be leaving the city they’ve called home for the last several years, she for graduate school at Harvard University and he for a stint driving the Oscar Mayer Wienermobile across the country.
Although avoiding bars and restaurants and limiting meet-ups to socially distanced small groups, they will host a larger gathering at a park prior to leaving, Pawley said. She’s requiring everyone wear masks, stay 6 feet apart and bring their own food and drink.
“We are doing what we can to stay safe, but in our circumstances we are also trying to say goodbye and move away from the last five years of our lives with at least some closure,” she said.
In Green Bay, 28-year-old Autumn Siudzinski’s plans after graduating from a master’s program were tanked when the coronavirus hit: the ceremony, a party with friends and family and an ensuing trip to Europe all had to be canceled.
Since then, she’s turned down other invitations, like one to a birthday party at a restaurant, and tried to keep her gatherings small and outdoors. She ate on an outdoor patio once with her parents, but said she has otherwise avoided bars and restaurants.
“It kind of feels pointless to have canceled (my graduation plans) to help protect people and then head out in a group of people – like what was the sacrifice for, then?” Siudzinski said.
Risky behavior from young people may tell some of the story. But not all of it. For example, a May CDC survey found that millennials ages 25-34 were more likely to report avoiding groups and wearing masks, second only to their 65-and-older counterparts.
And looking elsewhere in the U.S., states with newly skyrocketing case counts have another thing in common: They are also some of those in which state officials made the decision to reopen earliest.
In Texas, for example, where cases have jumped from a little over 1,000 on May 1 to nearly 6,000 last week, Gov. Greg Abbott allowed his stay-at-home order to lapse April 30. As cases surged, he moved to close bars and reduce capacity for restaurants.
Thus, it becomes an extension of the delicate balance we’ve had to maintain for months already. If bars and restaurants reopen, how can we best reduce risk for ourselves and others? Order take-out? Drink al fresco? As long as the virus is out there without an effective treatment or vaccine, Remington said, we can’t let our guard down.
Whatever lesson there is to be learned of young people getting the virus in increasing numbers, it will be learned shortly, Remington said. If people self-correct and pull back again on larger gatherings and outings, that rate will drop. If not, those numbers will increase, some will get sick, and some will die. That part, he said, is a fact.
“I predict there’ll be a little bit of a correction,” he said. “Young people will see this, and people will think twice. But not everybody.”