Experts wonder why young people seem to be getting sicker with COVID

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Experts wonder why young people seem to be getting sicker with COVID


With reports that young people get sicker faster, experts are wondering if it’s just because the variant infects cells better.

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As doctors in Montreal and across the country report an increase in the number of younger patients hospitalized for more serious complications from COVID-19, experts differ on exactly why it could be.

What they agree on though, is that it would be a tragedy to let our guard down now, with vaccinations on the horizon for so many.

Last week, directors of intensive care at two local hospitals told the Montreal Gazette that they had noticed a change in their intensive care units in recent weeks, with more patients under the age of 50 developing very symptoms very quickly. serious cases of COVID-19. Although both stressed that their observations were anecdotal, they questioned whether the change could be due to the fact that the more transmissible and virulent B.1.1.7 variant is circulating more widely than shown by the confirmed data.

“It seems, and I emphasize this, that there are more young people who are falling seriously ill and presenting” in hospitals and intensive care units, said infectious disease specialist Matthew Oughton of the Jewish General Hospital , noting that similar observations have been made in Ontario, British Columbia and Alberta.

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He stressed that all jurisdictions have prioritized the vaccination of the elderly because they are more susceptible to serious diseases, at least with regard to the so-called “wild type” virus, with which Quebec has been struggling since the start of the pandemic. . .

“So the proportion of the population not protected by vaccination gradually tilts towards an increasingly younger group,” Oughton said. But he said it was too early to attribute the phenomenon to vaccination alone.

Another possibility is that because the B.1.1.7 variant spreads more easily than the wild type, and because it seems to be present in schools in the Montreal area, it spreads to parents, who bring it at their workplace.

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“People in younger age groups are more likely to be exposed in their work… in frontline jobs or in contact with people. We know that the variants are more transmissible, so even if you increase transmissibility slightly, across the population you will see a large number of increases in these cases in these susceptible people. ”

Theresa Tam was asked about the matter Tuesday during a national update on COVID-19 by federal ministers and public health officials.

“It’s a complex picture, but what I’ll say is that with the increased replacement, if you will, of the previous virus strains with the newer variants, especially the B.1.1.7 variant, we know that it can take off quickly. Its reproduction number… is higher so it spreads faster. And right now, the highest incidence is found in the younger age groups. As soon as you have more people, you will see more serious cases. ”

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But Dr. Don Sheppard, an infectious disease specialist, medical microbiologist and director of the McGill Interdisciplinary Initiative in Infection and Immunity, said it was too early to conclude that the variants cause more severe symptoms in young people.

He said the variant was found to be better at infecting cells, which explains its transmissibility.

“If you have a bug that’s better for sticking and getting in, # 1 you’ll see more people getting infected because people who would normally have skated, because their innate immune systems would have killed the virus, now they don’t skate anymore. because there was enough to overwhelm their first line of defense.

He said it was much more difficult to measure the virulence of the bug. But data from the UK suggests that “if a (virus) is more successful in entering your cells, then … the effective dose you are infected with is higher, because more of them enter, for the same exposure. … So young people who received the equivalent of a million viruses now receive the equivalent of five million viruses to trigger their infection…. Thus, they contract a more serious disease ”

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But Sheppard warned that the observed increase in the number of sick young people in hospitals could be in part due to “observation bias.”

Sheppard took the time to plot the number of hospitalizations in Quebec over the past three months on a spreadsheet, an exercise that shows how dramatic the drop in hospitalizations for severe COVID-19 has been for those over 60. years compared to those under 50, although in all groups hospitalizations decreased.

“So that may explain why it appears that young people are disproportionately affected because they are the ones who stayed in the hospital, as our elderly population is no longer being admitted at the same rate.

Oughton noted that countries that have succeeded in minimizing deaths from the pandemic have done so by blocking hard for longer periods of time than Quebec and other Canadian jurisdictions have done so far. And because vaccines are now on their way, he argues people might be better prepared psychologically to accept a few more months of harsh measures.

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“We now have a disease that we can protect people from with vaccination. It would be an even more serious tragedy to see people fall seriously ill (or die) now. I think you could argue that now that we have the hope of protecting people, it is even more important to prevent it in other ways. ”

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