COVID-19 cases are surging among young people, and older adults could be next

As Ottawa's COVID-19 case numbers continue to surge, more is now known about how the second wave is taking shape in the city and where it might be heading next. 

What's clear is that it hasn't been a carbon copy of the first wave. 

The main driver of cases this spring were outbreaks in places like long-term care homes and retirement communities. Data suggests that in Ottawa, outbreaks in those sorts of facilities were a key source of transmission, and tellingly, more women than men got COVID-19.

Dr. Brent Moloughney, deputy medical officer of health with Ottawa Public Health (OPH), spoke with CBC in June about how the spread of COVID-19 in the health-care sector led to more older adults and more women getting sick.

More women work in the health-care sector than men, and they also make up a greater proportion of long-term care home residents. 

The second wave is, so far, behaving differently. 

The gender balance is edging closer to a 50-50 split. And, as has been reported extensively, many more young people are testing positive, compared to elderly adults. 

Cases in young people started to pop up after Canada Day, said Moloughney.

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"We started to see a lot of parties happening with large numbers of people." he said. "That's when we started to see more younger adults under the age of 40, particularly in the 20-to-29 age group."

As higher rates of spread among young people continues, Moloughney is now also concerned about rising case numbers in slightly older adults.

Public health is beginning to notice more people in their 50s and 60s testing positive, Moloughney said, and it's possible those people are parents, coaches or other close contacts of younger people. 

"The virus doesn't stay in any one age group. We're all interconnected," said Moloughney.

A lack of clarity

Another defining feature of the second wave is greater uncertainty as to how people are coming into contact with the virus.

During the first wave, most people had very few contacts beyond members of their residence. As a result, it was relatively easy to do contact tracing.

Now, during the second wave — and especially before the latest lockdown measures came into force on Oct. 10 — it's possible people have had dozens of contacts over a two-week period before testing positive. That's in part led OPH to log more "unknown" transmission sources, said Moloughney. 

"Before the restrictions were introduced, people had a lot of sources of exposure," he said.

Now that Ottawa is under increased restrictions, including prohibiting indoor dining, the hope is it will be easier to trace transmission. 

Racialized communities over-represented 

Racialized communities continue to be over-represented in case numbers during the second wave, said Moloughney. 

According to a September report from OPH, 66 per cent of people who've tested positive for COVID-19 in Ottawa are racialized — a term OPH is using to refer to Black people and others from non-white and non-Indigenous backgrounds.

"This is something that has been seen not just in Ottawa but in other cities in Canada and in other countries," he said.

OPH is working to improve their outreach, Moloughney said, by connecting with community groups, translating public health documents into more languages and working with faith communities to get reliable information out to people.

While case numbers have begun to decline in recent days, Moloughney said it's too early to breathe a sigh of relief.

Testing rates have also declined, he said, which means there is a possibility there are people with COVID-19 who are simply not getting discovered.

Health officials will be watching hospital data closely over the next week, Moloughney said, to see if rates rise, which could suggest there may be a significant number of positive cases going undetected.

So far, the hospital data shows fewer people have been admitted for care during the second wave.