The New York Times

Michigan’s COVID Wards Are Filling Up With Younger Patients

ROYAL OAK, Mich. — At Beaumont Hospital, Royal Oak, in one of America’s worst coronavirus hot spots, entire units are still filled with COVID-19 patients. People weak with the virus still struggle to sit up in bed. And the phone still rings with pleas to transfer patients on the verge of death to units with higher-tech equipment. But unlike previous surges, it now is younger and middle-aged adults — not their parents and grandparents — who are taking up many of Michigan’s hospital beds. A 37-year-old woman on a ventilator after giving birth. A 41-year-old father. A 55-year-old autoworker who has been sick for weeks. “We’re getting to the point where we’re just so beat down,” said Alexandra Budnik, an intensive care nurse who works in a unit with lifesaving machines, or circuits, that are in short supply. “Every time we get a call or every time we hear that there’s another 40-year-old that we don’t have a circuit for, it’s just like, you know, we can’t save them all.” Sign up for The Morning newsletter from the New York Times Across Michigan, which is experiencing by far the country’s most dangerous outbreak, more younger people are being admitted to hospitals with the coronavirus than at any other time in the pandemic. Michigan hospitals are now admitting about twice as many coronavirus patients in their 30s and 40s as they were during the fall peak, according to the Michigan Health & Hospital Association. The shifting demographics come as a majority of Michigan residents age 65 or older have been fully vaccinated, greatly reducing the risk to the most vulnerable. But the vaccinations of older people do not explain rising hospitalizations among people younger than 60, including those in their 20s and 30s. Public health experts say the outbreak — driven by the B.1.1.7 variant of the virus, which is more contagious and more severe — is spreading rapidly in younger age groups. And across the state, doctors and nurses are increasingly reporting a concerning trend: Younger patients are coming in more often with serious cases of COVID-19. “I am putting more patients in their 20s and 30s and 40s on oxygen and on life support than at any other time in this pandemic,” said Dr. Erin Brennan, an emergency room physician in Detroit. The B.1.1.7 variant — first identified in Britain and now the most common source of new infection in the United States — is believed to be about 60% more contagious and 67% more deadly than the original form of the coronavirus. A federal estimate of COVID-19 hospitalizations based on a sample of counties in 14 states, including Michigan, showed more patients between the ages of 18 and 49 hospitalized in mid-April than those older than 65. In early December, it was the other way around — and by a large margin, with more than twice as many patients older than 65 than in the younger group. The director of the Centers for Disease Control and Prevention, Dr. Rochelle Walensky, warned this month that hospitals were seeing “more and more” cases of younger adults with severe disease, and recent CDC data shows that adults in their 20s, 30s, 40s and 50s have helped drive recent COVID-19 hospitalizations in the Midwest, South and Northwest. From Minnesota to New Jersey to North Carolina, younger people are making up a growing share of hospitalizations. Public health experts point to a number of factors for the changing demographics, including the vaccination of older people. As pandemic restrictions have loosened across the country, younger people are also out and about, socializing and in the workforce, at a time when just one-third of American adults are fully vaccinated. “The restrictions were our pause button,” said Jennifer Nuzzo, a public health researcher at Johns Hopkins Bloomberg School of Public Health. “As soon as you press play, you are going to see the virus race back as quickly as it can.” With steep reductions in cases in much of the country, and with fewer than half as many people hospitalized nationwide as at the winter peak, some health experts said it was conceivable that more younger people were being hospitalized because some hospitals had lowered their standards for admission. “That’s one explanation that you have to think about,” said Dr. Amesh Adalja, an infectious disease expert and hospital doctor in the Pittsburgh area, who said he sent borderline cases to be treated at home when hospitals were full. “I have a lower threshold to admit when I’m not worried about hospital capacity.” But at Beaumont, Royal Oak, in suburban Detroit, where case numbers remain high, doctors said they had not lowered the bar for admissions. The younger people in their care often had fewer chronic health problems and a good chance to recover, but they exhibited serious symptoms that required immediate intervention. “Some of them have kids that are younger than my kids, and you think about these people and the circumstances for their family if they don’t survive,” Dr. Felicia Ivascu said as she looked out over a unit where the sickest of the hospital’s coronavirus patients were hooked up to machines in glass-walled rooms. The escalating situation in Michigan has upended the lives of people like Matthew Kirschner of Clinton Township, north of Detroit. After hosting a small lunch in his backyard late last month, when vaccines were not yet open to everyone in Michigan, several family members tested positive for the virus. Kirschner, 36, who transports COVID-19 patients in his job as a firefighter and had survived a bout with the virus last fall, thought he knew what to expect: He grew most worried for his mother, who is in her 70s, has underlying conditions and fits the profile of people most affected by the disease. But it was his 37-year-old sister, Cara Kirschner Estrada, who ended up seriously ill. Kirschner Estrada, who was seven months pregnant when she got sick, checked herself into an emergency room this month with a bevy of symptoms: fever, chills, a cough, difficulty breathing. Doctors did an emergency C-section to deliver her son, Angelo, who is doing well. Kirschner Estrada’s condition, however, grew precarious. She has been sedated at Beaumont, Royal Oak, and on life support, according to her family. “It is shocking. It is traumatic,” Kirschner’s wife, Lauren, said of her sister-in-law, who she described as an active young mother working as a nurse at a wellness spa and raising a toddler. “It’s kind of rocked my view. I can’t believe Cara. Why is it her?” Nationwide, more than 45,000 people were in hospitals with COVID-19 last week, far below the winter peak but up from about 39,000 a month ago. The hospitalization numbers have been largely stagnant for the past week. The risk of hospitalization remains low for younger adults. According to state data from Maryland, where overall hospitalizations are up from last month, people in their 30s have a 5% chance of being hospitalized if they learn they have the virus, far lower than the 20% chance of someone in their 60s. But as more younger people get infected, experts say, more will inevitably be admitted to hospitals. “I tell everyone how bad it was and how scary it is,” said Nic Cabrera, 26, of Oxon Hill, Maryland, who was hospitalized for five days this month and had to be put on oxygen. The rise in hospitalizations has been numbing, if familiar, for doctors in Michigan. At Beaumont, Royal Oak, where nearly 200 coronavirus patients were hospitalized Thursday, doctors discussed contingency plans to open more beds for COVID-19 patients if needed. “We were very hopeful in December when they rolled out the vaccines,” Dr. Barbara Ducatman, the hospital’s chief medical officer, said before leading her staff through a slideshow of discouraging statistics. “We didn’t want to be here. It’s like déjà vu.” The vaccines only recently became available to all adults, and the rollout has not yet reached many younger people. In hallway after hallway at the sprawling hospital, doctors and nurses donned extra masks to go inside the rooms of COVID-19 patients and spoke somberly about seeing people of their own generation in dire shape. “You take it home a lot more,” said Budnik, 32, the intensive care nurse. “Your mindset is a little different when you look at them and you think, this could be my friend, this could be my sister, this could be me.” Dr. Olusola Ogundipe, an infectious disease fellow, said he noticed that some of his younger patients also had a tougher time emotionally with their condition. “They have a feeling of immortality,” he said, “and so I think it does take younger people by surprise.” Reports of new cases in Michigan have finally started to decline in recent days, but that progress is not yet evident inside the hospital, where emergency room doctors see as many as 10 new coronavirus patients per shift and where some of those who are admitted will stay for weeks. James Dyer, 55, who works at a Ford plant, was just starting to feel better Thursday after three weeks in the hospital with COVID-19. Dyer said he had previously been daunted by the stiff competition to get a vaccine but now was eager for a shot. “I would definitely encourage other people to do it,” Dyer said. “And before I leave Beaumont, if I can, I’m going to get one.” Not far away, Eleanor Wilson, 53, was on her fourth day in the hospital with a nasty case of COVID-19 that had left her gasping for breath and struggling to walk even short distances. “I think we all kind of think we’re superheroes, like we’ll be all right,” Wilson, a day care provider, said. “Once you get it, you’re like, ‘Whoa, this is not a joke.’” But after a rough few days and a course of steroids, Wilson got good news: Doctors had cleared her to go home. This article originally appeared in The New York Times. © 2021 The New York Times Company