Maryland could be entering a phase of resurgence of the novel coronavirus as public health officials express concerns about a growing percentage of young adults testing positive for the disease.
Maryland has seen a number of positive trends regarding new infections and reduced deaths, hospitalizations and positivity rates even as dozens of states are experiencing sharp increases and spikes in intensive care utilization.
But legislators who are part of the General Assembly’s Joint COVID-19 work group were warned on Wednesday that the state is starting to see a trend of increases in cases and the positivity rate among younger adults, both of which have been precursors to the rise of infections in other parts of the country.
“In early May (the positivity rate) actually flipped around so that it was higher in younger people,”Clifford Mitchell, director of the Environmental Health Bureau at the Maryland Department of Health, said in an interview. The size of that has varied by a couple of percentage points, but it is pretty much wide enough that it is quite noticeable.”
Currently, the positivity rate among those under the age of 35 approaches 6.4%, compared to 3.8% for those older than 35.
Mitchell said the “widening gulf” in the positivity rate has public health officials increasing their efforts to educate the public, especially younger adults, on the need to wash hands, socially distance, wear masks and be vigilant in large crowds, especially those that are indoors.
State officials believe that their earlier emphasis on containing outbreaks within nursing homes and persuading older people to comply with social distancing and wearing of face coverings factored into driving down the positivity rate among those older than 35. At the same time, Gov. Larry Hogan had issued orders effectively closing bars, restaurants, churches, casinos, theaters, and most retailers.
As Hogan eased those restrictions — it has been nearly a month since he allowed casinos and malls to reopen and restaurants to offer limited indoor seating — cases have remained relatively low.
“I think some of the concerns we have is that young people ordinarily are likely to be more social, more interactive and more mobile but we also have been observing that with restaurants reopening, with bar reopening and with other venues opening, we’ve seen more anecdotal evidence that, in particular, young people are not necessarily always following the advice regarding social distancing and facial coverings,” Mitchell said.
The news comes less than two months before many young adults will begin to head to college campuses.
Sen. James Rosapepe, D-Prince George’s and Anne Arundel, said the recognition that the virus can potentially be dangerous to younger adults, even if death rates are lower, is “long overdue.”
“We say you shouldn’t go to places in large groups, and we’re talking about having tens of thousands of students come back to college campuses,” said Rosapepe, who represents an area that includes the University of Maryland, College Park.
Nationally, infections among adults 18-29 years old make up 18.9% of total cases so far, second only to the 50-64 year old age group, with 23.3%, according to the Centers for Disease Control.
A direct comparison with national numbers is difficult because Maryland publicly reports its cases by group differently.
Cases among people 20-29 years old in the state make up nearly 15.1% of all cases in the state — the fourth-largest amount. Patients who are 30-39 make up the largest group at 18.7% followed by those 40-49 at 17.6% and the 50-59 cohort at 15.6%, according to the Maryland Department of Health.
Also occurring during that period was the Memorial Day holiday as well as the large number of daily protests following the police custody death of George Floyd in Minnesota.
“I think that, if there was any impact from those it really actually reflected more of the general reopening. It did not appear that those protests affected the rates significantly,” Mitchell said.
On Wednesday, Maryland reported 465 new cases and a seven-day positivity rate of 4.61 percent. Even so, Justin Lessler of the Johns Hopkins Bloomberg School of Public Health said, upticks in the rate at which the virus is transmitted from one person to another suggests the state might be headed in the wrong direction.
“The interventions and actions that people are taking on their own appear to still be having a substantial effect,” said Lessler. “The models suggest, the data as we interpret it suggest that we’re in a growth phase now and no longer in a phase of stability or receding.”
The rate of transmission since early June has inched closer to 1.25 people per infection following a roughly two-week period where it fell below 1 transmission per infection. Falling below one transmission per case for an extended period makes it more difficult for the virus to sustain itself, Lessler said.
The positivity rate among younger adults means Maryland joins a trend seen in other states, including Arizona, California, Florida and Texas, where surges have been tied to, at least in part, to increases in infections of those under the age of 35.
So far, Maryland is not seeing the double-digit increases in cases in young adults as have those other states.
Mitchell said Lessler’s data doesn’t have to mean Maryland will see a resurgence similar to March and April.
“We are certainly hoping that people continue to use good judgment and follow the recommendations, but I think that as we look at the data, we recognize that if we are to maintain where we are right now that will require people to follow those recommendations,” said Mitchell. “If there is loosening of that social distancing and the (use of) face masks, that puts us as risk of seeing a recurrence of higher rates of COVID.”