Michigan is now hospitalizing more people under 40 than those over 80 for COVID-19

Dr. Stacey Sensor says her 18-year-old son, a high school senior, is “one of the healthiest people I know.”

“He works out every single day at five o’clock in the morning,” said Sensor, a Gaylord physician. “He takes all these supplements. He only eats healthy. And he got COVID at the gym.

“He was quite sick for about eight days,” she said. “So I’m telling you that it doesn’t matter what supplements you take, what your age is. ... Even in the healthiest individual, they still can get it and they can still become very sick and then the effects can be there for quite some time.”

It’s a cautionary tale, she said, for people who see COVID-19 as a serious health threat for the elderly but a much more benign illness for younger, healthier people.

In fact, Michigan’s current coronavirus surge has turned that assumption on its head: Last week, the state was averaging more hospital admissions for COVID patients under 40 than patients age 80 or older. The former was about 78 a day compared to 50 for the latter, according to data from the Michigan Department of Health and Human Services.

The biggest reason for the demographic shift, experts say: The difference in vaccination rates.

About 74% of Michigan residents age 70 and older have gotten at least one dose of vaccine, and two-thirds are fully vaccinated. For those 16 to 49, the numbers are 36% who have gotten one dose and 23% fully immunized; there is no vaccine authorized for children under 16.

Also contributing to the surge of virus among young people is the spread of variants that are both more contagious and more lethal; the tendency of many younger adults to disregard COVID-19 guidelines, and the fact that schools have reopened.

“It’s definitely become more of a young person disease now, probably because they haven’t been vaccinated and they’ve been more likely than older folks to go out and about, be in close contact with others and go to gatherings,” said Dr. Mark Hamed, a physician who is medical director for Huron, Lapeer, Sanilac, Tuscola, Alcona, Iosco, Ogemaw, and Oscoda counties.

The numbers bear that out. In the first year of the pandemic, Michigan residents age 60 and older accounted for 23% of cases; it’s now 13%. Conversely, those under age 20 accounted for 13% of cases during the first 12 months of the pandemic; it’s now 25%.

The chart below shows the April case numbers by age group compared to the monthly average through March 2021, as well as compared to December 2020 during the fall surge.

Source: Michigan Department of Health and Human Services

In theory, that’s actually a welcomed shift from the standpoint that old age is easily the biggest risk factor for being hospitalized or dying of COVID-19.

But experts have been taken aback by the spike in COVID-19 hospitalizations among younger adults and children.

Compared to the height of the fall surge in early December, Michigan’s average daily hospitalization admissions for COVID-19 are up 33% for those age 18 to 29, 58% for thirty-somethings and 64% for those in their 40s. Meanwhile, hospitalizations for those age 80 and older are down 60% compared to December.

A comparison of Michigan's average daily hospitalization admissions for COVID-19 in early December, which was the height of the fall surge, compared to the average for April 17-23. (Source: Michigan Health and Hospital Association and Michigan Department of Health and Human Services)

“It’s like, you take what we were seeing before and shift it down by one or two decades,” said Dr. Joel Fishbain, an infectious disease specialist for Beaumont Hospital in Grosse Pointe. “We’ve got 20-year-olds who are getting admitted, and 30-year-olds requiring oxygen, which we never saw before, and needing as much treatment as we can give them. We’ve got 40- and 50-year-olds ending up on ventilators.”

Pediatric cases also are up. Last week, the state was averaging almost 10 hospital admissions a day among pediatric patients with COVID-19, triple the number in mid-February.

Deaths among children and younger adults have spiked, too.

In the first 13 months of the pandemic, there were six deaths among children ages 10 to 19. In the past month, four deaths were reported. Another 65 deaths were reported in April for 20- and 30-somethings, quadruple the monthly average.

The chart below compares April deaths to the monthly average through March 2021 as well as to confirmed COVID deaths in December. The numbers show how deaths among seniors plummeted in April compared to December as a result of vaccinations while coronavirus variants spiked deaths among unvaccinated people under age 50.

Deaths and hospitalizations aren’t the only concern.

While most COVID patients under age 50 “don’t get severely ill, there are a growing number of people who have long-haul COVID symptoms,” said Dr. Liam Sullivan, an infectious disease specialists with Spectrum Health in Grand Rapids. “They have problems with smelling, with taste, with concentration, with memory, with fatigue, with night sweats.

“So even though they had a mild illness the first time around, they’re still dealing with these things month and months later, and that’s not something you want to deal with when you’re 25 or 35,” he said. “Of course, you don’t want to deal with it at any age, but especially when you’re in the prime of your life.”

And for women, the research is growing on the dangers of COVID-19 during pregnancy. Dr. Kurt Wharton, an Oakland County obstetrician, currently has four pregnant patients in intensive care units battling COVID-19.

All four are “fighting for their lives,” said Wharton, who works at Beaumont Hospital in Royal Oak.

While COVID-19-related deaths among pregnant women remain very rare, Wharton and others say the evidence is growing that coronavirus during pregnancy can put a woman at a much higher risk of preterm birth, preeclampsia and admission to the ICU and/or intubation, especially if the woman has pre-existing conditions such as high blood pressure, obesity, diabetes or heart disease.

Evidence growing on COVID-19 vaccines during pregnancy: Virus is dangerous; the shots are not

Doctors offer several theories on why more younger people are getting significantly ill with COVID-19 in the current surge.

One is the spread of variants, which are both more contagious and more lethal. The variants are “stickier,” Hamed said, which means it takes less exposure to make someone severely ill or even symptomatic.

Wharton noted the same pattern happened during the 1918 influenza pandemic. The initial surge in the spring of 1918 primarily impacted the elderly and babies. But the virus mutated and came roaring back in the fall of 1918, and its primary victims during that surge were younger adults.

“History is repeating itself,” Wharton said.

Another issue, suggests Hamed and others: More unvaccinated people are gathering in groups without masks. That increases the risk of exposure to a higher viral load, which has been associated with more severe disease.

“The best mask you wear, the less viral load you inhale,” Wharton said.

On top that, many schools have reopened and children and younger adults in particular are resuming their pre-pandemic social lives.

“You can see it,” Wharton said. “Younger people are all out in groups again, walking down sidewalks, shopping, going to restaurants and bars together. They just think they’re invulnerable.”

The good news is that COVID-19 vaccinations have proven “wildly successful” in significantly reducing the chances of getting the virus and spreading to others, Sullivan said. And just as vaccinations have blunted spread of the virus among senior citizens, the spread of COVID among younger adults can be stymied through immunization shots.

Vaccination programs “really need to target the younger people right now,” Sensor said. “They’re the ones who are getting sick. We’ve done a really good job of vaccinating our older population, but to really move forward and get out of this pandemic, we really need our younger people to step up to the plate and get the vaccine to protect themselves and protect their families.”

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