Rate of hospitalizations for 20 to 29

Chart showing spike in hospitalization rate for people age 20 to 29.

As of Tuesday, July 20, North Dakota has 292 active cases of coronavirus with 19 current hospitalizations. That’s down from the Nov. 13 peak of 10,408 COVID-19 cases, but of those 19 hospitalized people, two are individuals in the 20 to 29 year old age group.

That reflects a trend that has been growing across the nation, Dr. Paul Carson said in a Town Hall about coronavirus and the COVID-19 vaccines. Younger people are being hospitalized more often from the Delta variant, which is proving to be more contagious and more likely to cause serious illness. Carson, who is infectious disease specialist and professor of public health at North Dakota State University, urged those who are not yet vaccinated to seriously reconsider that choice.

The Delta coronavirus variant is at least twice as contagious as previous variants, Carson said, and a Scotland study found it 85 percent more likely to lead to hospitalizations for unvaccinated people, in an increasingly younger age group. It is also rapidly becoming the dominant strain in the U.S., and has already caused spikes in some states, straining health care capacity once again.

Mississippi, for example, reported 13 hospitals without ICU beds last week. Ninety percent of their COVID cases are unvaccinated people.

“Right now, it’s clearly an epidemic in the US of the unvaccinated,” Carson said. “There was an editorial in the paper recently kind of looking at North Dakota and how we are trending like Mississippi and that’s not a good thing on a lot of health care measures. And with our vaccination rates being close to theirs, it may be a cautionary note for us here in North Dakota.”

North Dakota has vaccinated just 39.7 percent of its population, which leaves 60 percent vulnerable to infection by the Delta variant. Some of those people may well have already caught a previous variant of coronavirus, but data so far suggests the immunity gained through infection by those previous variants is not as strong as the immunity developed by the vaccine. A prior case of COVID-19 may therefore not prevent re-infection by the Delta variant.

The vaccines, on the other hand, appear to be protecting people from the Delta variant, based on the available data so far. It doesn’t prevent all re-infections, Carson acknowledged, but it’s 90 percent effective. The remaining 10 percent are usually people who were either immunocompromised, people who were elderly, or people who had a weakened immune system for some other reason.

Those individuals are a primary reason Carson suggested everyone should get vaccinated, even if they are not worried about themselves falling ill from COVID-19. If everyone around the vulnerable are vaccinated, there is less chance they will catch a variant of the coronavirus and get seriously ill from it.

But, Carson added, those who think they are not at risk from a mild case of coronavirus may want to rethink that, based on the data he has been seeing in clinical studies.

In a six-month followup of outpatients aged 18 to 39, who supposedly had a milder coronavirus case, more than a quarter are still reporting symptoms six months after diagnosis. These include things like difficulty breathing, memory loss, fatigue, and, in some cases, a new diagnosis of anxiety or depression.

In Italy, which experienced coronavirus earlier than the U.S., a similar study of a larger group of patients found 69 percent of COVID patients still reporting such symptoms even a year later.

Meanwhile, in Britain, brain scans of people done pre-COVID were compared to later brain scans for those who later got COVID. These were then matched up with control groups using age group and underlying medical conditions for the purpose of comparison.

“They found the COVID-19 patients had significant shrinkage in the gray matter of their brain in five different areas,” Carson said. “Those areas of the brain are responsible for taste, smell, memory and emotions. So when you see reports of increased anxiety disorders, increased depression, ongoing troubles with taste or smell, difficulty concentrating, and then you have correlates of gray matter brain changes in the brain in those people.”

These patients, too, were mostly outpatients, Carson said. They had mild to moderate disease that didn’t require hospitalization at the time.

Safety data for the vaccine is so far good, Carson said. Close to 190 million people in the United States have been vaccinated so far.

“That’s a lot of people that we’ve been looking really hard at,” Carson said. “I mean these people are under a microscope.”

That microscope consists of various surveillance systems taking in reports of adverse effects ranging from the more common sore arms and headaches to the rare but more serious things like myocarditis.

About 50 people per 1 million doses of vaccine have experienced the latter, Carson said, which is the most prevalent side effect so far.

The risk for myocarditis in a male 18 to 24 from the vaccine is 1 in 20,000, Carson said.

That risk, however has to be weighed against the risk of heart inflammation from COVID-19. Looking at a study of Big 10 athletes, 2.3 percent of them experienced heart inflammation due to COVID-19. That’s a 1 in 43 chance of heart inflammation that may in many cases be much more serious than the symptoms caused by the vaccine.

“And that is just one thing we’re talking about,” Carson said. “We didn’t talk about Long COVID. We didn’t talk about hospitalization. We didn’t talk about the very small risk of death. Those are all also things this young man might have to contend with. So just even on the myocarditis alone, the risk of the virus greatly outweighed the risk of the vaccine on that one parameter alone, let alone putting it all together.”

Carson himself is vaccinated, he added, along with 96 percent of other doctors.

“I mean they see the value of this and jump to the front of line when they were able,” he said.

As far as social media memes suggesting the number of COVID deaths have been inflated, Carson said a simple approach ought to show that is unfounded.

“Forget a COVID label on the death certificate,” he said. “Just look at CDC data on deaths from anything from 2015 to 2019 as compared to 2020 for every week of the year starting in March. There were, at the lowest, 10 percent more deaths, to the highest, about 70 percent more deaths, every week of the year.”

That, he said, should make clear that something new was causing all those deaths.

“If you think it’s like loneliness or you know lockdowns or whatever, OK, maybe, but the obvious answer is COVID,” he said. “And when you look at those extra deaths, the vast majority of them had a COVID diagnosis attached to it. But even if we removed that, we’d still have to explain why there was 30, 40, 50, 60, 70 percent more deaths week on week throughout 2020 compared to our prior five years.”

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