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June 26, 2020
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New COVID-19 cases ‘dominated by young people’

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This morning, Texas Gov. Greg Abbott signed an executive order to close bars and limit restaurants to 50% occupancy in a roll back of the state’s reopening amid an increase in positive tests for COVID-19.

The decision came as the test positivity rate in Texas surpassed 10%, Abbott said.

“As I said from the start, if the positivity rate rose above 10%, the State of Texas would take further action to mitigate the spread of COVID-19,” he said in a statement. “At this time, it is clear that the rise in cases is largely driven by certain types of activities, including Texans congregating in bars.”

Texas is one of many states dealing with an increase in cases. It is also one of the states that has seen cases go up in younger adults, with Abbott announcing recently that patients younger than age 30 years accounted for a majority of cases in some Texas counties, according to The Texas Tribune.

In a telebriefing on Thursday, CDC Director Robert R. Redfield, MD, said “a significant number” of infections in Florida and the Southeast and Southwest U.S. are occurring in patients younger than age 50.

Robert R. Redfield

“Obviously, we’re seeing right now infections that are targeting younger individuals,” he said.

Also Thursday, the CDC expanded the list of people at an increased risk for severe illness from COVID-19, saying “risk increases steadily as you age, and it’s not just those over the age of 65 who are at increased risk for severe illness.”

“In the past, I just don't think we diagnosed these infections,” Redfield said. “Our best estimate right now is that for every case that was reported, there actually were 10 other infections. In the past, we didn't correctly pursue diagnostics in young, asymptomatic individuals.”

In Florida, from the first week of March to June 14, the median age of patients testing positive dropped from 65 years to 35 years, according to a graph shared online by former FDA Commissioner Scott Gottlieb, MD.

Anthony S. Fauci

“As individual states are opening up, they’re seeing a serious concern of increasing cases,” National Institute of Allergy and Infectious Diseases Director Anthony S. Fauci, MD, said during an interview at the Milken Institute’s Summer Series. “It’s not just because of increased testing ... soon we’ll be seeing more deaths. The demography of people getting infected are generally young people. There have always been young people, but right now, it’s dominated by young people.”

Like Florida, California has also seen a rise in younger patients testing positive. According to an article in The Mercury News, a published review showed that the proportion of new diagnoses that occurred among patients aged younger than 34 years increased from 29% to 44% in the last month while cases among adults aged 50 years or over declined.

“I remain concerned about trying to understand the effective public health messaging that we need to get to those individuals that are under the age of 45, under the age of 30, whereas the impact and consequences of COVID-19 infection on them may not be highly associated with hospitalization and death,” Redfield said. “They do act as a transmission connector for individuals that could, in fact, be at higher risk.”

Fauci said the death rate may be lower if more younger people are being infected, but “I can’t see anyone getting infected as good news.”