Yehyun Kim :: ctmirror.org

Frederick Morley, a Hartford Healthcare nurse, grabs a COVID-19 vaccine syringe to inject a patient.

As the delta variant has spread, people between the ages of 20 and 59 now account for a higher proportion of COVID-19 hospitalizations than in January, according to data compiled by the federal Department of Health and Human Services.

The data show that hospitalizations of people in the 20-29, 30-39, 40-49 and 50-59 age groups have ticked upwards incrementally, particularly in the past few months as the delta variant of the virus has taken over, while the number of hospitalizations of those over 80 has remained relatively flat.

In early January, the two-week rolling average of cases showed that people 60 and over accounted for about 67% of all hospitalizations. By July 31, that number had dropped to 57%.

Experts believe the delta variant spreads faster than some previous variants of the virus, and the numbers of cases and hospitalizations in Connecticut have steadily increased. Data show that vaccination rates largely align with age groups in the state.

A recent snapshot of hospitalizations in the state's two largest chains highlights the reversal of who is getting admitted now.

In the Yale New Haven Hospital system on Friday, Aug. 6, there were 67 COVID patients overall. Slightly over half were between the ages of 30-59, and only seven patients were over 80, Yale's Chief Medical Officer Thomas Balcezak said.

Balcezak said there were nearly as many people under 30 now hospitalized as there were patients over 80. Yale had five patients in the younger group, compared to seven over 80.

"It is completely different from the spring, and honestly the elderly people that we're seeing are for the most part having relatively mild illness," Balcezak said.

On Friday, Hartford HealthCare had 64 COVID patients in its system, and only one over the age of 80 was in critical care, according to Executive Vice President and Chief Clinical Officer Dr. Ajay Kumar.

Kumar said the hospital system only had five COVID patients in intensive care, and most were between 39 and 50.

"We are seeing a younger generation being in the hospital now, more so than the older ones," Kumar said.

Fewer deaths

Both men said not only are they seeing a shift in the age of their COVID patients, but they are also seeing significantly fewer deaths among the elderly population. Both believe that's clearly tied to the state's very high vaccination rates among its elderly population.

"So we're seeing fewer deaths, and there have been a few deaths of folks that are vaccinated in those age groups — but they have other conditions," Balcezak said. "They have heart failure, chronic obstructive pulmonary disease or other conditions that are contributing an added burden of disease. And add COVID on top of the burden that they're already carrying, and it just tips them over."

Kumar said he has no doubts that vaccines have saved the elderly population from the devastation of the delta variant.

"The patients over 80 are still coming in, but for the most part, they are vaccinated," Kumar said. "So they get better and then they go home ... That is a big difference from last spring. A very small percentage actually end up in the ICU now. So without a doubt, it is certain right now the vaccines protect and reduce deaths."

The state recorded seven COVID deaths in the first week of August, according to Department of Public Health data, and while death totals generally lag a few weeks behind hospitalizations, neither doctor foresees a large increase in deaths among elderly residents who are vaccinated.

'I think these numbers clearly demonstrate that the vaccines are working and continue to work against the variants we have now," Balcezak said.

Boosters needed

Experts are watching the hospitalization rates as well as mortality rates, particularly among older residents to see if the vaccines are still effective, to learn when, if at all, there will be a need for a booster shot.

"There's no question in my mind that at some point someday we're going to need a booster," Balcezak said. "There's two primary reasons for that. One is immunity is going to wane — we just don't know whether that's in one year, two years or five years."

Belcezak said the other reason is the virus continues to spread across the world, and new variants are popping as the virus mutates.

"Eventually a different mutant is going to emerge that's going to require us to tweak the vaccine," Balcezak said.

Kumar said they are waiting for the FDA and the CDC to determine whether booster shots will be needed.

"If we see an increase in the case rate and the mortality rate, especially the mortality rate among the elderly population, that will be the signal that could lead us to booster shots," Kumar said.

Kumar said he doesn't envy the experts who have to decide not only if a booster is needed but also when and for what.

"I would be thinking right now: What if the booster I'm providing isn't addressing the problem we have in hand?" Kumar said. "So if the delta variant is the one which is causing the havoc, and we're giving a booster, that's great — but what if a different variant comes in, and the booster doesn't work, and we may need a different type of booster for that variant?"

Kumar pointed to the Lambda variant now spreading in South America but not so much here yet as the perfect example of a variant we know little about. He said a booster shot would be similar to trying to decide what flu shot to offer every year.

"If we offer the booster which is not appropriate for a variant that is spreading, we lose public trust," Kumar said. "So I think the FDA taking its time is a very prudent thing to do right now because mortality among the vaccinated is still extremely low."

The World Health Organization has come out against administering booster shots until at least the end of September, citing concerns about global vaccine equity.



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