Spike in number of young adults contracting COVID-19 worry healthcare professionals

Infection among people of this age group increased after 'Unlock 1.0'

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As the country nears 'Unlock 2.0' and inches slowly but steadily towards the peak in COVID-19 cases, predicted to be anywhere in the months of October-November, experts worry about the rising number of coronavirus infections among India's young adults, especially those under the age of 45 years. According to Dr. Srivatsa Lokeshwaran, consultant in interventional pulmonology at Aster CMI Hospital, Bengaluru, 40 per cent of those in the under 45 age bracket got admitted in the hospital in the past one month, which is "much higher," than the number of those infected in the same age group three months back.

The World Health Organisation (WHO) clearly states that it is a mistake to believe that the virus only severely impacts older people and those with underlying conditions. Dr. Mike Ryan, executive director of WHO’s Emergencies Programme, says in Italy, which had one of the biggest outbreaks in the world, 10 to 15 per cent of all people in intensive care were under 50. Maria Van Kerkhove, head of the WHO’s emerging Diseases and Zoonosis unit, said at a news briefing from the organisation’s Geneva headquarters, “We’ve seen some data from a number of countries across Europe where people of younger age have died. Some of those individuals have had underlying conditions, but some have not."

The reasons differ from country to country and from individual to individual. However, the underwriting is clear: that most of the COVID-19 cases among the younger adults, as much as 90 per cent, are asymptomatic, mild or moderate cases. However, under 10 per cent of the COVID cases among children have been observed to be critical. In India, the reason for the increase in the number of young adults reporting COVID infections in the past months has much to do with the unlocking of the economy and people getting out of their homes for work, at times, with no regards to social distancing and mask etiquette.

Dr. Anant Bhan, a researcher in bio ethics and public health policy, points out that India, which has a young population with the average age under 28, has always had a high number of its young who were suffering from co-morbidities such as diabetes, hypertension, cardiovascular diseases and these have been linked to COVID-19. "We have always been under the scanner for having a high population suffering from non-communicable diseases and it is these diseases that are by far linked to the COVID-19 infection as well," says Dr. Bhan.

Nonetheless, the presence of a co-morbidity is not seen as a common factor across the country. In Maharashtra, Dr. Amol Annadate, a practicing paediatrician based out of Aurangabad, says from his own observation over the past four months, individuals without comorbidities too are getting infected and would even require ventilator support. "There are some DNA or genetic sequences in certain families where even with less viral load, the susceptibility to COVID-19 is more, and this is because immunity is subject to one's genetics. It is a multi-factorial aspect and each individual will respond in very different ways to the same virus or the same viral infection. For instance, if 100 people are infected, not everyone will have the same viral load. Someone at the age of 73 may recover because of low viral load while another individual at 33 may not because of a high viral load," he explains.

However, Dr. Anita Mathew, senior consultant, physician and infectious diseases specialist, Fortis Hospital, Mulund, Mumbai begs to differ. "The spectrum at our hospital continues to be upwards of age 10 since the past four months. Even as the government has started the process of unlocking, the elderly who stay back home after their children have left for work, are the ones who are coming to us complaining of COVID symptoms. The young landing up with the COVID infection largely remains asymptomatic and for those who show no symptoms, we do not conduct swab tests. So it is the elderly who are getting admitted more than the younger ones." She expects a huge surge in the numbers of positive cases once the process of unlocking is complete.