Young adults have been fueling a sharp rise in coronavirus cases around the country, and a similar surge in newly confirmed infections among those in their 20s and 30s in Maryland is alarming health officials and experts.
Those age groups make up a little over a third of all cases recorded in the state since the pandemic began earlier this year, but in recent days they have contributed up to 55% of new cases, according to an analysis by The Baltimore Sun.
These younger adults pushed new daily confirmed cases of COVID-19, the disease caused by the virus, to over 700 on both Tuesday and Wednesday this week, the highest level since early June. New cases had been hovering closer to 400 a day in late June and early July.
“In a number of other states where young people started getting [the] disease at higher rates, the weeks that followed brought higher test positivity, hospitalizations, and then rising deaths,” said Dr. Tom Inglesby, a top infectious disease expert at Johns Hopkins University who has been advising Gov. Larry Hogan on the pandemic.
“We need to try to reverse the trends in illness in young people and be vigilant for changes that might herald the epidemic,” said Inglesby, director of the Johns Hopkins Center for Health Security.
Inglesby broke with the governor last month when he criticized Hogan’s decision to reopen bars and restaurants, as well as other large gathering spots, calling it premature because cases were then still above 500 a day. He said Maryland cases were dropping, but pointed to rises in other states that were more reopened, including Arizona, California, Florida, Georgia and Texas.
Many of those states and others now have reimposed restrictions on bars and restaurants, where young people had been flocking and violating advice to distance themselves and wear masks.
Inglesby now favors closing Maryland bars “for the time being.”
The state should consider closing the bars, agreed Dr. Joshua Sharfstein, a vice dean in the Johns Hopkins Bloomberg School of Public Health, a former state health secretary and Baltimore city health commissioner.
“We shouldn’t be messing around with indoor places where young adults can come and give the virus to each other by the dozens,” Sharfstein said.
Urging young people to avoid “crowded bars, house parties and large gatherings of any kinds,” the Republican governor said Wednesday: “You are not only putting yourselves at risk, you’re also risking the lives of your parents, your grandparents and other vulnerable people in the community.”
He cited the testing positivity rate among Marylanders under the age of 35, which is now 83% higher than among Marylanders who are 35 and older, and connected the rise in cases with the failure to comply with public health requirements, particularly in bars and restaurants.
“They just aren’t taking it seriously,” Hogan said of young people in an interview Tuesday. “They feel like, ‘I’m not really going to get that sick. I’m bulletproof.’”
Data suggests young people tend to fare better when they become infected, though some become very sick and die. But officials say they contribute to more widespread infections, including in more vulnerable people.
“We shouldn’t be messing around with indoor places where young adults can come and give the virus to each other by the dozens.”
Dr. Joshua Sharfstein, vice dean in the Johns Hopkins Bloomberg School of Public Health
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Officials say the sharp rise in cases among young adults nationally is largely behind the record U.S. cases and threatens the nation’s ability to return more fully to normal activities, including reopening schools and businesses.
Governors, public health leaders, Vice President Mike Pence and Dr. Anthony Fauci, a top infectious disease expert at the National Institutes of Health, all have issued blunt warnings.
"Bars: really not good. Really not good," Fauci said during a recent U.S. Senate committee hearing. "Congregation at a bar, inside, is bad news. We really got to stop that right now."
Dr. Shad Marvasti, director of public health, prevention and health promotion at the University of Arizona College of Medicine, said younger adults across the country are being “reckless.” Some may feel they are unlikely to get seriously sick or they just don’t want to “waste their summer.”
Whatever the reason, some likely will get severe cases, and many could pass on the virus to family members and friends who may be elderly or have underlying health conditions. That will further push up the rates of hospitalization and death.
Marvasti said for the pandemic to end, everyone needs to act as if they have the virus and spend time only with people they live with and distance themselves from others. Bars and other venues that attract crowds should close, he said, adding there should be a national mandate to wear masks, and authorities should not only model this behavior, but also fine those who don’t comply.
“We need to make it socially unacceptable not to wear a mask, like not wearing a seat belt,” Marvasti said.
Bars in Arizona have been ordered to close, but other venues remain open, which won’t drive down cases effectively, he said. Arizona and other states should heed the lessons of other places that have controlled infections successfully.
“Unfortunately, it seems like people need to experience more personal tragedies” before they follow advice, he said. “They need to see and feel that pain to recognize how dangerous their activities are.”
Since the virus came to the United States, there have been more than 3.4 million people infected and more than 136,000 deaths. In Maryland, there have been more than 75,000 cases and 3,200 deaths.
Cases among those in their 20s and 30s are far outpacing every other age group. Each of the past eight days, more than 100 people aged 20 to 29 in the state have tested positive for COVID-19, including 193 Wednesday. There have been similar spikes over 100 cases among those aged 30 to 39 on five of the past eight days.
This week, they have accounted for 40% to 55% of all new cases each day.
Hogan said he didn’t want to close bars and restaurants again as he called for a crackdown on those violating state orders to limit the number of people inside their establishments.
“We took early and aggressive action and people have been listening,” Hogan said in a recent interview. “For the most part, you’ll see more people here wearing masks. You’ll see more people distancing and following [that] kind of guidance. But young people are our biggest concern right now.”
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Restaurant officials say they support the enforcement efforts.
“We support Governor Hogan’s call for enforcement efforts because we do not want to see the spike in COVID cases that other states have experienced which have led to mandatory restaurant closures and dining restrictions,” said Marshall Weston, president and CEO of the Restaurant Association of Maryland, in a statement. “Everyone can help Maryland restaurants remain open by wearing face coverings and practicing social distancing.”
But enforcement may not be enough, based on the spikes in other states, Sharfstein said.
“We don’t have to debate this like a theoretical risk,” he said.