On this fourth day of Illinois lockdown, I woke up to a reminder of how close and deadly Covid-19 is.
The first death in St. Louis, Missouri came Sunday, March 22, 2020. I live in the southern part of the state, in the St. Louis-metro area of Illinois, so this death is in my backyard.
The case seems to counter everything we’ve come to believe about Covid-19:
- The victim was young – in her 30s
- The victim hadn’t traveled.
- The victim apparently was healthy.
In the American mid-west, where we already live lives fairly separated, we may have a false sense of security.
- We’ve come to understand Covid-19 as generally affecting the older population. If we’re not 65+, we’re safe.
- Some believe they are safe because they haven’t traveled to China or Italy. The few cases in the mid-west are somewhere else and there’s no chance of exposure.
- Some believe they aren’t in danger because they are healthy. Even if they get the virus, they’ll have only flu-like symptoms.
The St. Louis death comes as a wakeup call that a virus is a small, invisible killer that could potentially affect all of us.
“At one point this was just a news blurb about something we heard going on in China, and now it’s our family. This is real. If there’s anyone out there that thinks they are immune to this, look at us, look at Jazmond.”
Today, I went in search of perspective, trying to understand if there’s a danger to simplifying our understanding of Covid-19.
Belief: Covid-19 Affects Old People
It’s widely reported that older individuals are more high-risk of Covid-19. Great steps are being made to isolate and protect people over 65.
Numbers coming out of studies in China suggest that while the older age group may be more severely affected because of other pre-existing medical conditions, Covid-19 itself does not just target the older population.
This study shows two-thirds, 68.8% of people with Covid-19 were under the age of 60. Over half were between the ages of 30 and 60.
Looking at Covid-19 cases severe enough to require hospitalization, this early CDC study conducted in the U.S. shows a similar trend.
Only 31% of the hospitalized cases were over 65 years of age. The majority of hospitalizations were younger.
We think of the children as being immune to Covid-19. They are not.
Children seem to catch the disease at the same rate as adults, but If they are infected, they generally have no or only mild symptoms. But children, especially infants, can develop severe breathing problems leading to hospitalization and death.
Edit: Just after I posted this article, a teenager in Los Angeles died from Coronavirus.
Rather than targeting older individuals, Covid-19 seems to favor the middle age brackets. People who are out and about at work or with children This leads to more possible exposures.
The death rate is higher in older people, but only because they tend to have other conditions as well. Nearly 1 in 5 deaths from Covid-19 are individuals under the age of 60.
Young people who believe Covid-19 is an old person’s disease may be less vigilant about self-distancing. Thus, putting themselves and their social circle in danger.
Belief: I have to Travel to Get Exposed
Early in the epidemic, many of the cases in the U.S. could be traced to a person who had traveled to China – and then Italy once the outbreak escalated in this county.
At first, most countries tried to contain the virus by isolating individuals who had traveled to known “hot spots.”
But it appears that containment hasn’t worked. Most of the cases in the U.S. are now from “community spread.” The virus is in the community and passing from person to person. No travel is necessary! The virus comes to you.
Most cases of Covid-19 cannot be traced to travel exposure or contact with a known positive case. This means the virus is spreading unchecked through communities.
It seems the virus has been circulating in U.S. communities for nearly a month. In late February, the CDC warned of community spread in the U.S. At least one case of Covid-19 could not be traced to travel outside the U.S.
As of today, 27 states are reporting community spread of the disease. In other words, they have cases that are not linked to travel or a known positive case.
This interactive map developed by the New York Times shows the spread of Covid-19 across the U.S. from January 21 to March 20, 2020. The spread is slow at first and then quickens alarmingly.
In contrast, there remains the idea that to get exposed, you must have traveled to a “hot spot”.
Just yesterday (March 23, 2020), a friend of mine posted on Facebook that she is very ill and was denied a Covid-19 test in Missouri because she hadn’t traveled to a hot spot.
Community spread means that the virus is circulating in our home communities. Most people will get the disease without traveling.
The government continuing to limit Covid-19 tests to people who have traveled is dangerous to communities.
Belief: Healthy People are Safe from Covid-19
With the information we have, it does appear that the majority of people die with Covid-19 as opposed to from Covid-19.
A large majority of people who die have at least one other serious health condition.
In a limited Italian study, only 1% of those who died after testing positive for Covid-19 had no pre-existing condition. The majority of those who died also had high blood pressure, or diabetes, or heart disease.
In some cases, the pre-existing condition was undiagnosed.
One of the early Covid-19 deaths in Spain, a 21-year old soccer coach Francisco Garcia, died after testing positive for Covid-19. It came to light during his hospitalization for the virus that he also had leukemia. He died two days after his hospitalization.
In a major push to protect people with pre-existing conditions, the U.K. is contacting 1.4 million people and advising them to self-isolate for 12 weeks. People of all ages with the following conditions should self-isolate:
- chronic obstructive pulmonary disease (COPD),
- chronic heart disease
- chronic kidney disease
- chronic liver disease, such as hepatitis
- chronic neurological conditions – Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy
- problems with spleen – sickle cell disease or if you have had your spleen removed
- weakened immune system – HIV and AIDS, or medicines such as steroids or chemotherapy
- seriously overweight (a body mass index (BMI) of 40 or above)
- organ transplant recipients
- cancer patients
- severe chest conditions such as cystic fibrosis
Some of these conditions, like asthma, are fairly widespread in the general population.
There is also an early indication that smokers can be at higher risk of severe Covid-19 symptoms.
Many health conditions can affect how your body responds to Covid-19, including those you are unaware of.
It will be many years before we fully understand Covid-19.
- Young people can get the Covid-19
- Anyone can catch Covid-19, even without traveling
- Many pre-existing health conditions can make Covid-19 more severe
As we weather the storm of the virus, we all need to assume that we can be infected and that we could develop a severe form of the disease.
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