The World Health Organisation has warned that young people could be driving spikes in coronavirus across Europe, with the continent said to be on the edge of a second wave.
The organisation’s Europe director has said that a higher proportion of new cases are being seen among the young.
But is that the case in the UK? And, if there are higher rates among the young – especially when it is documented that, on the whole, young people are less affected by COVID-19 – is that cause for concern?
Dr Hans Kluge did not go into specific countries when he told BBC Radio 4’s Today’s programme on Wednesday: “An increasing number of countries are experiencing localised outbreaks and a resurge in cases… It’s a consequence of a change in human behaviour.
“We’re receiving reports from several health authorities of a higher proportion of new infections among young people. So, for me, the call is loud enough to rethink how to better involve young people.”
His warning comes at a time of increased concern about the risk of communities being reinfected by people returning from holiday hotspots, some of which have been accused of observing less social distancing than might be seen at home, and also reports of post-lockdown street parties and raves.
The European Centre for Disease Prevention and Control, which collates data about coronavirus infection rates across Europe, has patchy information about the rise in rates among different age groups.
The UK is one of a number of European countries that publish data on the number of people of different ages testing positive, but not all do so.
Austria, Denmark, Slovakia, Spain, Latvia and Estonia publish figures for infection rates among different age groups and, indeed, some of their graphs do show slightly rising rates among younger groups.
In Belgium – which is said to be close to a second wave – the other Baltic and some Scandinavian nations there are no obvious signs of a clear trend occurring in young people.
The exceptions, where there are clear trends occurring, are Luxembourg – which is currently experiencing Europe’s worst outbreak – and Croatia, where incidence in young groups is clearly rising.
But Germany, France and Italy – the EU’s biggest countries – have provided no statistics on the prevalence of COVID-19 in different age groups to the ECDC for some months, if at all.
In the UK, Public Health England has been publishing the rates of infection among different age groups for several months.
The figures show that over the majority of the pandemic, infection rates have been highest in older groups.
But the graph is deceptive, as it is hard to see the impact of the easing of the lockdown, when so many people aged 65 and over were affected in the earlier stages.
A look at more recent figures suggests that infection rates among younger people in England, at least, are becoming more significant.
With those aged over 85 excluded, the 15-44 age group currently has the highest rate of infection of any age group – almost one and a half times the level of the next highest group.
And the rates are rising – albeit slowly and only for the two weeks before the last PHE weekly surveillance report.
But how do we know whether young people are to blame, when the PHE figures only look at an age group as large as those aged 15 to 44?
Extra data that suggests young adults may have the greatest rates of infection was provided recently by a pre-print study from Imperial College London, which found out of some 120,000 swabs taken from people in England in May, the highest levels of infection were found among those aged 18-24.
So why is this bad? Especially when countless studies have said that, in general, young people are at a much lower likelihood of dying if they catch the virus.
Experts say there are consequences, and they could get worse.
While young people often do get the disease less seriously, they can still get a form that has a long-lasting impact on their health.
And, the greater risk is to others in the community – and a renewed spread in the community will result in a new upsurge of deaths among more vulnerable groups.
Dr Jeremy Rossman, a senior lecturer in virology at the University of Kent, told Sky News it could be worse than the official figures suggest, because many younger people – who are less affected by the virus – are not being tested.
Because their symptoms are mild, they never show up in Public Health England figures, but they can still transmit it to others.
He said: “This rate in the healthy young adult population is actually being underestimated because… the testing is skewed… and everybody, regardless of symptoms, is not being tested.”
A study of the surge in coronavirus cases in Florida, which has been seeing thousands of new infections a day in recent weeks, found the group that saw sharp rises in infection rates earlier than others was those aged 20-24.
The curves of the graph show how once cases among the 20-24s started to rise, there was a rise in the number of those in the next oldest group being infected, and then the next oldest and so on.
This, researchers say, is exactly what will happen in some European countries and would be expected in the UK, if rates start to rise in younger people.
It is because studies have shown that the younger age groups have higher contact rates – that is they meet more people than others in older age groups – and are therefore more likely to catch the virus and to spread it to others.
Yuliya Kyrychko and Dr Konstantin Blyuss, readers in mathematics at the University of Sussex, studied the spread of COVID-19 in the south Sussex area, and found that was exactly what happened in the earlier phase of the pandemic – it spread from Brighton which has a younger age structure, to surrounding areas with older age structures.
Dr Kyrychko said: “Younger people tend to socialise more, will tend to go into clubs and bars and restaurants and try and enjoy themselves as much as possible.
“Vulnerable and older people will still be shielding. In some ways, younger people don’t care that much for this. They are not scared in the sense that it does not cause death rate at such a high rate of them.
“So those people will have disease earlier and then… it’ll obviously move into the next age group and the next age group, and then it goes on and on and on.”
Dr Rossman said the reason this is happening is that young people are interpreting the messages they have been getting as saying they are less at risk, and reacting to the end of lockdown.
“The virus is not now suddenly affecting a different population,” he told Sky News. “It’s that we’ve had very strong messaging for quite a while now about protecting the elderly, and those at high risk… there’s been a consistent message that says younger people are at much lower risk… and from my perception, there’s this attitude that says ‘I’ve been cooped up during lockdown for all this time. The pubs are finally open. I want to go out’. And so that’s what we’re seeing.
“At the same time is not unexpectedly a significant decrease in compliance with safe precautions, such as physical distancing, face covering, proper hands hygiene.”
The experts say more needs to be done to get the message across to young people.
Dr Rossman added: “Germany was one of the first countries that saw the shift to a healthy young adult population being the highest rate in positivity. And it was correlated with a lower rate of precaution taking. They saw this very early in the pandemic. And now later on, we’re seeing this in the UK.
“We need to increase precaution taking. We need to decrease transmission in this age group. We need to change the framework saying that most cases are mild because a lot of cases are incredibly severe and that can affect any age group. That’s an aspect we need to be messaging.”
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