Emily Victoria Viegas’s death puts spotlight on increasing spread of COVID-19 in younger people in third wave

The tragic news that 13-year-old Emily Victoria Viegas died of COVID-19 on Thursday has once again highlighted one of the third wave’s most striking features in Ontario: the increasing spread of the virus among young people.

Nearly 60,000 Ontarians in their 20s or younger have become infected since March 1, the approximate start of Wave 3. That’s a much larger share of total cases, 40 per cent, than the first and second wave, which saw huge outbreaks among unvaccinated seniors, especially in long-term-care homes.

The number of people in their 30s and younger who die after contracting COVID-19 has also been increasing as a percentage of overall deaths since the start of the third wave. In Wave 2, COVID-19 deaths among this cohort made up 0.5 per cent of all deaths (20 of 4,253); since the beginning of Wave 3, people in this age group have made up about three per cent (20 of 728 to date).

The province’s chief coroner also says most of the people who have died suddenly from COVID at home over the last month in south-central Ontario were under 60.

While the growth in younger cases is undoubtedly alarming news for parents who still rely on daycare, or people who live in multi-generational homes, seniors still make up the vast majority of people suffering the worst outcomes.

Of the 165 deaths due to the virus that have occurred in the last 14 days, 142, or 86 per cent, were among people 60 years old and above. And older Ontarians still represent most hospitalizations; adults 60 and over accounted for 58 per cent of hospitalizations in the last 14 days, while those 20 and younger accounted for about six per cent in the same time frame.

Dr. Samir Sinha, director of geriatrics at the Sinai Health System and the University Health Network, said while the death of any young person from COVID-19 is tragic, he notes that there are many more deaths of older Ontarians that don’t get the same attention.

“We tend to look at older people who are dying in this pandemic, including people who are in their 60s, as rather disposable or more easily expendable,” he said. “I think it really reflects that there’s just systemic ageism in our society.”

While older Ontarians continue to make up most COVID-19 deaths in the third wave, the targeted vaccination of seniors during the province’s first phase of its vaccine distribution program has made a notable impact. In the second wave, those 80 and older made up 66 per cent of all COVID-19 deaths. So far in Wave 3, that cohort is responsible for 45 per cent.

Sinha said the cause of continued high numbers of infections and deaths in older people could be due to the fact that many live in intergenerational households in Ontario’s hotspot regions, which also have more older adults who may not be comfortable communicating in English or French.

“You also have more older adults who may not have access to the technology they need to be able to book an online appointment or to even book an appointment over the phone,” Sinha said. “When we think about the barriers, especially in these hotspot regions … you realize that there are more older adults at risk here with poorer access to becoming vaccinated.”

While deaths in younger people are still rare, there have been a few in their 20s and 30s who have died at home during the third wave.

Ontario’s chief coroner, Dr. Dirk Huyer, told the Star on Monday his office has been called to investigate 27 “unexpected” COVID-19 deaths in south-central Ontario in April among mostly young people with mild symptoms that rapidly turned severe.

Seventeen cases have been in people under 60: 10 in their 40s and 50s, six in their 20s and 30s, and one in a child — Emily Victoria Viegas.

“We have seen more cases that have been dying in the community,” said Huyer, who first mentioned the disturbing trend at a press conference last week.

The Office of the Chief Coroner is not typically involved in deaths involving diseases, and only gets called in when someone dies unexpectedly from COVID-19, Huyer said, which is happening more during the third wave as variants of concern are causing symptoms to escalate more rapidly.

Many of the victims were people who were isolating at home after testing positive or having a family member test positive for COVID-19, suffering mild symptoms until they either “suddenly deteriorated or were found without vital signs,” Huyer said.

Huyer added that investigations into the deaths are ongoing and it’s too soon to tell the exact reason for rapid decline, but COVID can kill suddenly when it causes infection in the lungs, blood clotting, or myocarditis — when inflammation disrupts the heartbeat.

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The increase in deaths occurring out of hospital comes as the number of COVID-19 patients in Ontario intensive care units continues to climb, with record numbers of patients being transferred hundreds of kilometres to other hospitals to create ICU capacity.

As of Monday, there are 2,271 COVID-19 patients in Ontario hospitals, including 877 patients in ICUs; 605 are on ventilators. Ontario Solicitor General Sylvia Jones asked the federal government to help get more medical personnel — including from the military and other agencies — to the province’s hospitals struggling to admit a surge of critically ill patients.

Emily, a student at the Dufferin-Peel Catholic District School Board, is one of Canada’s youngest COVID victims. B.C’s provincial health officer Dr. Bonnie Henry confirmed Monday that a baby in that province had died of the disease in January.

A moment of silence was held in Queen’s Park, Monday, as politicians of all stripes offered their condolences to the teen’s family.

It’s not yet clear exactly what happened in the 13-year-old’s case.

Dr. Zain Chagla, an infectious diseases physician and associate professor at McMaster University, said COVID patients can have sudden blood clots, or heart problems that could cause them to die relatively suddenly. They are seeing more younger people get sicker in the third wave, he added.

But what also seems to be new with the variants, is how quickly a patient’s breathing can deteriorate. It used to take a day or two for someone to really go downhill.

Now “they go from OK to terrible very quickly,” he said, they can “in a couple of hours go from on a couple litres of oxygen to needing a ventilator.”

When people have low oxygen they can also get confused, and if they’re trying to “grin and bear it at home” they might not even be able to call for help. “Which is really sad because that one is probably the more preventable event.”

There may be some fear of going to the hospital, or of being sent away from family members, as patients from the GTA are transferred “as far south as Windsor as far north as Thunder Bay.”

But the message, said Chagla, is that you should not be afraid to get help.

If symptoms are mild and you can go about daily activities, you’re probably fine at home.

But “if you’re feeling breathless, you’re feeling chest pains, you’re feeling confused, you’re feeling out of it, those are bad signs that need to be assessed right away,” he said.

“The hospitals are OK to come to, we’ll take care of you.”

Lex Harvey is a Toronto-based newsletter producer for the Star and author of the First Up newsletter. Follow her on Twitter: @lexharvs

Ed Tubb is an assignment editor and a contributor focused on crime and justice for the Star. He is based in Toronto. Follow him on Twitter: @edtubb

Cameron Tulk is the lead digital designer at the Star, based in Toronto. Reach him via email: ctulk@thestar.ca

Kenyon Wallace is a Toronto-based investigative reporter for the Star. Follow him on Twitter: @KenyonWallace or reach him via email: kwallace@thestar.ca

May Warren is a Toronto-based breaking news reporter for the Star. Follow her on Twitter: @maywarren11

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