As reported cases of the coronavirus continue to surge in Georgia, an Atlanta Journal-Constitution analysis shows adults under 30 make up the fastest growing group of new infections.
The spike in cases overall and among people aged 18 to 29 in Georgia mirrors other Southern states, including in Florida, which have also begun reopening their economies. Adults under 30 now make up Georgia's largest cohort of cases.
People 18 to 29 made up about 29% of the new cases so far in June, up from 21% in May and 13% in April, the AJC analysis shows. New cases among older adults have declined, public health experts said, reflecting stepped up efforts to protect vulnerable populations.
Cases of COVID-19, the disease caused by the coronavirus, tend to be milder for young adults than for the elderly, but the disease isn't without risk. Of the 13,496 adults under 30 who had tested positive through Tuesday, 542 or about 4% have been hospitalized and 11 have died, according to state data.
The virus is highly contagious and people in their teens and 20s can easily spread it to more vulnerable people.
"We do see severe cases of COVID-19 in young people, particularly with people with co-morbidities," said Dr. Jesse Couk, assistant medical director of infection control at Piedmont Hospital and medical director of infection control at The Shepherd Center in Buckhead. "And as the spread continues and cases continue to rise, and they will if we don't do anything differently, we will see it work its way into more vulnerable populations."
Georgia reported 7,008 newly confirmed cases among all age groups from June 14 to Saturday, the highest weekly count so far, and an increase of nearly 29% from the week before.
Confirmed cases generally are a snapshot of the virus from several days or perhaps two weeks ago, because a person often does not seek a test until they exhibit symptoms, and it often takes days before results are known.
Reported coronavirus cases have risen in Georgia in each of the past three weeks, and the state has reported week-over-week increases in five out of the past six weeks after four weeks of gradually declining cases.
In that time, Georgia has loosened restrictions on movement and businesses after Gov. Brian Kemp ordered residents to shelter-in-place in April. The state also has been swept by protests of racial injustice and police brutality, though it's unclear if any cases have been connected to demonstrations.
Nancy Nydam, a spokeswoman for the state Department of Public Health (DPH), said the median age was in the mid-30s for new cases in June, compared to the mid-50s in April.
"The increase in the number of cases among younger adults is related to people being out and about, and in too many cases not following guidelines for social distancing, wearing face coverings and hand washing," she said. "People in general have become more lax about these basic prevention measures."
Younger adults are more likely to hold entry level and service jobs that bring them into close contact with the public, health experts said. People in their teens and 20s also are either letting down their guards, health experts said, or are less likely to heed guidance to wear masks and socially distance.
1,706 new cases Wednesday
Georgia is also experiencing a surge among farm and poultry plant workers, many of them Hispanic, who tend to be younger, public health experts from Emory University said in a recent conference call with reporters. Many of these cases are among people who live and work in crowded places with limited ability to socially isolate.
"We see that we have different outbreaks going on around the state and different underlying conditions across the state," said Jodie Guest, vice chair in the Department of Epidemiology at Emory's Rollins School of Public Health.
Georgia is one of 27 state s reporting growth in reported cases over the past 14 days, according to The New York Times. Case growth is occurring in each of Georgia's neighboring states and overall in the U.S. after several weeks of gradual decline.
Daily death counts remain well below the April peak nationwide, but deaths are lagging indicators and generally follow new infections within a matter of weeks.
On Wednesday, DPH reported 1,706 new cases of COVID-19, the third-highest daily total since the pandemic began.
Georgia has reported 69,381 cases since the pandemic started. There have been 2,698 deaths attributed to the disease, including 11 reported on Wednesday.
Current hospitalizations remain lower than the 1,500 Georgia reported May 1, but the number continues to trend upward. On Wednesday, the state reported 1,124 current hospitalizations from the virus, up from a low of 783 reported June 7.
Restaurants in various parts of the state have temporarily closed because of COVID-19 cases. Outbreaks have been tied to nursing homes, churches, jails and house parties.
"We're undoing all that hard work that we did in March and April when we stayed home," Couk said. "With this virus, we don't see the impacts until weeks down the road. The time to act is now. With the rising cases we need to take a step back and rethink reopening."
'Wear a mask,' Kemp says in video
Kemp has not held a media briefing with his top coronavirus team since June 2, though his office said briefings are planned this week. In a video message Wednesday, Kemp said that though he was "proud of our swift response and measured steps forward, we cannot grow complacent."
"Wear a mask, practice social distancing and continue to follow guidance from public health officials," said Kemp, who was not wearing a mask in the video address.
Spokespeople for Kemp referred questions asked by an AJC reporter to DPH. The AJC asked about any new steps the governor's office is taking to curb the spread, or whether Kemp is rethinking his reopening strategy or considering allowing local jurisdictions to enact tighter controls.
Nydam said DPH is "ramping up its social media presence" to reach younger people with information about preventative measures, testing and taking part in contact tracing. The agency is also working with social media influencers to share videos. Ryan Seacrest and NASCAR driver Chase Elliott have shared messages with their followers.
Inconsistent messages
On Saturday, Georgia reported 1,800 newly confirmed cases, a single day record, followed by the state's second-highest daily report on Tuesday with 1,747 new cases.
Nydam said earlier this week the increased case counts reflect expanded testing, including of long-term care facilities and farm workers in different parts of the state. But the rise in cases also is a sign of community spread, she said.
Nydam said Wednesday "there is no definitive way to link cases to demonstrations," and DPH does not ask people tested about participation in protests. But she encouraged demonstrators to get tested.
In the past few weeks, the largest increases in cases had been seen in several rural counties along the Alabama and Florida borders and in Gwinnett County. But in recent days, Fulton, Cobb and DeKalb counties also have reported larger numbers of cases.
On Wednesday, Kemp announced the state will establish a temporary hospital in Milledgeville, about 95 miles southeast of downtown Atlanta, relocating 80 beds there from a little-used stand-up facility at the Georgia World Congress Center.
Testing is broader than in April when the outbreak initially raged, but testing is generally flat in recent weeks.
"Clearly we have a trend here that you can't explain on increased testing alone," said Dr. Harry J. Heiman, a clinical associate professor at the Georgia State University School of Public Health.
Health experts have said Kemp and the state need to more aggressively communicate the need to socially distance, wear masks and frequently wash hands and model that behavior. While Kemp frequently wears a mask around the State Capitol and events, he did not in a recent visit with Vice President Mike Pence to an Atlanta area restaurant.
Masks are required in the state House of Representatives, but they're only encouraged in the state Senate.
Dr. Melanie Thompson, principal investigator of the AIDS Research Consortium of Atlanta and a practicing physician, said DPH should have regular briefings, led by its epidemiology team.
Thompson said state leaders must stress the importance of wearing a mask and that distancing is crucial to limiting the spread.
"We need to have them saying this over and over and over and over again," she said. "Be consistent and drive it home."
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Staff writers John Perry and Johnny Edwards contributed to this report.