Immunity Through Surviving Infection

This week I will continue discussion on the topic of gaining protection against COVID-19 through vaccination versus infection. Last week’s article focused on potential COVID-19 vaccine side effects. Both vaccination and surviving infection provide a level of protection against future severe COVID-19 disease. In this article I will start discussing the consequences of becoming infected with the virus.

Information presented in these articles is intended to provide a medical perspective - the articles are not intended as a political statement for or against any public policy. Statements in these articles should be considered coming from myself, not from any organization I represent or my employer.

What are the consequences of getting infected with SARS-CoV-2?

This is a big question I will answer by breaking the question up into questions that address the different aspects of being infected with SARS-CoV-2.

What must be considered in discussing the consequences of being infected with SARS-CoV-2?

There is a spectrum of consequences that result from being infected with SARS-CoV-2. When discussing these consequences, it is important to consider not just the person infected. Being infected with SARS-CoV-2 has consequences for those around the infected person as well as for our society and economy. There are many factors that influence what the consequences are of being infected with COVID-19.

How important are age and underlying medical conditions in determining risk of hospitalization from COVID-19?

Risk of hospitalization is certainly higher for older individuals with serious underlying health problems. However young healthy people are still at some risk for being hospitalized from COVID-19. Several studies have looked at the influence of age and underlying health problems on risk of hospitalization. It is well documented that young healthy people are still at some risk of being hospitalized with COVID-19. For example, an analysis published in the MMWR (October 2021) found that of the adolescent hospitalizations in their sample - only 42.3% of the kids “had one or more underlying conditions.”

How important is age in determining risk of dying from COVID-19?

There are many factors that influence how sick someone gets with COVID-19. Advanced age is a major factor that determines a person’s risk of dying of COVID-19. However young adults and tragically far too many kids have died of COVID-19. In the United States as of December 29, 2021; there have been 803 COVID-19 pediatric (0 -18 years old) deaths. COVID-19 has taken the lives of 245 children under the age of 5. To put these numbers in perspective, one can compare pediatric COVID-19 deaths to pediatric influenza deaths. If you average the number of pediatric influenza deaths that occurred during the previous three major influenza seasons (199, 148, 188) you get an average of 178 pediatric influenza deaths per season. That is excluding last season in which we recorded only 1 pediatric influenza death in this country - everything we were doing to limit the spread of SARS-CoV-2 worked amazingly well at crushing influenza.

While the majority of COVID-19 deaths have occurred in people over the age of 64, COVID-19 has been a significant cause of death in younger adults. The Kaiser Family Foundation: a nonprofit organization, published an analysis in December that broke down COVID-19 deaths by age group and compared those numbers to deaths from other causes. They found that COVID-19 was the number one leading cause of death for people aged 35-54 during the months of August and September. In October COVID-19 was the leading cause of death in people in the United States aged 45-54. In August, September and October COVID-19 was the second leading cause of death in people aged 25-34. Even for the 15 to 24 year old age group, COVID-19 has been a significant cause of death ranking as the fourth leading cause of death during the months of August, September and October.

Does the Omicron variant cause less severe disease?

We are still learning much about the Omicron variant. I expect that within a couple weeks we should be getting a clearer picture of just how often infection with the Omicron variant results in severe disease. I will include information specific to the Omicron variant next week. For those interested in up-to-date information on the Omicron variant I will include suggested sources in the resources section of this article. It should be noted that in Nebraska currently the Delta variant is still by far the most common variant.

While many believe the Omicron variant results in less severe disease overall - we are still seeing people being hospitalized and dying from being infected with the Omicron variant. For example; in the state of New York where over 90% of the new cases are thought to be the Omicron variant, they are experiencing record numbers of cases. While it is expected that an increase in deaths and hospitalizations would lag case counts - they are having significant increases in hospitalizations and deaths. There are reports of a substantially higher numbers of pediatric hospitalizations. Time will tell just how high their deaths and hospitalizations will rise but it is believed that the numbers will not be as bad as they had been with previous surges. The state of New York and especially New York City has very high vaccination rates - much higher than the vaccination rate in Fillmore County.