Recklessness or reopening: Why are more young people getting coronavirus?

Millennial, Gen Z workers often on the front lines of retail, restaurants

OAKLAND, CA – JUNE 27: Katherine Brady, 25, of San Francisco, has lunch with Cinque Curry, 25, of Oakland, at Jack London Square in Oakland, Calif., on Saturday, June 27, 2020. Brady and Curry talked about the changes they made to their daily routine because of the coronavirus pandemic. Curry changed his behavior after members of his family were infected by COVID-19. (Jose Carlos Fajardo/Bay Area News Group)
Mercury-News, by Nico Savidge and Leonardo Castañeda, June 28, 2020

A surge of coronavirus cases among young people is leading to a generational blame game as California and other states grapple with a second wave of the virus.

Reports of outbreaks across the country tied to fraternity houses and college-town bars have helped fuel a perception that people in their teens and 20s — who are far less likely to die from COVID-19 but can still suffer debilitating bouts of the virus or pass it along to others who are more vulnerable — have thrown caution to the wind because they don’t feel threatened by it.

A long list of other factors may also be at play in the increase, however.

“I see plenty of irresponsibility going on across the age spectrum as we have opened up,” said Dr. Kirsten Bibbins-Domingo, chair of the University of California San Francisco’s Department of Epidemiology and Biostatistics. “I don’t think it’s helpful to demonize one group or another.”

An analysis released last week found 44 percent of new coronavirus cases in California were among people 34 or younger, compared to 29 percent a month ago. Meanwhile, the analysis of California Department of Public Health data, conducted by infectious disease epidemiologist George Lemp, found the share of cases from people over 50 was dropping.

At a press conference Friday, Gov. Gavin Newsom said the state is seeing an alarming increase in coronavirus cases among people under 35, which he called “that age cohort that believes in many cases that they are invincible, and they are somehow immune from the impacts of COVID-19.”

But the increase tracks with what Bibbins-Domingo said she expected as more businesses reopened.

During that process, she noted that government and public health officials told people at higher risk from coronavirus — particularly those who are older — that they should still stay at home to avoid infection. Younger people at lower risk, meanwhile, were given the OK to go out again, making it more likely they would catch the virus.

Now, after seeing a massive increase in new coronavirus cases last week, states and counties are rethinking their reopening plans.

“The age doesn’t concern me as much as the big rise in cases,” Bibbins-Domingo said.

Another possible explanation for the rise among young people: It’s a lot easier to get a COVID-19 test these days, which has meant people with milder or even asymptomatic cases, who skew younger, are finding out they have the virus, Bibbins-Domingo said.

And the jobs young people do could be playing a role as well. Nationwide, only about one-third of workers are in the 16 to 34 age group, but those in essential, public-facing jobs — as well as industries that have started reopening more broadly in recent weeks — tend to be younger.

In retail, where officials have been easing lockdown restrictions, about 56 percent of workers at clothing stores are 34 and younger, as are 70 percent of workers at shoe stores and 60 percent of those at electronics stores.

Nearly two-thirds of restaurant workers are 34 or younger, as are nearly half of grocery store employees, according to data from the U.S. Bureau of Labor Statistics.

Workers in food service “are so exposed,” said Sameer Shah, the 36-year-old co-owner of Voyager Coffee, who noted the business model of a coffee shop relies on serving perhaps hundreds of customers each day — all of whom could pose a risk in the coronavirus age. Nearly every worker at Voyager’s three cafes is under 35.

To lessen risk, Voyager workers serve customers at doorway counters, and don’t let people inside their cafes. Shah said it seems like irresponsible behavior from customers is becoming more common as the pandemic has dragged on — but he didn’t chalk it up to any particular age group.

“People are just not quite as on guard as they were before,” Shah said.

Still, there is some evidence that young people are more likely to take risks during the pandemic: While most people across all age groups report they are consistently wearing masks, avoiding groups and staying at least six feet away from others, people from 18 to 24 were much less likely than older adults to say they were doing so, a May CDC survey found.

Then again, millennials from 25 to 34 tend to be more cautious — they trailed only people 65 and older in their likelihood to report they were avoiding groups and wearing masks. (People from 45 to 54, the age range 52-year-old Newsom falls into, reported the second-lowest levels of compliance with those guidelines.)

Cinqué Curry, a 25-year-old construction worker from Oakland, admitted he didn’t take coronavirus very seriously at first — he went on a cruise in February, and traveled to Las Vegas in March, just as casinos started shutting down.

But then, Curry said, “I started to really think about my grandmother,” who was terrified of the virus. Seven of his family members across the country fell ill with COVID-19. All have since recovered.

Now, Curry said, he wears a mask, doesn’t venture out much and takes other precautions. On Saturday, he was enjoying some takeout tacos on a bench in Jack London Square with plenty of distance from other groups; unlike some peers, Curry isn’t jumping at the chance to start dining in restaurants or drinking in bars again.

“I feel like I’ve taken it as seriously as I can,” he said.

One new COVID-19 death in Solano County, a senior citizen, 13 new hospitalizations


Monday, June 29: 8 new cases today, 1 new death. Since the outbreak started: 1,126 cases, 103 hospitalized, 24 deaths.

Compare with previous report, Friday June 26:Summary

  • Solano County reported 8 new cases today, total of 1,126 cases since the outbreak started.  Last week, Solano reported 258 new cases, an average of 37 per day.
  • 1 new death today, total of 24, 13 more hospitalized, total of 38.
  • Solano reported 80 fewer ACTIVE cases today, total 70.  How can this be??  8 new cases and 13 new hospitalizations, yet active cases are down by 80?  Maybe County officials phoned around and asked how infected people are feeling, and a bunch of them reported feeling better?  Sorry, I can’t explain this….
  • Testing – Solano county reported 2,504 residents were tested over the weekend and today.  Good progress!

Solano’s new Public Health Dashboard design has 2 tabs

The County’s new Public Health Dashboard design includes a second tab (panel), the “Details / Demographics” tab (shown here).  Note that both tabs are user interactive – hover over a chart (or tap) to get details. On this Details/Demographics tab, most of the small charts have a small additional tab showing the rate per 100,000.   Go there and explore the two tabs.  (Expand a chart by clicking the small button in its upper right corner.)

SEVEN DAY MOVING AVERAGE – MISLEADING!

The County has added a Seven day moving average chart of laboratory-confirmed cases.  Maybe I’m just getting curmudgeonly, but I don’t see how this chart reflects reality.  Unless you really study the detailed description of the chart, it would seem to show that Solano is in great shape!  Far from it!  Cases are up here.  Masks and social distancing are still required and important!  The chart is “The average of the number of laboratory-confirmed cases of COVID-19 in Solano County residents over the past 7 calendar days, by the date that their specimens were collected,” whatever that means.  Today’s chart shows a 7-day moving average of only 5 new cases per day, down from 28 yesterday That just seems nuts to me.

BY AGE GROUP

  • Youth 17 and under – good news: no new cases today, total of 88 cases, only one ever hospitalized.  But notice: 14 days ago, there were only 40 cases among this age group – we’ve seen 48 new cases in two weeks!  I continue to be alarmed for Solano’s youth.  Cases among Solano youth have increased in recent weeks to nearly 8% of the 1,126 total confirmed casesThe Centers for Disease Control and Prevention puts the figure of coronavirus-infected kids younger than 18 at around 4% of those with the disease.  Our youth are testing positive at almost double the national rate!
  • Persons 18-49 years of age – 4 new cases today, total of 638 cases.  This age group represents 57% of the 1,126 total cases, by far the highest percentage of all age groups.  The County reported no new hospitalizations among this age group today, and no new deaths.  Total of 27 hospitalized at one time and 2 deaths.
  • Persons 50-64 years of age – 2 new cases today, total of 233 cases.  This age group represents 21% of the 1,126 total cases1 new hospitalization today, total of 35 hospitalized at one time.  No new deaths, total of 3 deaths.
  • Persons 65 years or older – 2 new cases today, total of 166 cases.  This age group represents 15% of the 1,126 total cases1 new hospitalization and 1 new death today.  Total of 40 hospitalized at one time and 19 deaths.  In this older age group, 24% were hospitalized at one time, a substantially higher percentage than in the lower age groups And this group counts for 19 of the 24 deaths, or 79%.

CITY DATA

  • Vallejo added 2 new cases today, total of 462.
  • Fairfield added 3 new cases today, total of 363.
  • Vacaville added 2 new cases today, total of 152 cases.
  • Suisun City remained at 70 cases.
  • Benicia remained at 25 cases.
  • Dixon added 1 new case today, total of 39 cases.
  • Rio Vista and “Unincorporated” are still not assigned numerical data: today both remain at <10 (less than 10).  The total for “other” shows 15 cases somewhere among the 2 locations in this category (same as last reported)Residents and city officials have pressured County officials for city case counts.  Today’s data is welcome, but remains incomplete for folks in Rio Vista and unincorporated areas of the County.
  • A “Rate” column shows the rate of positive COVID-19 cases (per 100,000 population) for each city.  Benicia is leading the way here, with a rate of only 90.7 cases per 100,000. Compare with other Solano cities in the chart, and note that the CDC reports today’s rate in California at 534 per 100,000 (up from 494 Friday).  Johns Hopkins lists the overall Solano County rate at 250 (up from 245 Friday).

RACE / ETHNICITY

Cases, hospitalizations and deaths by race/ethnicity – Solano County, June 29
Incidence rate, hospitalization rate, and death rate (per 100,000) by race/ethnicity – Solano County, June 29

The County report on race / ethnicity data includes case numbers, hospitalizations, deaths and Solano population statistics.  There are tabs showing a calculated rate per 100,000 by race/ethnicity for each of these boxes  (second image above).  This information is discouragingly similar to national reports that indicate worse outcomes among black and brown Americans.  As of today:

  • White Americans are 39% of the population in Solano County, but only account for 24% of cases, 22% of hospitalizations and 22% of deaths.  (Note these numbers are all down from 25%, 23% and 23%.)
  • Black Americans are 14% of Solano’s population, and account for 13% of cases, but 28% of hospitalizations and 35% of deaths.
  • Latinx Americans are 26% of Solano’s population, but account for 38% of cases.  They account for 26% of hospitalizations and 17% of deaths.  (Note these numbers are all UP from 36%, 24% and 14%, indicating an uptick in Solano’s Latinx community.)
  • Asian Americans are 14% of Solano’s population, and account for 12% of cases and 15% of hospitalizations, but 22% of deaths.

MUCH MORE…

The County’s new and improved Coronavirus Dashboard is full of much more information, too extensive to cover here on a daily basis.  The Benicia Independent will continue to summarize daily and highlight a report or two.  Check out the Dashboard at https://doitgis.maps.arcgis.com/apps/MapSeries/index.html?appid=055f81e9fe154da5860257e3f2489d67.

Solano County and nationwide: Coronavirus revealing inequities in public health due to societal factors

[NOTE: Latest COVID-19 analysis by Solano County Public Health shows Whites at 39% of the county’s population, but only 25% of cases, 23% of hospitalizations and 23% of deaths.  Vallejo and Fairfield account for 54% of the population, but 73% of COVID cases, surely reflecting the two cities’ relatively poorer and browner neighborhoods.  – R.S.]

The Interwoven Threads of Inequality and Health

The New Yorker, by Isaac Chotiner, April 14, 2020
People in a spread out line.
The coronavirus crisis is revealing the inequities inherent in public health due to societal factors, Nancy Krieger, a professor of social epidemiology, says. Photograph by Johannes Eisele / AFP / Getty

According to preliminary data about the coronavirus pandemic, African-Americans are bearing a strikingly disproportionate share of the suffering in the United States. In Illinois, where fourteen per cent of the population is African-American, black Americans represent more than forty per cent of the state’s confirmed coronavirus deaths. Coronavirus fatalities have a similar breakdown in Michigan, and several Southern states show even greater disparities.

The possible reasons for these inequities are myriad: African-Americans are less likely than white Americans to have the option of working from home and to receive high-quality medical care, and more likely to have preëxisting medical conditions that lead to worse outcomes from the novel coronavirus. New research links coronavirus deaths to air quality, which is often worse in poor communities and communities of color.

Nancy Krieger is a professor of social epidemiology at the Harvard T. H. Chan School of Public Health. Her work focuses on health disparities between demographic groups and the social structures that help determine those disparities. We recently spoke by phone about how American health inequities are playing out during the pandemic.  During our conversation, which has been edited for length and clarity, we discussed why the field of social epidemiology is crucial to understanding inequality, the causes of racial disparity in health outcomes, and what can be done to ameliorate the suffering of the most vulnerable Americans during this crisis.

Is the spread of the coronavirus, and especially its disproportionate impact on the African-American community, teaching us new things about racial disparities in health care and health outcomes or confirming things we have long known?

More the latter. What the virus is doing is pulling a thread that is showing how many things are actually connected, and how deeply people are actually connected. But it’s also revealing the very different conditions in which we live because of social structures that are inequitable, both within the United States and between countries. By pulling the thread, it’s revealing patterns that have been long known in public health.

So, when you think about something like this coronavirus, you have to think about who’s exposed in the first place and where they are exposed—at work, at home, and what are the conditions? You have to think about, if they’re exposed, do they get infected? You have to think about, if they get infected, do they get ill? And you have to think about, if they’re ill, do they actually die?

And you take each of those steps, which are all different steps in this process, and turn to what are the preliminary—and, I emphasize, preliminary—data on the excessive death rates. My state, Massachusetts…  […continued…]


 

At least 14 dead in COVID-19 outbreak at Concord nursing facility

The outbreak is among the largest in the East Bay

East Bay Times, By Annie Sciacca, UPDATED June 24, 2020
At least 15 people have died from COVID-19 infections at the San Miguel Villa nursing facility in Concord, according to data from the California Department of Public Health as of Tuesday, June 23, 2020. (Photo courtesy of Google Street View)

CONCORD — At least 14 people are dead after COVID-19 infected 75 people at an East Bay skilled nursing facility, according to data published by the state.

The state Department of Public Health’s latest report shows that 14 patients at San Miguel Villa, a post-acute nursing facility in Concord, have died after contracting the virus, which infected 62 residents and 13 workers at the facility.

A call to the facility was not immediately returned, so it’s unclear when the deaths occurred. Data reported to the state by the nursing home within the past 24 hours reveal that there are still 45 patients there infected with COVID-19

The state list on Tuesday showed that at least one healthcare worker at the facility had also died of COVID-19, but a spokesman for the facility, Dan Kramer, said Wednesday that it had been incorrectly reported, and that no workers had died.

The latest outbreak is yet another example of how the disease has ravaged the Bay Area’s most vulnerable population of elders living in congregate settings such as skilled nursing facilities or assisted living centers.

Of the 94% of the state’s 1,223 skilled nursing facilties that reported COVID-19 cases this week, there are currently 2,300 patients and 49 health care workers with confirmed COVID-19 infections, according to the state data. Cumulatively, there have been at least 12,282 confirmed cases across California and 7,655 cases among workers at skilled nursing facilities. And 2,299 patients and 89 health care workers have died from causes related to the deadly virus.

In non-medical residential care facilities — known commonly as assisted living facilities — there have been at least 2,969 confirmed COVID-19 cases among patients and staff, who often provide assistance in feeding, bathing, taking medication and other activities. At least 398 people in those facilities have died from COVID-19.

In Contra Costa County, health services director Anna Roth told the Board of Supervisors during its Tuesday meeting that of the 18 COVID-19 deaths that occurred the past week, 16 were from long-term care facilities, such as nursing homes. She did not identify the facilities.

Dr. Sara Levin, a deputy health officer for the county, told the supervisors a county task force had been set up to visit care facilities and help them proactively beef up infection control protocols and provide support in acquiring masks, gloves and other protective equipment, as well as ensuring they had enough staff if workers had fallen ill. The county at the end of May issued a health order to conduct mass testing as a baseline for all long-term care facilities, and then to continue testing staff monthly.

“Where we’ve seen a lot of the spread is when staff in these low-wage jobs are having to work in multiple facilities to ensure their financial stability, without benefits that don’t necessarily allow them to have sick leave,” Levin said. When federal, state and county mandates prevented most visitors, she said, “many residents were staying in facilities, so it was staff members going out to the community … and bringing it in.”

Concord’s San Miguel Villa is a 190-bed nursing facility on San Miguel Road owned and operated by Mark Callaway, Gary Jarvis and Velda Pierce. Pierce and Callaway also own other Contra Costa nursing facilities: Alhambra Convalescent Hospital, Lone Tree Convalescent and Antioch Convalescent Hospital, according to state records.

Since 2017, the facility has had a total of 106 complaints or reported incidents, and state inspectors found a total of 36 “deficiencies.” Some of those deficiencies included problems with infection control.

In an inspection in April 2019, for instance, state inspectors found multiple licensed vocational nurse staff members had not followed proper handwashing protocols.

Last year, the family of an elderly man who died at San Miguel Villa sued the facility, saying its lack of staffing and training led to the man’s suffering. The facility used drugs to sedate him, the lawsuit alleged.

Staffing shortages and lack of adherence to infection control practices have contributed to the outbreaks in nursing homes, experts have said.

“We are really concerned about the lack of oversight in skilled nursing facilities like San Miguel Villa,” said Nicole Howell, executive director of Ombudsman Services of Contra Costa, Solano and Alameda counties. “This underscores the need to improve regulation and oversight — particularly one that specializes in dementia and memory loss.”

The outbreak and death toll at San Miguel Villa is among the largest in East Bay skilled nursing facilities.

East Bay Post-Acute in Castro Valley has had a total of 16 COVID-19-related patient deaths, and 18 patients at Gateway Care and Rehabilitation Center in Hayward have died of the virus.

In San Mateo County, Millbrae Skilled Care has had 14 COVID-related deaths, and more than 100 cumulative infections among patients and 31 cases among health care workers there. But the state data shows there are no infections reported in the last 24 hours at that facility.

In Santa Clara County, 12 patients of Canyon Springs Post-Acute nursing facility in San Jose have died of COVID-19, and at one point 106 patients and staff were infected with the virus. There were no current cases within the last 24 hours, according to the state data.

Update: An earlier version of this story reported at least 15 people had died of COVID-19 at San Miguel Villa. A spokesperson confirmed the state data incorrectly reported that a healthcareworker had died.

For safe and healthy communities…