The most COVID-19 cases in NC are now among young people. Here’s why officials are worried.

Just after midnight last Friday, Sam Cates and Nathan Alexander stood on a corner of Glenwood Avenue looking for the next bar to go to. Joined by a third friend, they had driven in from Nashville earlier that day with no agenda or plan, other than to see a city they had never seen before.

There, in the area known as Glenwood South, they saw Raleigh’s busiest nightlife district looking much like it would in the days before the coronavirus, with crowded restaurants and sidewalks and music in the air. Life, it would appear, was returning to normal.

And that’s what worries public health officials, who have spent the last week pointing to data that shows coronavirus cases among people ages 18 to 49 not only are on the rise, but they account for the growth in new cases.

“Over the last two weeks we have seen that the majority of our new cases are in a younger cohort, age 18 to 49,” said Dr. Mandy Cohen, Secretary of N.C. Health and Human Services, at a press conference Tuesday. “That’s where the majority of the cases are.”

Cohen didn’t single out a specific reason for the spike, but attributes the increase to younger people working and putting themselves in environments where they could be exposed.

Cohen and Gov. Roy Cooper have said people taking the virus seriously is essential to improving North Carolina’s case numbers, and moving forward in any form of reopening.

North Carolina is now in Phase Two of Cooper’s three-phase reopening plan. That means places like restaurants and taprooms are open at 50% capacity, but gyms and bars are closed. Indoor gatherings are limited to 10 people with outdoor gatherings no more than 25.

Meanwhile, scenes like those on Glenwood South prompted the City of Raleigh to start requiring people to wear face coverings. That requirement has since been expanded statewide.

Cohen said younger people may feel less susceptible to the virus. That, she said, could be a dangerous way of thinking.

“When you’re younger, you feel more invincible,” Cohen said. “You don’t think, ‘Well, if I get it, I get it and it’s not going to harm anyone.’ But that’s actually the wrong way of looking at this. When we see more spread in our younger folks, who may not get quite as sick, they are still risks to those that would get more sick.”

A rise of cases in young people

Since the beginning of the coronavirus pandemic, health officials have said older people and those with underlying health conditions are the most susceptible to getting COVID-19 and experiencing the worst symptoms. In North Carolina, 31% of cases are in people 50 and older, with 80% of COVID-19-related deaths from people 65 and older.

But statewide, 58% of cases have emerged in people 18 to 49 — the largest percentage of cases among all age groups. They account for 5% of the state’s deaths.

The trend is mirrored in Wake County, with the 18-to-49 age group representing most of the county’s cases — 63%. Wake County reported their highest levels of the pandemic in that age group in the last week. Similar percentages are seen in Durham and Orange counties.

Raleigh now ranks 16 in the country for fastest growing coronavirus cases, according to data from Johns Hopkins University reported by CNBC Thursday.

Nationally, it’s a similar story, as public health officials say rising case counts among young people put others at risk.

The new positive cases skewing younger means North Carolina is facing more community spread, rather than outbreaks, as more people become more active, said Emily Sickbert-Bennett, director of infection prevention at UNC Medical Center.

“We’re learning from contact tracing that a lot of these exposures are acquired from the community as people return to lifestyles more similar to pre-COVID times,” said Sickbert-Bennett. “I think there’s a reluctance in our culture to not miss out on fun.”

Reluctant to stay at home

Young people say they trying taking precautions, but are also reluctant to stay at home.

After four years in the United States Marine Corps, Davis Averett, 28, hoped for a bit more flexibility in his post-military life. Then a week after discharging earlier this year, North Carolina largely shut down in an effort to slow the spread of the coronavirus.

“I had one week of freedom before everything shut down,” Averett said.

Averett was out on Glenwood Avenue on a recent Friday night and said he’s been out regularly since restaurants have opened back up — even at 50% capacity. He carries a mask and said he takes precautions, but that he won’t live in fear of the virus.

“I feel comfortable, but that’s not to say I go up close to people,” Averett said. “For the most part, I leave it up to God, because that’s who I believe in. If I get it, I get it. If he wants to take me, he takes me. If not, then I’m here.... There’s a lot of businesses going down, a lot of people going broke, a lot of people losing their jobs over this virus, but America cannot stop. We’ve got to keep pushing forward.”

Kenny Czigler, 30, Averett’s friend, said he is aware of the spike of cases among young people. But he said he doubted those numbers, as he doesn’t believe many young people are being tested for the virus.

At the beginning of the pandemic, health officials across the country didn’t “aggressively” test people who were asymptomatic, young people or those who weren’t considered vulnerable, said Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, in a media briefing June 25.

But testing has expanded, both a result of having more testing supplies and locations, and also in the categories of people who can be tested. Now people who aren’t symptomatic can be tested. Those who have attended mass gatherings and protests in the past month are encouraged to get tested.

In recent weeks, Czigler said he has visited Myrtle Beach, Wrightsville Beach, Wilmington and made trips to Walmart.

“I am not sick, I do not feel sick, I’m not coughing, I don’t feel any shortness of breath,” Czigler said. “I feel fine. What I’m saying is I’m not buying into it.

“Honestly I don’t think we should still be all locked in,” Czigler said. “I get wearing masks and having precautions, but at the end of the day, we’re also people and need that human connection. If people can go to Walmart and go to Lowes Foods and wherever and still shop, I don’t see a difference in having a bar with a (limited) capacity.”

The crowds that night on Glenwood Avenue surprised Arianna Smith, 26, who said she was out for dinner for the first time since the pandemic began. After finding the first restaurant too crowded, she said her group left and ate somewhere else.

“I didn’t know it was going to be this packed,” Smith said. “There are so many people, I’m kind of nervous to be out, honestly.”

Sending out a message

The surge of new cases has led some states to pause their reopening plans, or even take a step back, as Texas and Florida did last week in closing down bars.

North Carolina paused its reopening, extending Phase Two for another three weeks as cases in the state reached their highest levels of the pandemic. Now, Phase Three could begin in mid-July at the earliest, if trends improve.

Cohen cautioned she doesn’t want to see North Carolina mirror Texas, Florida and Arizona, where new cases are surging.

“It’s not just about your own personal risk, it’s about what is your risk to our community members as a whole,” Cohen said. “We need folks who are younger to not only understand the risks to themselves, but the risks to their friends, their family and the rest of the community.”

Public health officials are concerned with how they can encourage people to stay home and wear masks and take precautions in public places.

“I remain concerned about trying to understand the effective public health messaging that we need to get to those individuals that are, say, under the age of 45, under the age of 30, whereas the impact and consequences of COVID-19 infection on them may not be highly associated with hospitalization and death,” Redfield said in his briefing last month.

“They do act as a transmission connector for individuals that could, in fact, be at higher risk,” he said.

At the beginning of the pandemic, Sickbert-Bennett said people seemed more eager to buy into efforts to slow the spread of the virus, to flatten the curve. Now, more than 100 days with the coronavirus, with cases still high, Sickbert-Bennett said people can’t give up.

“It’s the million dollar question: ‘How do we get back that energy and passion we had at the beginning to really turn this back around?’” said “I feel like the sense is we’re worn out and can’t do that anymore. In the beginning we were concerned about bringing in groceries and mail. ... The most important things we’ve got to hang on to is wearing masks, staying six feet apart and staying home when we’re sick.”

Coming from Nashville to Raleigh, Cates and Alexander drove more than 500 miles to visit a new city in the midst of a pandemic.

But standing on Glenwood, they were among the few wearing masks. They said they’re trying to find a safe balance.

“Our risk of dying from COVID is the same as driving a car every day,” Alexander said. “But if we transmit COVID to someone else who is vulnerable, that’s not good. We’re trying to take the right precautions. We’re trying to help businesses get back on their feet, support businesses, but we also don’t want to be irresponsible. We want this thing to be over.”