'Vectors' for infection: How young people are a 'huge problem'
Dr. Mehmet Oz and Dr. Manny Alvarez discuss the role of young people amid the coronavirus after the state of California issued a statewide 'stay at home' order
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As stories of young people infected by COVID-19 being placed on ventilators -- or worse -- continue to multiply in news headlines and on Twitter feeds, officials are faced with the dire task of getting the message through to the younger generations.
For weeks, young Americans have been instructed to practice social distancing, stay home, and to cancel Spring Break plans as the nation aims to stifle the spread of COVID-19.
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But somewhere along the line, the message seems to have been lost.
“I’m like prime age, you know what I mean?” 21-year-old San Francisco resident David Brown told KRON4 News on Sunday, while hanging out with his friends at famed Mission Dolores Park, despite the statewide stay-at-home order. “Like not a lot of people my age are dying.”
Emergency medicine and critical care physician at Boston’s Beth Israel Deaconess Medical Center – and professor of emergency medicine at Harvard Medical School – Dr. Michael Donnino told Fox News said that it’s true that the majority of people between the ages of 20-60 without pre-existing health conditions will have “a milder course of disease.” At the same time, Donnino noted, what was being left out of the conversation is what happens to the minority within that age bracket who do become profoundly ill — requiring mechanical ventilation or other life support measures.
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Donnino said that the number of patients in this age range around the world is much higher than doctors would see during a normal flu season.
“So, the virus can indeed cause severe, life-threatening disease for those ages 20-60 without any health problems,” he confirmed. “I believe this is important to understand not to cause excess alarm or panic, but so we can take the proper actions to mitigate.”
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Most 19-years-olds and younger seem to do better against the deadly virus based on international data and the hope is that the trend will continue in the U.S.
That said, there are still doctors like Columbia Medicine’s Craig Spencer who are tweeting about “really sick” patients in their 30s. And there's 44-year-old David Lat, who went viral tweeting about his experience with the virus and has reportedly since been intubated and is on a ventilator. New Orleans Bounce DJ “Black N Mild" — born Oliver Stokes Jr. — died at 44. And a 20-year-old Spanish soccer coach who was told by doctors he had "no need to worry," died a few days later.
As of Tuesday, there were over 383,944 confirmed cases worldwide with over 16,000 deaths recorded. The U.S. now lays claim to over 46,000 of those cases with almost 600 deaths reported. Many of New York's 23,000-plus cases are in New York City.
"We do have an issue with young people who are not complying," New York Gov. Andrew Cuomo said, according to Business Insider. "You can get the virus, and you can hurt people."
But messaging to the younger generation certainly isn't the only problem for emergency medicine and critical care specialists. Donnino echoed a call heard nationwide for more resources and for their own safety.
“A lot of people want to talk about stretching health care resources in the abstract, but I want to share a concrete example of why the mechanical ventilation needs threaten to exhaust resources. Many patients will likely require prolonged mechanical ventilation — life support — which translates to continued accumulation of patients,” he explained. “For example, if a hospital has a 10-bed Intensive Care Unit, the daily routine is usually to admit a few new patients and discharge a few others.”
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However, the problem with that system under the threat of COVID-19 has to do with the duration required to provide life support for some patients infected with the virus.
“With COVID-19, you keep accumulating more patients each day. So, a 10-bed Intensive Care Unit grows to a 12-bed, 16-bed, and 20-bed. And now, you have to figure out how to create another Intensive Care Unit and figure out how to find the personnel to staff it,” said Donnino. “And, this problem can continue to grow, threatening to overwhelm capacity.
“This is why some are calling for field hospitals,” he added.
After U.S. Defense Secretary Mark Esper said Monday that the military was looking into deploying field hospitals and personnel to hotspot areas like Seattle and New York City, President Trump tweeted Tuesday morning that he was sending 400 ventilators to New York and beginning construction on four new hospitals.
Several officials, such as Surgeon General Jerome Adams, have warned that the pandemic is going to "get bad" in the U.S.
A week ago, Adams warned the White House press corps that the United States was at a “critical inflection point.” He said there was “every chance that we could be Italy” if citizens do not follow basic public health measures the administration and the Centers for Disease Control and Prevention (CDC) have advised.
But, whether the U.S. is in a situation like Italy or whether it can emulate South Korea's example remains to be seen. Reports from South Korea suggest that widespread testing, social distancing, and a strong relationship between the people and the health care system allowed for more effective control – at least to this point.
As tests become more available to the general public, numbers continue to spike — putting fear in both the hearts of physicians and the public.
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“This battle isn’t going to be won in the emergency department or Intensive Care Unit,” Donnino remarked. “Don’t get me wrong in that we will ‘hold the line’ as best we can. But, to win this fight, I think that we need an unprecedented partnership between health care providers, [the] health care industry [and] manufacturing, government leaders, and the public.
“Thus, I encourage all Americans to do their part, whether that be helping on the production line for medical equipment or practicing social distancing,” he concluded. “The answer to getting through this is working together.”
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