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A Florida COVID-19 pattern: Cases in young adults, then seniors

Cases in people 25-34 have come before those in older people, spelling trouble for the future, especially as Thanksgiving approaches.

In Florida, we see the coronavirus in young adults first. Then the elderly catch it.

That sequence could mean current trends are more dangerous than they appear. While the state hopes it is protecting the vulnerable, it’s not clear that this pattern has changed since the summer, when deaths skyrocketed.

Trends in the state’s data since the spring show a pattern: cases in people 25-34 years old (the ages where people have been most likely to test positive) foreshadow cases in people 65 and older by several days. Older COVID-19 patients are more likely to experience worse symptoms and die from the disease.

For those well beyond 65, cases lag even more: For all those 85 and older, cases trail young adults by about 10 days. And in nursing home residents, the summer wave was a full three weeks behind that in young people.

(*Data released on hospital patients and long-term care facilities shows current patients and cases, not newly reported cases, so a lot of this delay could be built-in, as people can remain hospitalized or positive for a long time.)

This chart shows that trend: the rise and fall in cases in young people comes first, as older cases come later.

This progression of cases from younger people to older people probably isn’t a result of testing delays or reporting quirks. More likely, young adults — those who work, travel, raise children and party — catch and spread the virus first. Then, seniors, more likely to be retired and staying home, catch it later, as the virus spreads and spreads, even into more isolated environments.

A CDC study found that across the South, spikes in young adults came four to 15 days before those in people 60 and older, “suggesting that younger adults likely contributed to community transmission” of the virus.

Daily new cases in young adults have been increasing for more than a month. As of this week, they had rebounded to about 46 percent of where they were at their peak, when more than 2,300 young adults would test positive in a day. They’re almost halfway back to those July numbers, but it’s not an apples-to-apples comparison, because more tests are being done now. Case numbers can fluctuate depending on how many people get tested. But we can compare the trends across age groups.

Current COVID-19 hospitalizations are increasing too — but they’re only at about 33 percent of their highest level, during the summer spike. That sounds like good news: maybe this time around, old or vulnerable people aren’t getting sick as much as young people are testing positive.

But remember the chronology. Hospitalization numbers trail cases in young adults by about 13 days. Thirteen days ago, cases in young people were only at 32 percent of their peak level from the summer — almost exactly where hospitalizations are now.

In short, if you consider the lag time, hospitalizations and cases in old people have rebounded just as much as cases in young people have.

Cases in long-term-care facilities are rebounding more slowly than those in young people. That’s good news, although it’s not a drastic difference.

A caveat: public data only shows people’s age for positive tests, not all tests conducted. So it’s possible overall testing in some age groups has grown since the summer more than others, which could muddy the case data. But such testing changes wouldn’t affect the hospitalization numbers.

Overall, there’s no clear evidence that it’s harder now for old people to get the virus from young people. As cases in young people continue to rise fast, there’s reason to worry about Florida’s most susceptible residents.

This Thanksgiving, young people across the country will visit family. Undoubtedly, many will pass the virus to their parents or grandparents. That will only exacerbate the spread, which shows no signs of going away right now.

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