COVID-19 story in young people is more complicated than statistics show
While those under 24 make up about one-third of COVID-19 cases, they account for less than 2 percent of hospitalizations, leading some to mistakenly say they shouldn’t have to worry about the virus
The pain started three weeks after Turner Geddes thought he’d fully recovered from COVID-19.
“At first it was kind of an odd feeling,” the Orem, Utah, 16-year-old said. “I compared it with having a granola bar stuck in my chest. ... The next day, when I started running again, it came right back as a pain. It was just a pain that is not normally there.”
It was annoying, but he ran through it. He didn’t give it much thought until it happened two days in a row.
“And it happened as soon as I started running, even in my warmup jog,” Geddes said. “I told my coach, and he said I needed to get it checked out. ... It was bad enough that it was hard to run with it.”
That pain took Geddes and his family on a terrifying journey of doctor visits and medical tests that haven’t given the teen many answers or much hope. His heart and lungs look fine, but his heart races and he experiences severe pain in his chest when he exercises.
“The pain still exists,” his mother, Liesha Geddes, wrote in a Facebook post last month. “So now what? They don’t know. This is COVID. They don’t know. When will it go away? They don’t know. When can he resume all normal activity? They don’t know. What will be the final outcome? They don’t know. ... My mama heart breaks and weeps for him. Seeing your son break down and cry because we still have no answers and he is scared to death to resume normal activity is heartbreaking.”
According to statistics, Turner Geddes is an anomaly. Most young people, especially those under age 25 experience very mild symptoms, if any.
In Utah, those cases involving people 24 and younger account for 34% of all cases, but just 2% of hospitalizations. Of the more than 5,200 hospitalizations, that same age group accounts for just 423 of them, and less than 15 of the nearly 600 deaths. Exact numbers of deaths in those under age 24 are not available because there are so few cases that officials will only say “less than 5” in each of the three age ranges — younger than a year, 1-14 years and 15-24 years.
Lincoln and Ollie
The experience Lincoln and Ollie Ferrin had with COVID-19 is much more indicative of the norm. Lincoln Ferrin, 17, said he had a sore throat in June, and “decided to stay home in my basement.”
His parents took him to get tested the next day, but it took four days to get the results, and he was positive.
“It was pretty crazy,” he said of testing positive. “By the time I found out that I actually had it, I was feeling a lot better. I only had symptoms for four or five days.”
Unfortunately, his attempts to quarantine in the basement weren’t foolproof, and his entire family eventually tested positive.
“It is pretty hard to quarantine when you live together, and we don’t have the biggest house,” he said. “We tried our best. But I gave it to my whole family.”
His brother, Ollie, 13, had symptoms that started with a fever.
“It may have even been in my head,” he said of how mild the fever felt. “I had a tiny bit of a breathing problem and then a cough.”
The ease with which most young people tend to handle the viral illness has become fuel for those who want to reopen schools, play youth and high school sports, and allow young people to go back to living pre-pandemic lives. But infectious disease doctors, both locally and nationally, offer a much more cautious view of the situation.
“The problem with the view that by and large they’re not impacted so there is no reason to take precautions is like saying there is no reason to wear a seat belt because most of the time you’re driving your car, you don’t have a crash,” said Dr. Andrew Pavia with Primary Children’s Hospital.
“Children have much lower rates of serious complications, but that doesn’t help the child that does.”
While many measure the ferocity of the virus by death tolls, Pavia said that is a mistake — especially when it comes to examining the impact on younger patients. While there are less than 100 deaths among teenagers nationwide, “death is just the tip of the iceberg, and it’s not really what we worry about.”
What they worry about is heart damage.
“Especially and predominantly in young athletes,” he said. “We don’t know how common it is, or how long it will last.”
This is exactly the situation in which Geddes finds himself.
“They said everything was fine,” he said of the battery of tests he endured as doctors tried to pinpoint the source of his pain. “That was the worst part for me. They said, ‘We think you’re OK. Just lower your expectations for this year. We think you’re still recovering from coronavirus, and that nothing is wrong.’”
Geddes went back to running with his team, but he can’t run more than a mile or two, and he can’t come close to maintaining the pace he’d routinely run in summer training. He was desperate for answers, but now he lives in limbo.
“My cross-country season has already been ruined, but now it’s threatening my track season and into next year’s cross-country,” he said. “They cleared me to run and race, but that was the worst day of all of it. I hated it. It’s the only day I cried during all of it.”
Liesha Geddes told doctors she just wanted to ensure her son wasn’t going to “collapse or have a massive heart attack” if he went out and pushed himself in a race. And while they could offer some assurances, they could offer no guarantees.
“It was a weird feeling because you’re like, ‘Nothing is wrong, yay!’ But we still don’t know, and we still can’t go back to normal life,” she said.
Turner Geddes pulls no punches when asked about those who believe the virus is relatively innocuous to young people.
“That’s a bunch of crap,” he said. “It’s not true at all. I’m one of the healthiest people, and here I am with possible heart problems, possible lung problems. It’s just not true. ... I have friends who think that, and they think it’s stupid they have to quarantine because it’s not going to affect them. Even after seeing what I’m going through.”
He shakes his head and looks down at the floor.
“I have to leave the room when they are talking about coronavirus,” he said. “Because all of the stuff they’re saying is normally false.”
In fact, while Liesha Geddes shared their story on Facebook to dispel the myth that the virus is harmless to young people, they said they avoid the subject with friends most of the time because it is such a toxic conversation.
She said they’re grateful that Turner’s situation isn’t worse because as they’ve shared their story, they’ve learned that there are a lot of ‘recovered’ COVID patients living in what they now refer to as “the messy middle.”
“You think that people either die, or they recover from this,” Liesha Geddes said. “We didn’t know this before Turner got sick, but we realize there are so many residual effects that people are having, and it’s been very eye-opening. Since we did post on Facebook, we have a lot of people reach out to us say, ‘Oh, here’s everything that I’ve been going through,’ and it’s crazy, but nobody talks about that. ... It doesn’t just go away, and it doesn’t have to kill you.
“There’s a lot of gray area in between those two that still affects people’s lives and changes their day to day.”
There are a lot of indicators that concern doctors, Pavia said, including what is now being called “long-hauler syndrome” because people — while technically considered recovered because they didn’t die after three weeks — they continue to exhibit symptoms weeks and months after a COVID-19 diagnosis.
“The symptoms are prolonged serious fatigue, decreased exercise tolerance ... and what’s been described as brain fog,” he said. “We’ve seen a number of cases like that.”
He said young people have also developed multisymptom inflammatory syndrome (MIS-C), where “the whole body goes into inflammation shock, with serious heart impact, as well as other organs.”
Utah has had 14 of those cases.
The Ferrins and the Geddes are attempting to balance reengaging in work, school and sports, but doing so in a safe way. That, says Pavia, is the key.
“What’s important is to have a balanced view and approach,” Pavia said. “Most kids will do OK, but you shouldn’t treat it cavalierly. Politicians who’ve said it’s nothing to worry about, they’re dead wrong and irresponsible.”
He continued, “There is really clear evidence in Utah that the disease doesn’t stay in young people, so advising them to just continue to go about their lives, while they’re able to spread the disease, is not a safe strategy.”
He points to the most recent surge in cases. It began in early September with the largest spikes among those ages 15-24.
“About 10-14 days later, we started seeing a spike in people ages 25-45 and then 45-65,” he said. “It very clearly shows that when you have uncontrolled spread among young people, it soon spreads to their parents, grandparents and teachers.”
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, cautioned young people about a cavalier approach to contracting the virus because of their role in spreading it.
“Because by allowing yourself to getting infected or not caring if you do get infected, you are propagating a pandemic,” he said in June. “Because it doesn’t end with you. You get infected and have no symptoms. The chances are you’re going to infect someone else, who will then infect someone else.”
Lincoln and Ollie Ferrin said that was their gravest concern when they tested positive. They were especially worried about their parents, who both tested positive, but who have both recovered.
“I wasn’t really worried for myself,” said Ollie, who was sick for about three days with a mild cough and fatigue. “I worried if I’d given it to other people.”
Both boys wear masks and they said they are shocked their schools, each in the Davis School District, are thinking of moving from a hybrid of online and in-person classes to a full-time in-person model, despite case numbers averaging over 1,500 each day.
“It’s scary,” Lincoln Ferrin said. “The COVID cases are going up. It’s scary for my friends who haven’t been infected, and there is always the chance for reinfection.”
That does not mean that young people have to be as cautious as more vulnerable populations, like those over age 65 or those with underlying health conditions.
“Balance is exactly what you’re looking for,” he said. “Kids should be able to play, have athletics and do sports, but we have to do it safely. That means evaluating everything we do. You can play outside with your friends if you wear masks. You can play other outdoor sports, and that’s pretty safe. ... But interscholastic games up the risk dramatically.”
He said while fall sports proved to “be pretty safe, with football being more of a mixed bag, winter sports are going to be tough.”
The current high case numbers, however, make attempting indoor sports, and in many cases in-person school classes “not safe.”
“The best way to let kids have a normal life is to control the disease,” he said. “Our goal has to be to get our case numbers down to no more than 200 cases per day. Then we can let our kids be kids and give them access to these opportunities. Right now we’re really in a crisis.”