Who's getting sick (and who's not) in Nova Scotia's second wave

With the onset of COVID's second wave in Nova Scotia, the picture of who is getting sick in this province has changed. 

"It is focused in that 18 to 35 demographic," Dr. Robert Strang, the province's chief medical officer of health, said Tuesday in a briefing.

"That is just the nature of this virus when you get it in an age demographic where social activity is an important part of the way they live."

All age groups had cases during the first wave, but the focus turned to outbreaks among seniors as COVID-19 spread from the community to staff and residents in the province's nursing homes. 

The first wave

Just over half of Nova Scotia's COVID-19 cases from March to the end of September were people of prime working age, between 20 and 59 years old. 

A further 21 per cent fit into the 60 to 79 age bracket, and 17 per cent were over 80 years old. About 10 per cent were 19 and under. 

Overall, 61 per cent of the cases were women and 39 per cent were men. 

The outbreak at the Northwood long-term care facility in Halifax alone accounted for 345 cases between staff and residents. Smaller outbreaks were reported in at least seven other long-term care or seniors facilities around the province.

More residents in long-term care tend to be women, as women have a longer life expectancy than men. Staff in long-term care are also more likely to be female. 

Experts in aging and long-term care have said this is one reason why the first wave showed an uneven gender split that was weighted toward women. 

The second wave

At this point in Nova Scotia's second wave — which Strang said began at the start of October — the age and gender split looks very different.

Between Oct. 1 and Strang's briefing on Nov. 24, a full 71 per cent of COVID-19 cases fell in the 20 to 39 age bracket. Trailing that group were people between 40 and 59 years old, who made up 13 per cent of the cases. 

Ten per cent of the cases were 0 to 19 years old, and seven per cent were 60 to 79. 

No cases had been recorded in the 80 and older age bracket as of Nov. 24.

The gender split has also switched, with 55 per cent of cases in the second wave being male and 45 per cent female. 

What's to come

The second wave is not over and it is still possible that older age groups or nursing homes could get hit hard again, which is why the province has set up isolation units in six long-term care homes and hospitals. 

Younger adults are less likely to be hospitalized or die from COVID-19, although it can happen. 

"If you look at the vast majority of our positive cases in the last several weeks, they've been young adults," Strang said.

"Lots of social life, going out to work.... as we're testing contacts, there's been a number who've been asymptomatic. But there's also been many who have very mild symptoms." 

And that can be problematic. 

Strang said the very fact that young people are experiencing mild symptoms — or none at all — makes them excellent transmitters of a virus that isn't going away any time soon.