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The current wave is different
From the second half of August, the spread of the coronavirus epidemic in Hungary entered a new phase, and since then we also know that this wave differs from the spring wave in several respects. For one thing, the virus is spreading negligibly in institutions (hospitals, social homes, nursing homes) (for the time being), as community case numbers dominate strongly. On the other hand, which is of course tied to community spread, the average age of those infected has dropped by more than 30 years in the course of a few weeks, which means that the epidemic has clearly skyrocketed between Young. Both new features of the second wave of epidemics were illustrated with a diagram in a presentation in late August by the Research Team on Epidemiology and Epidemiology Modeling of the Ministry of Innovation and Technology.
At first glance, we might think that because of the latter phenomenon, that is, the virus mainly infects young people, we don’t even have to worry about the speed at which the virus spreads, since the younger age group does not is so threatened by this disease. The American Center for Disease Prevention and Control (CDC) has previously produced an infographic for this (translated into Hungarian by the Pécs Virology team), which is a good example of what age group is exposed to this COVID- 19.
However, this only leads to a delusion. The figure above clearly shows how much the risk of infection increases with age. For example, compared to the age group 18-29 (this was the reference age group), even the age group 50-64 is 4 times more likely to be hospitalized and 30 times more likely to be hospitalized. die from the infection.
At first, an epidemic that is spreading almost uncontrollably among young people should be a very serious warning to everyone, given the risk factors mentioned above.
The warning is an international example
To illustrate the seriousness of the situation, we cite as an example the spread of the epidemic in Florida, as several epidemiologists have done in the last two weeks.
- In an interview with Portfolio, mathematician Gergely Röst, a member of the epidemiological research group, emphasized that the Hungarian processes are similar to those in Florida, which is a bit worrying. “There was also a period when the number of cases increased, but the number of hospitalizations and deaths did not increase. This made them less concerned about the increase in the number of cases. Five weeks after the number of cases increased, too The number of deaths did. Several weeks it was necessary for the virus to spread to other age groups and reach the elderly and vulnerable groups. “
- At a conference in late August, Russian epidemiologist Beatrix also recalled the case in Florida: First, young people fell ill there, and within five weeks, the infection had already reappeared in higher deaths.
- And more recently, virologist Ferenc Jakab, head of the Coronavirus Research Task Force, said in an online conversation that no one should be fooled by the fact that the young are now mainly infected and the older age group safe. . “Unfortunately, the number of deaths generally increases 5 to 7 weeks after the increase in the number of cases.”
And why is the epidemic situation in Hungary (and Europe in general) similar to Florida now? We can illustrate this through various figures. On the one hand, more and more young people were infected in Florida: the average age of those infected decreased by 30 years in 15 weeks.
THINK LIKE AN EPIDEMIOLOGIST: What does it mean that the median age of new cases is decreasing in some areas? I see three possible explanations, not all good ones. A thread on how to tell them apart. 1/10 (Figure h / t) @ScottGottliebMD
– Natalie (E.) June 23, 2020
The following heat map shows in which age group the epidemic spread the most. The brighter and tan-colored it is, the more it spreads. Each cube shows a period of 4 days (x-axis) and 5 years of age (y-axis). This shows that as of June the disease mainly infected the 15-49 age group.
Heatmap of COVID-19 cases in Florida, by age over time, updated to current case numbers. This time showing 3-year age groups: # covid19
– Beͫvͣaͬnͨd (@zorinaq) July 15, 2020
On the other hand, the uncontrolled spread of the virus in Florida (there was a day when, as an independent state, it set a world record for the number of cases per day) happened what is also called the natural phenomenon of pandemics.
The spread of the epidemic is such that, over time, the virus will spread to other more vulnerable age groups.
The figure we made shows that in the US state, it took 4-5 weeks for an outbreak of infection to be followed by an increase in deaths.
The creation of the same figure for Hungary offers a spectacular parallel. Although we are talking about few deaths at the moment, the daily mortality is also increasing and, according to the 7-day moving average, the trend began to rise, just 4 weeks after the outbreak of positive cases.
According to local reports in Florida, the rehab and elderly care system simply couldn’t handle the pressure. Imagine this as a waterfront homeowner fighting bitterly with a pack of sandbags against a flooding river.
The rushing current not only breaks the dam, it simply carries it away.
Two more aspects, not secondary
The New York Times wrote an entire article just a month ago about the large number of relatively young people who lost their lives in Florida. Among other things, the document noted that more people in the 25-44 age group died in July alone than in the previous 4 months combined. That is, although young people are not at risk on paper, it is inevitable that as the number of infected people in their age group increases, many more will die.
With this, the NYT author, who delves into the Florida data, noted that not only the elderly may be a vulnerable group in the epidemic. A disproportionate number of those who died in the youngest age group were African American. Between the ages of 25 and 44, the proportion of people of color within Florida’s total population is 18%, but for coronavirus deaths, the proportion is 44%.
Thus, it is clear that coronavirus mortality, regardless of age, is also a significant risk for Florida in poor health (eg, obesity, diabetes). Researchers interviewed for the article also noted that people living in poor financial conditions and with limited access to adequate health care are also at much higher risk. This is because they are less likely to follow epidemiological advice in the event of an infection (such as distance and hygiene at home) and are at risk of receiving late care if the disease worsens.
conclusion
The Florida example also shows that the spread of the epidemic is uncontrollable, initially with great danger, especially among young people. As we pointed out in our previous article, in the case of a generalized epidemic, full protection of the elderly is not possible, and death, sooner or later, will not spare the younger generations either. And the widespread spread of the virus will not spare hospitals either, and hospital workers are even more exposed to infection, so the epidemic alone will severely destroy health capacity. Based on all this, it would be a mistake to assume that the system can cope with millions of infections.
Top image: Local residents will protest in Miami on July 10, 2020 over the reopening of restaurants and bars closed due to the coronavirus epidemic. In Florida, one of the most infected states, more than 11,000 new infections have been diagnosed in a single day. Source: MTI / EPA
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