COVID-19 Confirmed Case Incidence Age Shift to Young Persons Age 0-19 and 20-39 Years Over Time: Washington State March - April 2020

Abstract

Background: As the coronavirus (COVID-19) epidemic passes the peak infection rate in some states and counties a phased re-opening with changes of stay-at-home restrictions and social distancing recommendations may lead to an increase of non-essential work, social activities and gathering, especially among younger persons. Methods: A longitudinal cohort analysis of Washington State Department of Health COVID-19 confirmed case age distribution March 1-April 19 2020 for proportional change over time using chi square tests for significance (N = 13,934). Results: From March 1st to April 19, 2020 age distribution shifted with a 10% decline in cases age 60 years and older and a 20% increase in age 0-19/20-39 years (chi-square = 223.10, p <.001). Number of cases over the eight-week analysis period were 0-19 years n = 515, 20-39 years n = 4078, 40-59 years n =4788, 60-79 years n = 3221, 80+ years n = 1332. New cases increased steadily among 0-19 and 20-39-year olds. After the peak (March 22, 2020), there was no decline among age 0-19 and a lesser decline among age 20-39 than older groups. As incidence declined in older age groups, the combined percentage of cases age 0-19 and 20-39 increased from 20% to 40% of total cases. Conclusions: Increased COVID-19 infection among children and young adults is not without serious morbidity and mortality risk to them and others they may come in contact with, indicating a targeted approach for awareness and safety measures is advisable to reduce incidence among the supposedly less vulnerable but more mobile young population age 0-19 and 20-39 years.