Dr Sharon Levy, MD, MPH

The trends are chang­ing, we are ob­serv­ing younger per­sons trans­mit­ting COVID-19 and there is much to ex­plore!

Ac­cord­ing to CDC in the months of Ju­ly/Au­gust/Sep­tem­ber 2021, per­sons un­der age 30 ac­count­ed for more than 20% of COVID-19 cas­es and were seen as more like­ly to trans­mit the virus than oth­ers. This trend has con­tin­ued in­to 2022.

Last week, Trinidad and To­ba­go saw a con­cern­ing in­crease in the num­ber of con­firmed pos­i­tive cas­es and we must be mind­ful, COVID-19 is still lurk­ing in the back­ground in the en­dem­ic stages.

COVID-19 has swept across the globe, in­fect­ing mil­lions, and re­sult­ing in over 6.2 mil­lion deaths glob­al­ly. Age is the most of­ten cit­ed risk fac­tor; 75% of glob­al deaths, have been in peo­ple over the age of 65, while younger peo­ple gen­er­al­ly have milder symp­toms. In ad­di­tion to age, the Cen­ters for Dis­ease Con­trol (CDC) has de­lin­eat­ed a list of health fac­tors that in­crease vul­ner­a­bil­i­ty, most of which are chron­ic dis­or­ders that gen­er­al­ly al­ter health sta­tus.

So what in­creas­es the risk fac­tor of young adults?

Ac­cord­ing to HAR­VARD HEALTH, the sin­gle most mod­i­fi­able risk fac­tor for se­vere COVID-19 in­fec­tion is in­haled sub­stance use through smok­ing or va­p­ing. A new study pub­lished in the Jour­nal of Ado­les­cent Health used na­tion­al da­ta to es­ti­mate the toll of smok­ing and va­p­ing on COVID-19 risk for young adults. The team found that over­all, near­ly one in three young adults ages 18 to 25 in the US are at height­ened risk, though that num­ber falls to one in six among those who do not smoke or vape. In oth­er words, smok­ing and va­p­ing dou­ble the num­ber of young adults in the at-risk cat­e­go­ry.

Va­p­ing and smok­ing in­crease young adults’ risk of COVID symp­toms

Smok­ing and va­p­ing both cause lung in­jury that threat­ens pul­monary re­serve. Sub­stance use can al­so weak­en the im­mune sys­tem, re­sult­ing in re­duced ca­pac­i­ty to fight off in­fec­tion. A re­cent study found that ado­les­cents and young adults who smoke and vape were five times more like­ly to re­port COVID-19 symp­toms and sev­en times more like­ly to have a di­ag­no­sis, com­pared to their peers. A com­bined analy­sis us­ing da­ta from mul­ti­ple stud­ies found that among peo­ple in­fect­ed with COVID-19, those with his­to­ry of smok­ing were twice as like­ly to have dis­ease pro­gres­sion.

Risk-tak­ing dur­ing ado­les­cence could mean greater risk for COVID

Dur­ing ado­les­cence and young adult­hood, de­vel­op­ing brains are wired to seek large neu­ro­log­i­cal re­wards, re­sult­ing in the risk-tak­ing that is as­so­ci­at­ed with this stage of life. Most young adults en­joy good health and hearty phys­i­o­log­ic re­serve, al­low­ing them to tol­er­ate the in­sults of sub­stance use with­out no­tice­able im­pact, un­til the cu­mu­la­tive ef­fects ac­crue in mid­dle adult­hood — or at least that was gen­er­al­ly as­sumed to be the case pri­or to the COVID-19 pan­dem­ic.

Un­like oth­er risk fac­tors for se­vere COVID-19 dis­ease, smok­ing and va­p­ing al­so in­her­ent­ly in­crease the risk of res­pi­ra­to­ry virus trans­mis­sion. Smok­ing and va­p­ing are of­ten so­cial ac­tiv­i­ties for young adults. Both in­volve ex­hal­ing forcibly, which may pro­pel droplets that car­ry vi­ral par­ti­cles fur­ther than at-rest breath­ing. It goes with­out say­ing that both smok­ing and va­p­ing are in­com­pat­i­ble with wear­ing a mask. These fac­tors com­bine to pose a re­al threat in places where young peo­ple gath­er. It would be smart to in­sti­tute strict no-smok­ing and no-va­p­ing rules and en­force them vig­or­ous­ly as part of a COVID-19 con­tain­ment plan.

Younger peo­ple may be over­con­fi­dent about health risks

Young peo­ple tend to over­es­ti­mate their

own abil­i­ty to

con­trol a sit­u­a­tion

and think of them­selves as in­vin­ci­ble.

Many are in­clined to think that they will be able to quit smok­ing when­ev­er they want to. A lit­tle ex­tra con­fi­dence may be use­ful dur­ing the tran­si­tion to adult­hood, even if based on a faulty as­sess­ment of one’s own ca­pa­bil­i­ties. But the same ten­den­cy can cause re­al prob­lems in this pan­dem­ic. The best thing we can do for young peo­ple is to pro­mote ac­cu­rate in­for­ma­tion about their true risks. More than any oth­er group, young adults who are able to quit smok­ing and va­p­ing have the pow­er to flat­ten their own per­son­al risk curves.

COVID-19 Pre­cau­tions for Young Adults

While most young peo­ple who get COVID-19 re­cov­er, some do not. Many may pass the ill­ness to oth­ers un­know­ing­ly. Be­hav­iours make an enor­mous dif­fer­ence. COVID-19 pre­cau­tions such as mask-wear­ing, phys­i­cal dis­tanc­ing, hand hy­giene and self-mon­i­tor­ing for coro­n­avirus symp­toms are ef­fec­tive in lim­it­ing in­fec­tion and spread of the dis­ease. They are es­pe­cial­ly im­por­tant for those with a vul­ner­a­ble house­hold or com­mu­ni­ty mem­bers such as chron­i­cal­ly ill, old­er and im­muno­com­pro­mised peo­ple.

It is para­mount for young adults to re­alise their role in the COVID-19 pan­dem­ic. Even healthy per­sons in their 20s and 30s can catch the coro­n­avirus, spread it to oth­ers, and suf­fer from se­vere ill­ness re­sult­ing in last­ing health prob­lems or even death.

For more in­for­ma­tion:

https://www.cdc.gov/to­bac­co/ba­sic_in­for­ma­tion/e-cig­a­rettes/Quick-Facts-on-the-Risks-of-E-cig­a­rettes-for-Kids-Teens-and-Young-Adults.html

https://www.health.har­vard.edu/blog/blown-up-in-smoke-young-adults-who-vape-at-greater-risk-of-covid-symp­toms-2020082820859