New Delhi: They are young, they are largely more socially active than their older counterparts, and contracting Covid-19 often leaves them not feeling sick at all.
The World Health Organization (WHO) said earlier this week that people in their 20s, 30s and 40s, most of them asymptomatic, are driving the Covid-19 pandemic.
A similar trend seems to be underfoot in India, with data from the Indian Council of Medical Research (ICMR) suggesting that people aged between 21 and 50 account for 61.31 per cent of the 27,32,992 Covid-19 cases recorded in India so far.
This is far higher than the share this age cohort — comprising Generation X (born roughly early 1960s to late 1970s, millennials (born 1980 to mid-1990s) and Generation Z (born mid-1990s to around 2010) — constitutes in the population.
According to Census 2011 data, 36.3 per cent of Indians are aged between 20 and 44 years.
The trend plays out in the top five high-burden states — Maharashtra, Tamil Nadu, Andhra Pradesh, Karnataka and Uttar Pradesh — too.
Experts say the prevalence of the disease among the young is not surprising, and has historical precedent in the Spanish Flu of 1918. It all boils down to the fact that the young are out on the town much more often than older people, they claim.
Also Read: Lift lockdowns, protect the vulnerable, treat Covid like a health issue and not a disaster
All in the numbers
In Maharashtra, the state worst affected by Covid-19 in India, people in the age group of 20 to 50 account for 56.34 per cent of the total cases.
Those in the age group of 31-40 have been the most affected, with 1,27,110, or 21 per cent, patients among them.
Patients aged 21-30 make up for 17.55 per cent of the total cases, while those from the 41-50 age group, who are also prone to comorbidities such as diabetes and hypertension, account for 17.76 per cent of the total cases.
In UP, out of the 1,67,510 cases registered until 18 August, 49.84 per cent — or 83,486 cases — are aged between 20 and 40 years. Around 8.34 per cent of the total cases — 13,970 cases — are aged above 60 years.
Among the 3,61,435 cases registered in Tamil Nadu until 20 August, 82 per cent — or 2,98,124 — were aged between 13 and 60, with 46,055 cases in the 60-plus age category.
Andhra Pradesh had registered 3,16,000 cases until 20 August, of which 78,603 are in the 21-30 years category. There are 74,731 cases among the 31-40-year-olds and 61,935 in the 41-50 age group. Another 48,227 cases are in the 51-60-year age group.
Until 18 August, Karnataka had reported 2,40,948 cases, of which 80,659 were active on that day. The highest number of active cases is in the 21-30 age group, 55,453. In the 31-40 age group, there are 53,033 active cases, and another 41,787 cases in the 41-50-year cohort. There are 29,474 cases among the over-60-year-olds.
The 20-50 age group may also have less severe illness and more favourable outcomes. According to data shared by the Union Ministry of Health earlier this month, those in the 26-44 age group comprise 11 per cent of all Covid-19 deaths, while the number is 37 per cent for the 45-60 age group.
On 18 August, WHO western pacific regional director Takeshi Kasai noted how the “epidemic is changing”.
“People in their 20s, 30s and 40s are increasingly driving the spread. Many are unaware they are infected. This increases the risk of spillovers to the more vulnerable: The elderly, the sick people in long-term care, people who live in densely populated areas and underserved areas,” he said.
In a report dated 27 July, Bloomberg had reported “infections among millennials and Generation Z are driving new waves of cases which don’t seem to be abating despite re-imposed restrictions”, saying social distancing curbs are proving “untenable”.
Also Read: Why Covid-19 herd immunity may be closer than we believed so far
‘Asymptomatic, active people’
Talking about the greater prevalence of Covid-19 among the 20-50-year-olds, Dr Anurag Agarwal, director of the Delhi-based Institute of Genomics and Integrative Biology, said people in this age group “are likely the most active socially and professionally, especially now that the country is unlocking”.
“These are the most active people. They also tend to be asymptomatic, so even if people follow the guidelines of staying at home if feeling unwell, they do not feel unwell,” he added. “That is the issue and that is what makes them the driving force. In the coming days, this will become even more important as schools and colleges open up, whenever that happens.”
The phenomenon of young people driving a pandemic is not exactly new, said Dr S.K. Sarin, director at the Institute of Liver and Biliary Sciences in Delhi who also heads a Union Territory government committee on Covid-19.
“If you go back to the Spanish flu 102 years ago, the disease was dominantly — about 70-80 per cent — spread by 20-40-year-olds but mortality was higher above 60,” he added.
“It is true now and true for any infectious disease. Young people are more mobile, also more careless, tend to defy more. They use mobile phones, take off their masks and eat in common places. They are more likely to mix. We are looking at whether we can change this trend and use them as ambassadors of change.”
Bhaskar Katamaneni, commissioner for health and family welfare in Andhra Pradesh, however, disagreed.
“I don’t think we can say a particular age group has very high cases. It is evenly distributed, just that the prevalence among higher age group is more for obvious reasons — comorbidities.”
Trend holds for other states too
Of the 47,153 Covid-19 cases reported from Haryana until 16 August, as many as 13,186 — roughly 28 per cent — are in the age group of 25-34 years. Another 9,250, or 19.6 per cent, are in the 35-44 age group, and 7,360 or 1.6 per cent among 15-24-year-olds. This means 15-44-year-olds account for 63 per cent of all cases.
In Punjab, of the 29,931 cases recorded until 15 August, as many as 7,592 or 25 per cent are in the age group of 25 to 34 years. Another 5,734 or 19 per cent are in the age group 35-44 years. The number is 3,788 or 12.7 per cent in the 15-24 age group. Thus, the age group of 15 to 44 years constitutes 57 per cent of Punjab’s total cases. Then there are another 5,480 cases in the age group of 45 to 54 years.
In Nagaland, 81 per cent of cases are from the 18-44 age category, according to information provided by the state’s health department. Those aged 45-75 constitute 15.7 per cent of the total.
Dr Nyan Kikon, the nodal officer for Nagaland’s Integrated Disease Surveillance Programme, said “98 per cent of cases in the younger population are asymptomatic”.
He, however, added that this has not been a significant factor at the core of the state’s response strategy. “The strategy keeps on changing with the evolving issues at hand which may differ from district to district and groups of people,” he said.
Inputs from Aneesha Bedi, Angana Chakrabarti, Prashant Srivastava, Manasi Phadke
Also Read: I am a public health adviser who got Covid. This is my advice to Delhi and Modi govts
CORRECTION : there is a miscalculation or misprinting, the number stated was 1.6%, calculated was 16%.
“Of the 47,153 Covid-19 cases reported from Haryana until 16 August, as many as 13,186 — roughly 28 per cent — are in the age group of 25-34 years. Another 9,250, or 19.6 per cent, are in the 35-44 age group, and 7,360 or 1.6 per cent among 15-24-year-olds. This means 15-44-year-olds account for 63 per cent of all cases.”,