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The trends are changing, we are observing younger persons succumbing to COVID-19 and it derails us.

COVID-19 has swept across the globe, infecting millions, and resulting in hundreds of thousands of deaths. Substantial resources have been invested into understanding individual vulnerability in order to protect those at greatest risk. Age is the most often cited risk factor; 75% of global deaths, even here in Trinidad and Tobago, have been in people over the age of 65, while younger people generally have milder symptoms. In addition to age, the Centers for Disease Control(CDC) has delineated a list of health factors that increase vulnerability, most of which are chronic disorders that generally alter health status.

However, according to CDC in the months of July|August|September 2020, persons under age 30 accounted for more than 20% of COVID-19 cases and were seen as more likely to transmit the virus than others. This trend has continued into 2021.

So what increases the risk factor of young adults?

The single most modifiable risk factor for severe COVID-19 infection is inhaled substance use through smoking or vaping. A new study published in the Journal of Adolescent Health used national data to estimate the toll of smoking and vaping on COVID-19 risk for young adults. The team found that overall, nearly one in three young adults ages 18 to 25 in the US are at heightened risk, though that number falls to one in six among those who do not smoke or vape. In other words, smoking and vaping double the number of young adults in the at-risk category.

Vaping and smoking increase young adults’ risk of COVID symptoms

Smoking and vaping both cause lung injury that threatens pulmonary reserve. Substance use can also weaken the immune system, resulting in reduced capacity to fight off infection. A recent study found that adolescents and young adults who smoke and vape were five times more likely to report COVID-19 symptoms and seven times more likely to have a diagnosis, compared to their peers. A combined analysis using data from multiple studies found that among people infected with COVID-19, those with a history of smoking were twice as likely to have disease progression.

Risk-taking during adolescence could mean greater risk for COVID

During adolescence and young adulthood, developing brains are wired to seek large neurological rewards, resulting in the risk-taking that is associated with this stage of life. Most young adults enjoy good health and hearty physiologic reserve, allowing them to tolerate the insults of substance use without noticeable impact, until the cumulative effects accrue in middle adulthood — or at least that was generally assumed to be the case prior to the COVID-19 pandemic.

Unlike other risk factors for severe COVID-19 disease, smoking and vaping also inherently increase the risk of respiratory virus transmission. Smoking and vaping are often social activities for young adults. Both involve exhaling forcibly, which may propel droplets that carry viral particles further than at-rest breathing. It goes without saying that both smoking and vaping are incompatible with wearing a mask. These factors combine to pose a real threat in places where young people gather. It would be smart to institute strict no-smoking and no-vaping rules and enforce them vigorously as part of a COVID-19 containment plan.

Younger people may be overconfident about health risks

Young people tend to overestimate their own ability to control a situation, and think of themselves as invincible; many are inclined to think that they will be able to quit smoking whenever they want to. A little extra confidence may be useful during the transition to adulthood, even if based on a faulty assessment of one’s own capabilities. But the same tendency can cause real problems in this pandemic. The idea that younger people are safe from COVID-19 is inaccurate; according to this report from the CDC, one in five people ages 20 to 44 who become infected are hospitalized, and 2% to 4% require treatment in an intensive care unit. The best thing we can do for young people is to promote accurate information about their true risks. More than any other group, young adults who are able to quit smoking and vaping have the power to flatten their own personal risk curves.

COVID-19 Precautions for Young Adults

While most young people who get COVID-19 recover, some do not. Many may pass the illness to others unknowingly. Behaviours make an enormous difference. COVID-19 precautions such as mask-wearing, physical distancing, hand hygiene and self-monitoring for coronavirus symptoms are effective in limiting infection and spread of the disease. They are especially important for those with a vulnerable household or community members such as chronically ill, older and immunocompromised people.

It is paramount for young adults to realise their role in the COVID-19 pandemic. Even healthy persons in their 20s and 30s can catch the coronavirus, spread it to others, and suffer from severe illness resulting in lasting health problems or even death.