Since mid-July 2020 in Maryland, we understood that the 20-59 yr age group was problematic, especially the 20-29 yr age group that is racing to overtake all age groups in terms of number of COVID-19 cases (relative to their population, see top chart below).
In terms of COVID-19 hospitalizations, we also saw a small rebound (see chart below; it seems that it subsides since beginning of August).
But what we didn’t know (for this small peak as well as since the beginning) was what is the age of these hospitalized populations. Did these hospitalizations impacted more the older adults? The younger ones? Or the children? The Maryland Department of Health COVID-19 dashboard doesn’t report that information (nor in the API).
Now, the CDC also has an interactive graph where you can see and filter the data by yourself. Here is the situation up to August 9, 2020, for Maryland:
The peak of April-May is well represented, with the 85+ population reaching a peak at nearly 100 weekly hospitalizations per 100,000 pop. All the other age groups increased during that time, the older the higher (unfortunately).
Now, since July, we see some of these age groups increase again. At the end of July:
Weekly hospitalization rate
Weekly hospitalization rates for the week of July 27, 2020 in Maryland, MD, USA
This, in my opinion, reinforce the view that, cases might be increasing in the younger population (also thanks to testing being more available) and children and young adults might be less impacted when infected. But the older population is the first impacted by any increase in cases. It was true in April-May. It is again the case with this small peak. If we should take preventative measures to contain COVID-19, it is for us – but especially for the older population, our parents.
After my previous post on the age of COVID-19 cases in Maryland, it was logical that I write about the age of COVID-19 deaths in Maryland. So far, media and State Departments of Health all agreed that the older someone is, the more risk this person has to die from coronavirus.
So far, this is unfortunately also true in Maryland. In the graph below, we clearly see that people 50-59 years old have more than 250 deaths, people 60-69 have more than 500 deaths, people 70-79 have more than 750 deaths and people 80+ have nearly … 1,5000 deaths! The graph at the bottom also clearly shows that people in age categories 60 and above provide most of the new daily deaths due to COVID-19 (even if we came back down from a peak at about 40 deaths in 80+ at the end of April).
The simpler section at the latest date for which death data by age is available (i.e. today, July 9th, 2020) also shows this curve highly skewed towards older age groups (at the bottom, compare that to cumulative cases, on top):
The two graphs below confirm that people in old age are at much higher risk of death due to COVID-19. On top, if we report the deaths in each age group by the population they actually are in Maryland, we also see that deaths in 80+ disproportionaly affect this age group, reaching a COVID-19-specific mortality rate of 629 per 100,000 pop.!!! The table under the graph gives all the data points.
And when we look at it to see the relative importance of each age groups compared to the total number of cases, we see again that people aged 80+ have 46% of all deaths, followed by people 70-79 (25%) and people 60-69 (16%).
COVID-19-specific mortality rate, by age group, in Maryland, on July 9th, 2020
As opposed to cases by age, we don’t see here any shift in most affected age group: the older some is, the more risk of dying from COVID-19 exists (and part of the problem is the close living conditions in nursing homes). There aren’t 1,000 solutions to protect them: wear a mask and practice physical distancing, especially when there is a risk to meet elderly people and transmit the disease to them!
We recently heard in the US media that, if COVID-19 affected more the older population, beginning of 2020, the younger population was now more affected, especially young adults (various reasons were mentioned: the various academic breaks, being more active or “forced” to work, the sentiment of invincibility …). I wanted to see if one could see a similar trend in Maryland.
If you look at the section of the Maryland population by age (graph below), as of today (July 9, 2020), you see that cumulatively, people 30-39 have the majority of cases, followed by people aged 40-49, 50-59 and 20-29 years old. There are relatively few cases above 70 years old and fewer cases below 20 years old.
This snapshot doesn’t show a trend we indeed saw in the past few weeks. In the chart below, representing the cumulative cases by age categories, one can see a faster increase of cases in 20-29 years old (than the increase in, let’s say, 40-49 years old) – since mid-May. This fast increase is such that one could predict that 20-29 years old will soon have more cases than 40-49 years old and become the 3rd age group with most cases.
Two other age groups also saw their number of new cases accelerates, at a lower rate than 20-29 but still: children (both groups below 20 years old) seem to catch up with the older group (both group above 70 years old). This needs to be watched and, ideally, prevented!
Note the bottom graph shows the number of daily new cases. Although it’s messy, we can see that all age groups are now adding less cases than in May but the middle aged groups (20-59) sill add more cases every day than the younger (< 20) or older (> 70) ones. I could smooth it with a 7- or 14-days average but then we wouldn’t see new trends emerge.
The direct impact of COVID-19 cases on each age category can be better grasped in the next chart, where the evolution of cases is again displayed but this time relative to the respective population in each age category. These populations by age were found from a projection from 2018, for 2020 by the Maryland Department of Planning. This demographic spread is a bit odd because all age groups below 70 years old are between 700k and 800k (I would have expected more a bell/Gaussian distribution):
Age group (years old)
Projected total population by 2020
Age pyramid of Maryland, projection from 2018 for the year 2020 From the Maryland Department of Planning, August 2018 / OpenData Maryland
In the top chart, below, one can see the evolution of cumulative cases relative to the total number of people (sick and healthy) in each age category (for instance: how many cases 70-79 years old relative to 100,000 individuals in this age category). Because of the relatively constant number of people in each age category (see table above), we find back approximately the same mix of curves. However, we should first note the high toll of people 80+ who have the highest number of cases per 100,000. We should also note the fast increase of the 20-29 years old population: they were just above the less than 20 years old in the beginning of the pandemic; they are now the 4th age group in relative cases. The table below indicates the relative cases for yesterday (July 8, 2020):
Age group (years old)
Relative COVID-19 cases (cases / 100,000 pop.)
Cumulative number of COVID-19 cases relative to population, by age group, in Maryland, on July 8th, 2020.
Another way to look at it is to see the relative importance of each age groups compared to the total number of cases. This is done in the last chart, above. We can see that around mid-April, COVID-19 cases in adults 80+ “carved” their share of number of cases. Starting in May, the share of COVID-19 cases in children below 20 also started to increase (from 1.9% on March 29 to 8.5% on July 8). Despite this, 20-29 increased their share of cases (from 13.3% on March 29 to 15.1% on July 8); 30-39 also increased their share of cases (from 16.3% on March 29 to 18.7% on July 8).
All this indicates a shift in new cases, with more and more new cases being discovered in the young adult population. This can be due to a number of factors … The first one is probably that tests were not restricted (or became widely available, without restriction) mid-May: this would have allowed people younger to be tested and therefore would have increased their share of cases. Another parameter could be that younger adults are still in the workforce and therefore more exposed and more often exposed than older adults. A last parameter could also be that some younger adults may care less about their health, may be less willing to follow state and federal rules, may be composed of more Hispanics or African-Americans – two populations specifically at risk for COVID-19 … Nevertheless, this increase / these populations should be watched carefully and reminded that they are also at risk of COVID-19 (maybe less deaths – that’s for a follow-up post – but the disease itself and its long-term consequences).