The Delta virus spreading through greater Sydney is proving to be “an epidemic of younger people,” Prof Greg Dore, an infectious diseases doctor with St Vincent’s hospital in Sydney, said.
On Wednesday the NSW chief health officer Dr Kerry Chant announced a man in his 20s from south-western Sydney contracted the virus and died at his home on Tuesday. Aude Alaskar, 27, was being cared for by South Western Sydney Local Health District during his isolation period and was followed up daily by nursing staff. Milder cases are managed at home, while more serious cases are treated in hospital.
“Rapid deterioration in a younger person is unusual, but not unheard of,” Dore, who helps to manage Covid patients quarantining in the community, said. “A coroner’s report is essential to determine factors contributing to death.”
Alaskar suddenly deteriorated on day 13 of his isolation and Chant confirmed his death is being referred to the coroner for investigation.
“It’s an epidemic of younger people, with a large proportion in their 20s and 30s, and we are certainly seeing that in the people we are looking after,” said Dore, who also treated patients during Australia’s first wave of the virus in 2020.
“That’s probably more so in south-west and western Sydney. In terms of people who are hospitalised – and the data is clear about this – the age distribution is somewhat different to the first wave in that we are seeing a relatively younger population as inpatients. That’s partly due to the higher impact of higher vaccine coverage in older populations, and that’s certainly also the experience of the UK as well.
“It’s a reminder that Covid-19 can be severe in young people, and that’s a really important message. It’s also evidence of the positive impact of vaccination.
“No one in intensive care has been fully vaccinated. A small proportion are partially vaccinated. It’s clear full vaccination is having a strong impact on risk of hospitalisation.”
From 30 July, NSW Health began offering the AstraZeneca vaccine to people aged 18 and over in vaccination clinics throughout greater Sydney. Up to 40,000 Pfizer doses are being reallocated from NSW Health’s rural and regional supply of vaccine to year 12 students in south-west and western Sydney. This is because younger people are often the most mobile, working essential jobs and going to school, and are therefore at high risk of catching and spreading the virus.
But it will take weeks for those young people now eligible for vaccination to get both doses and be fully immunised.
Dore said while he was bracing for higher case numbers being announced by authorities each day for the near future, he felt empowered compared with last year’s virus wave, which was driven by the Ruby Princess Cruise ship outbreak, because he and many of his colleagues are vaccinated.
“I’m still feeling hopeful and not anticipating hospital cases to escalate to an alarming level, but I am anticipating ongoing cases for the long haul on the path to greater vaccine coverage,” he said. “Until then the risk to life and burden of disease will continue.”
His colleague Prof Gail Matthews, head of infectious diseases at St Vincent’s hospital in Sydney, agreed with Dore that “we’re here for the long run”.
“I think everybody is determined, everybody is really stepping up to the challenge,” she told ABC’s Radio National on Thursday morning. She said her hospital was preparing for more cases despite there being no evidence yet that the Delta variant is more deadly.
“I think we’ll see increasing numbers of patients … and those cases are going to translate in the weeks to come to more patients coming into hospital,” Matthews said. “Even if we saw the cases go down to zero next week, we would still be expecting a lot more patients.”
Seven people in their 20s in NSW currently require specialist hospital treatment. There are 247 Covid patients in hospital throughout the state, 53 of them in intensive care.
In Queensland, all Covid-19 cases regardless of severity are required to quarantine in hospital. While there are currently no cases in intensive care in Queensland as part of the current outbreak that has seen the state enter into lockdown, the president of the Australian and New Zealand Intensive Care Society, Dr Anthony Holley, said “I think its days until that happens,” with 81 delta cases throughout the state.
“Anybody who declines can get to intensive care rapidly and at the moment I’m happy to report, we do not have a single Delta case in intensive care, though we do have someone with residual symptoms recovering from a previous outbreak in ICU,” said Holley, who is based in Queensland.
However, a large number of health workers in Queensland had been exposed to the virus and are now quarantining, which could prove to be an issue if cases increased, Holley said.
“We’ve lost a significant number of our staff to quarantine, and two of my intensivists today are languishing at home and feeling frustrated not to be at work, but obviously the responsible thing is to stay home and protect the community,” he said.
He said health workers in NSW were currently managing, but bracing themselves.
“I am in touch with my NSW colleagues five times a day, and people there are worried because the intensive care capacity has been running at about 55% to 60%, and about half of those intensive care cases have been ventilated,” Holley said.
“Their other major concern is transmission, and people are working hard on PPE and infection control procedures and practices so that nobody gets infected in the healthcare environment.
“The other thing to say is the population that’s been affected in NSW has been younger than what we saw last year. Last year this was largely killing octogenarians and part of that was to do with where the virus was infecting people, which was in institutions where old folk were getting cared for, particularly in Melbourne. So that skews the data – where the virus breaks out.
“But this year we’re also seeing younger people with equally severe disease to some of the older people, even though they don’t necessarily have the same co-morbidities. That is unusual.”
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