The vulnerabilities of younger people: It’s the pandemic update from Britain

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England’s world-beating Covid test and trace system has people beating their heads against the wall. Anyone can mistake a wall for the world. It’s natural enough. Even in pandemic hot spots, symptomatic people are being turned away. The government’s labs had a backlog of 185,000 tests that were sent abroad over the weekend. But if test samples sit around too long, they’re useless. So, um, yeah. I’m not sure how that’s going to work. But let’s not be silly and hold out for competence.

English schools are warning that they’ll grind to a halt if students and staff can’t get tested, because people who might test negative will have to isolate.

Wales says it’s going to process its own tests. Scotland accused England of trying to limit its access to tests. Northern Ireland doesn’t seem to be taking part in the conversation, and nobody ever listens to Cornwall.  

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Screamingly irrelevant flowers. Whatsit flowers–probably osteospermum. In bloom. In our yard. They’re wonderful–the slugs don’t eat them.

Meanwhile, Doug Jaquier sent me a bit of wisdom from a Facebook site called Puns, One Liners & Clever Wordplay: 

“Due to the success of Covid testing the Government has taken over pregnancy testing too. The waiting list is currently 10 months.”

The capitalization is not mine. Neither, sadly, is the inventive mind that thought of that. If they’d waited another lifetime, I would’ve come up with it. I just know I would’ve.

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China has announced that it may have a vaccine ready for use by the public in November or December. It’s currently in phase 3 trials–the ones where they test it on a large number of people to see if it’s both safe and effective.

Britain’s Oxford vaccine phase 3 trials were interrupted when one of the test subjects got sick. They’ve resumed now. Presumably her illness was unrelated. Not that anyone’s actually said that. Confidentiality and discretion absolutely ruin a good bit of gossip. 

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An advisor to the British government said that details of the new rules limiting how many people can gather in what circumstances are irrational–you can get a larger group of people together for a sports event but a family of five can’t have two grandparents visit them at home. 

“It is on the other hand very simple,” he said.

And it is simple until you try to sort through the who, what, when, where, and how.

In case you were worried, you can gather in groups of up to thirty to shoot grouse. So don’t feel too bad about the grandparents. At least no one (that we know of) is hunting them.

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A lot of Britain’s recent Covid cases are among younger people, so let’s talk about the people who it’s hitting like a sledgehammer. The reason I want to focus on them is that we have the illusion that Covid’s only a danger to people over sixty. Or seventy. Or eighty. Younger people are immune. 

Okay, most of us have that illusion. You probably know better, but the rest of us can be pretty dumb sometimes.

At Mount Sinai Health System, in New York, doctors treated five Covid stroke patients in two weeks, all under fifty. Normally they’d see one every three weeks. Four of them were relatively healthy beforehand. Two were in their thirties and had no risk factors. 

That’s a lot of numbers in one paragraph. Five in two weeks instead of one every three. Hold onto that. It’s not a huge number, but it reminds us that the danger to younger people is real. If you have to draw a card out of the Covid deck, you have no way to know what card it’ll be. 

Dr. Adam Dmytriw, a University of Toronto radiologist, says, “We’re seeing a startling number of young people who had a minor cough, or no recollection of viral symptoms at all . . . and they have a sudden stroke.” 

How many is a startling number? Enough to startle a doctor. That’s the best I can do, because the article didn’t say. Some of them had underlying medical conditions, but none had risks that should have increased their chance of having a stroke. For some, the stroke was the first sign that they had the coronavirus because they had the mild cases we all expect them to have.

In the U.S., the number of hospitalizations among 18- to 29-year-olds quadrupled in just a couple months. From the week ending April 18 to the one ending June 27, it went from just under 9 for every 100,000 to roughly 35 per 100,000. It’s not a huge number, but it’s a big jump for a short stretch of time.

One study, again of Americans, says a third of all younger people have at least one risk factor for severe Covid. 

Other younger people end up with some version of post-Covid syndrome, which can include exhaustion, chest pains, migraines, breathlessness, dizziness. About 600,000 people (I think that’s in Britain, and it seems to include all ages, but don’t take my word for that) have some version of post-Covid syndrome as measured by the app Covid Tracker. Around 12% of them have had it for more than a month and one in two hundred for more than 90 days.

Something close to 100% of British publications (at least the ones I read) don’t bother to translate their statistics into comparable categories. I think that would be .5%, but I’m not going to crawl too far out on that limb.

The initial belief that Covid risk rises with age still seems to hold true, but even so the evidence is increasing that younger people aren’t immune. A retrospective Chinese study of Covid in children counts 2,143 cases. More than 90% of them were mild or moderate, but 6% of pediatric cases were severe and even critical, compared to 19% of adult cases. 

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Isn’t it just fun to spend time with me? Doom, gloom, and after that I’m out of relevant rhymes.

Zoom.

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A paper published in the New England Journal of Medicine floated an unproven theory about Covid: that mask wearing may be immunizing people. The idea is that masks may cut down on the number of viruses that a person breathes in, so the body’s able to mount an immune response instead of getting overwhelmed. 

It’s the same process that made variolation–the early form of inoculation against smallpox–work. A person was deliberately exposed to a small amount of the disease and the body probably mounted an immune response. Emphasis on probably. You couldn’t be sure who would become immune and who would get sick and quite possibly die. 

The mask theory rests on two unproven assumptions: that exposure to a lower dose results in a milder case and that mild or asymptomatic cases confer some immunity. More than that, the only way to directly prove it is through clinical trials that would expose people, some wearing masks and some not, to the coronavirus. Which is unethical. So at this point it’s basically an interesting thought.

47 thoughts on “The vulnerabilities of younger people: It’s the pandemic update from Britain”

    • Hard to say. But given the various ways so many other countries have been in denial (and they really have varied) I’m not inclined to do too much finger pointing. We almost all screwed up. They just happened to be at the front of the line, so their terrible decisions were magnified.

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  6. Ellen, I sent the part of your post that pertains to the US to my sons who have young adults in their families. I know young people get the virus as readily as the old. But, I didn’t know the symptoms of post-Covid syndrome. I need to research that. Wow! Thanks for keeping us up to date. Have a happy week. 📚🎶 Christine

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    • I’m glad it’s some use. The post-Covid stuff is horrifying. Someone we know–she’s in her fifties–has it and last I heard could barely get up a flight of stairs, and that was a good long time after she first got sick. You might want to see Sheila Morris’s comment for a truly horrifying example of young people not taking in the danger.

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      • Oh my god … Covid roulette in a South Carolina college? What if it catches on? You know young people. It can never happen to me! So, the Post-Covid syndrome fatigue & brain fog are the front runner symptoms. Also for other symptoms the contribution of inflammatory cytokines (large group of proteins) make up the viral sepsis of systemic involvement. The level matters and where those cytokines are secreted by specific cells of the immune system. The bottom line is if the person with the post Covid syndrome is fairly healthy, they can get better over time. You know the answer if the person has other serious medical conditions. The other group is people who were supposedly healthy that had strokes or other severe complications. It’s not good news to get the virus at any age or health status. You just never know what kind of havoc it can cause. Stay safe out there people! There are bad bugs everywhere! 📚🎶 Christine

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  7. When, she asked, did you start posting in a foreign language? Other than English, that is? Not to be verbally abused by some (other abusives) who will , no doubt, think I’m disabusing them for speaking more than one language….that would be the bilingual adaptation of speaking with/in tongues. Sanctioned of course, and having nothing to do with alternative facts, religion or witch craft. Is it too late to stop by for biscuits and tea? That’s a question in one language, mostly in English. Comprende?

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  8. Re: Covid among the young, actor Paul Rudd has helped New York with a PSA to address this. The video dropped Monday evening and can be found on the Governor’s Twitter if you’re interested, @NYGovCuomo.

    Have you read about the bradykinin hypothesis? I think we’re finally on the right track in understanding COVID-19. I don’t know if the American public is following along, though; it’s likely a vascular disease, not a respiratory one.

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    • I did read about the bradykinin hypothesis but can’t reassemble enough of what I learned quickly enough to say anything even vaguely intelligent about it. I should look it up again and remind myself. I do remember thinking I should write about it and then wondering if I could do it clearly enough to be any use.

      The kind of thing you’re talking aboutk–Paul Rudd, etc.–is what we need more of. The New Yorker had a long article on public health education, and one of the things that stayed with me from it is the idea that to reach the public you need to not have politicians be the face of the campaign. No one trusts them. Put health people at the front. Let them tell us what they understand, and be honest about what isn’t known yet. (I’m diverging from the article a bit here.) Treat it as a public health campaign, not a political campaign.

      Rant over. I’ll take a minute and breathe now.

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    • Take a look at Sheila Morris’s comment (somewhere below) for a horrifying example of that. Public health people have a huge amount of experience in health education and if they hadn’t been sidelined (not to mention underfunded) could have made this a very different story.

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  11. My wife and I were enjoying a pleasant evening this past weekend playing Sequence with two friends who have been allowed in our home over the past six months when one of the women mentioned that her nephew, a college student at Clemson University (known primarily for its football team), and his fraternity brothers were all trying to somehow contract Covid and pass it around so that they could become mildly symptomatic to acquire immunity from more “serious” health – related issues.
    Apparently it’s a game of Covid roulette that’s become quite popular on college campuses throughout South Carolina.
    Needless to say, we had, like a thousand followup questions for our friend including whether she planned to see her nephew over the holiday season. She does not.
    I continue to be stunned at the disconnect between truth and consequences.

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    • I heard of Covid parties back in July. Everyone that attends, puts money in a pot. The first to contract Covid wins all. I thought the popularity would disappear after someone wound up in the hospital (died? I don’t recall). The parties were said to be taking place largely in Alabama. Unfortunately, far too many people in the United States believe that Covid is not dangerous and that the true threat lies in taking a vaccine. Sorry for your friend and for families across the country aren’t able to reunite for a variety of reasons.

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  12. The media are focusing on the wrong things. I get that everyone’s annoyed about the testing system issues. I don’t get the fuss about grouse shooting – I don’t agree with shooting wildlife for fun, but football, netball, etc, are allowed too. But the front pages should be screaming about the fact that Israel’s gone back into lockdown, hospitals in Bordeaux and Marseille are struggling to cope, and young people are affected too, to show people just how dangerous this can be. Moaning about the authorities just makes people feel disaffected and less likely to stick to the rules. End of rant! Sorry!!

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    • Rant on. You have a good point. The Guardian, at least, has covered the second waves in other countries. Other papers, I’m not sure. It’s the only one I read through as opposed to just picking up a story here and there. But it’s true, we don’t seem to be focused on that, although it’s coming for us. But I think the moaning about the rules comes from the government having sacrificed any legitimacy–Dom Cummings, etc. So when people see something that matters to them (a family visit, say) blocked while something else isn’t, they yell. Understandably, even if you could justify it epidemiologically.

      The test-and-trace yelling, though–for me, that’s well worth yelling about. Massive amounts of money are being paid to incompetent corporations to mess it up while the NHS is still being starved of funding, not to mention undercut by outsourcing. That’s not only infuriating, it’s dangerous. And corrupt.

      Um, yes, I can rant with the best of ’em.

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  13. People, especially young people, are heavily influenced by their peers so until they know of a young person who has long-covid or dropped dead from a covid-inspired stroke they think they are invicible (after all young people will still take up smoking despite the known risks).
    You need a famous person young people care about to suffer badly from it, I suppose. Not being a young person any more I have no idea who they care about, its probably not Kim Kardashian anymore, but someone like that. You get the point.

    The government’s “world beating” joke of a testing systemis yet more proof that neo liberal economics dont actually,er, work.

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    • Boy, do they ever not work, except to line the pockets of some already very rich people and corporations. Which was, I suspect, the point all along. The rest was just window dressing.

      Me, cynical? Heavens, no.

      You’re probably right about what would influence people, although the anti-smoking campaign has had some effect. Young people don’t take up smoking in the numbers that they used to. When I was in high school, I was one of very few non-smokers, and I only held back because I just couldn’t make myself get used to it. So I think public health campaigns can have an effect, even if it’s not total.

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    • I’ve seriously started wondering if getting celebs to speak out about the need to keep the rules might help. I know that the “hands, face, space” adverts are talking a lot of sense, but they do rather make you feel like a primary school kid being told off by a teacher. I suspect that, as with party political broadcasts, most people either don’t listen or use them as a chance to go and get a cup of tea … and I doubt that most young people watch the mainstream TV channels or listen to mainstream radio stations anyway. Someone cool saying it might have a better chance.

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      • I think you’re right. And at a certain point, people do stop listening, especially when–yeah, it does make you feeling like a grade school kid. If they’d back the instructions up with some genuine information, it might be a good idea as well.

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  14. You write:
    “It’s the same process that made variolation–the early form of inoculation against smallpox–work. A person was deliberately exposed to a small amount of the disease and the body probably mounted an immune response. Emphasis on probably. You couldn’t be sure who would become immune and who would get sick and quite possibly die.”
    Actually Jenner used a milder disease called cowpox to vaccinate people against smallpox.

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  15. Thank you once again, Ellen. Notes from the UK is an international treasure.

    A celebration of ignorance and a disdain for science: unmasked — my two farthings on the powerful charlatans who do *only* harm.

    “…over the past 20 years, better uniformity in patient care was obtained by placing patients into ‘pathways.’ All patients with a particular subtype of disease are treated similarly using a proscribed written pathway guide for care. Market forces lauded the approach, and the physician’s primary job became one of patient categorization. Those who could sort more patients into particular pathways the fastest received the greatest financial rewards. Insurance companies and for-profit medical centers loved the approach for its bland and monotonous efficiency.”

    https://stke.sciencemag.org/content/13/649/eabe4242?fbclid=IwAR1NyaUMs5xWN-zy_i9ZLfkAgq1KUqQIymAwGwPGyjAZK1N642A3zN7bLd8

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  16. Every day I become more glad that I chose to keep my t(w)eens learning from home. The in-person option was removed for the first school term anyway but I was always going to keep them home and I anticipate continuing to do so even when brick and mortar school resumes. There are far too many unknowns when it comes to the risks involving young people. My youngest brother is in his late 20s, healthy, and has zero co-morbidities, and had what is considered a mild case but it is looking increasingly likely that he will have long-term health impacts. He certainly has the post-viral fatigue symptoms, several months on from recovering, and he is now on inhalers for asthma-like respiratory problems.

    We have gained a lot of knowledge about this virus in a short and intense period of time but there is even more that we do not yet know and have not yet begun to understand. We need, I think, to be taking the most cautious approach while we fill in more of those gaps. We are otherwise just gambling with people’s lives from a place of ignorance.

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