1 in 3 young adults is vulnerable to severe Covid-19, and smoking plays a big part, research finds

One in three young adults is at risk of severe Covid-19, and smoking plays a big part in that risk, according to new research published Monday in the Journal of Adolescent Health.

Researchers at the University of California, San Francisco, looked at more than 8,000 participants ages 18 to 25 who had participated in the National Health Interview Survey to see what their medical vulnerability to severe Covid-19 was in relation to risk indicators that had been set out by the US Centers for Disease Control and Prevention, including health conditions and smoking habits.

The researchers found 32% of the total study population were medically vulnerable for severe Covid-19. However, when the group of participants who smoked cigarettes or e-cigarettes were taken out of the analysis, the medically vulnerable percentage decreased by half, to 16%.

The research showed that in the whole study population, young adult men were at a higher risk for severe Covid-19. Although more women reported having asthma and immune conditions, higher rates of smoking in men overrode this. However, looking at just the non-smokers, women had a higher risk.

“Recent evidence indicates that smoking is associated with a higher likelihood of COVID-19 progression, including increased illness severity, ICU admission or death,” said Sally Adams, lead author of the study, in a press release. “Smoking may have significant effects in young adults, who typically have low rates for most chronic diseases.” 

Other findings: Another interesting finding from the research is that in the 18 to 25 age group, White young adults had the highest vulnerability. 

“Our finding of lower medical vulnerability of racial/ethnic minorities compared with the white subgroup, despite controlling for income and insurance status, was unexpected,” the study said. “It is also inconsistent with research showing higher rates of Covid-19 morbidity and mortality and other chronic illnesses among racial/ethnic minorities, specific to one age group.”

The researchers said it is also inconsistent with the 15 to 24 age group, where Hispanic and Black Americans were shown to have the highest rates of Covid-19 deaths.

“This suggest that factors other than the CDC’s medical vulnerability criteria play a role in the risk of severe Covid-19 illness in the young adult population,” the researchers said.

The study did have some limitations, including the lack of information about Covid-19 in the 18 to 25 population, and a chance that it could underestimate the vulnerability rates for certain ethnic or racial subgroups of young adults due to the data source.

People cross a street in Santa Monica, California, on July 12. Marcio Jose Sanchez/AP

At least 35 US states are seeing a rise in new cases compared to the previous week, according to data from Johns Hopkins University. Across the country, health officials are sounding the alarm over the number of infected patients seeking medical care.

Both local and state leaders have said in recent weeks new cases are largely driven by Americans who have opted to resume gatherings and outings to bars. In many states, the average age of new cases has shifted downward, with more young people testing positive than ever before.

In Louisiana, officials reported more than 1,300 new coronavirus cases Sunday  — 99% of which were spread through the community and more than a third of which were in people aged 29 or younger, officials said. 

In Florida, where there's no statewide mask mandate, health officials reported Sunday a staggering record of new cases in a single day: 15,300. In Miami Beach, hospitals are reaching full capacity, the mayor told CNN Sunday night.

Across the state, there are more than 7,500 patients hospitalized with the virus, state data showed Sunday. In Florida's Orange County, where Disney World reopened over the weekend, more than 540 patients were in hospitals.

In California, Los Angeles County health officials reported more than 3,300 new cases Sunday — the second highest daily case count in the last week. There are nearly 2,100 people hospitalized, a number "substantially higher" than hospitalizations a month ago, officials said.

And in Arizona, Phoenix's mayor told CNN health care professionals are reporting they are "already tired" and worried about additional strains on hospitals stemming from the July 4 holiday, even as the city is already seeing record-breaking ventilator usage.

In efforts to prevent further spread, Mayor Kate Gallego said she's joined other leaders across the state to urge the governor to expand safety precautions in response to the virus.

Here's a look at where cases are increasing across the country:

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, speaks during a hearing in Washington, DC, on June 30. Al Drago/Bloomberg/Getty Images

The White House made a concerted effort to discredit Dr. Anthony Fauci this weekend, after he gave a widely-publicized interview with the Financial Times. The interview commanded headlines because Fauci conceded he had barely spoken to the President in months.

Though last week's interview with the FT was approved by the White House press shop, according to an aide familiar, administration officials distributed a list this weekend to multiple outlets that included statements made by Fauci during the early stages of the coronavirus pandemic. The White House cited this as evidence Fauci had been wrong -- without noting statements from the surgeon general urging people not to buy masks, or acknowledging the president’s own misstatements about the virus.

Trump annoyed by Fauci's comments: A person familiar with the situation said it was because Trump had grown annoyed by Fauci's public statements. Though Trump was already displeased by Fauci’s television appearances early on, the White House has sought to downplay tension between the two for several months. The press shop stopped approving Fauci's television appearances, believing it would help alleviate the situation, though they continued to allow him to give interviews with print outlets.

Rare in-person meetings with the Trump and Fauci are not awkward and don't involve raised voices, but Trump has complained about Fauci privately, according to a person familiar with the situation.

Sources say part of that irritation is over the "good press" Fauci has received. Trump's irritation with Fauci has also, at times, been encouraged by Peter Navarro, Trump's trade adviser, who has repeatedly blamed Fauci for doubting the efficacy of hydroxychloroquine.

Navarro once told Fauci he would be personally responsible if it was later shown that hydroxychloroquine worked to treat coronavirus, despite multiple studies questioning its use.

In an interview on Meet the Press Sunday, Admiral Brett Giroir said there is "open discourse" within the task force.

"I respect Dr. Fauci a lot, but Dr. Fauci is not 100% right and he also doesn't necessarily, and he admits that, have the whole national interest in mind. He looks at it from a very narrow public health point of view," Giroir said.

Fauci is scheduled to be in the West Wing Monday for meetings.

Watch Dr. Sanjay Gupta discuss:

A person walks by a closed liquor shop in the Hillbrow neighborhood of Johannesburg, South Africa, on July 13. Michele Spatari/AFP/Getty Images

The World Health Organization (WHO) reported the highest daily number of Covid-19 cases globally on Sunday, with 230,370 new infections. 

In the US, where the virus is raging across parts of the country, nearly one out of every 100 Americans have tested positive for Covid-19.

The US has recorded more than 3.3 million coronavirus cases since the pandemic began, according to Johns Hopkins University, and at least 135,205 Americans have died.

In Florida, where there's no statewide mask mandate, health officials on Sunday reported a staggering record of new cases in a single day: 15,300 -- the highest number of new cases reported in a single day by any US state since the coronavirus pandemic began.

Across the world, 12.9 million people have tested positive for the virus, according to figures from Johns Hopkins.

Here's the latest on the pandemic:

WHO advance team arrives in China to investigate origins of coronavirus: Two experts from the World Health Organization have arrived in Beijing to work with their Chinese counterparts on tracing the origin of Covid-19, China’s Ministry of Foreign Affairs (MOFA) confirmed Monday. The visit comes at a time of fraught political tensions between the US, China and the WHO -- the WHO has been under fire for its relationship with China, and the US, under President Donald Trump, is withdrawing from the WHO.

South Africa suspends alcohol sales, enforces curfew, amid surge in cases: South Africa will resume a ban on alcohol sales and reinstate a daily curfew from 9pm until 4am, to free up hospital capacity as the country’s Covid-19 cases continue to rise.

Spanish judge blocks Catalonia from confining 156,000 people to their homes: A  judge has blocked the Catalan regional government’s home confinement order, designed to contain the spread of Covid-19 in the provincial capital of Lleida and 7 nearby towns. The measure would have left 156,000 people unable to leave their homes, with few exceptions, after Segría county tallied 1,438 new cases of Covid-19. A ruling late Sunday found that the confinement came under state jurisdiction, not that of the regional government.

UK PM Johnson encourages use of face coverings in confined spaces: UK Prime Minister Boris Johnson said people should wear face coverings inside shops, adding that the government would outline how it planned to enforce its advice over the next few days. 

Bollywood stars test positive: Coronavirus has hit one of Bollywood's leading families with superstar Amitabh Bachchan, his son Abhishek Bachchan and daughter-in-law, actress Aishwarya Rai Bachchan all admitted to hospital. Authorities in Mumbai have declared Bollywood star Amitabh Bachchan's Jalsa residence a containment zone, after the actor and other family members tested positive for coronavirus. 

Lebanon records highest daily increase in coronavirus cases: Lebanon has seen a surge in coronavirus cases, less than two weeks after it virtually ended its lockdown. Early in the pandemic, the eastern Mediterranean country took aggressive measures to stem the spread of the virus, but less than two weeks after Beirut's international airport reopened, infections have risen rapidly. Yesterday, Lebanon reported 166 new cases -- a record high for the country.

UK Prime Minister Boris Johnson visits the headquarters of the London Ambulance Service NHS Trust in England on July 13. Ben Stansall/WPA Pool/Getty Images

British Prime Minister Boris Johnson said Monday that people should wear face coverings inside shops, adding that the UK government would outline how it plans to enforce its advice on masks over the next few days. 

"I do think that in shops it is very important to wear a face covering if you are going be in a confined space and want to protect other people and receive protection in turn," Johnson said during a televised interview on Monday.

"In terms of how we do that, whether we'll be making it mandatory, we'll be looking at the guidance, we'll be saying a little bit more in the next few days," he added. 

The Prime Minister's remarks came just a day after his cabinet minister, Michael Gove, said he did not believe the use of face masks should be made compulsory. 

"I don't think mandatory, no, but I would encourage people to wear face masks when they're inside in an environment where they're likely to be mixing with others," Gove told the BBC on Sunday. 

"It's always better to trust people's common sense," he added. 

What's the situation in the UK? The UK is one of the countries worst hit by coronavirus. With almost 45,000 fatalities, it stands third behind Brazil and the United States.

"The UK is way behind many countries in terms of wearing masks," Venki Ramakrishnan, the head of the Royal Society, Britain's national academy of sciences, said last week.

Ramakrishnan argued that not wearing a mask should be regarded as antisocial as drink-driving, reasoning that there is a "growing body of evidence that wearing a mask will help protect others -- and might even protect you."

Despite this, the only places where face masks are compulsory in England is on public transport, a measure brought in on June 15, and in healthcare settings.

Government considers enforcement measures: While the Prime Minister said Monday that members of the public had shown "amazing sensitivity" to others over the course of the pandemic, he confirmed that the government is looking into enforcement measures.

"We'll be looking in the next few days about how exactly how, with what tools of enforcement, we think we want to make progress," Johnson said. 

"As the virus comes down in incidence and we have more and more success, face coverings are a kind of extra reassurance that we can all use to stop it coming back and stop it getting out of control again," he added.

As the number of new coronavirus cases continues to rise sharply in the United States, the Trump administration persists in its messaging about children returning to classrooms in the fall.

A source close to the Coronavirus Task Force told CNN's Chief Medical Correspondent Dr. Sanjay Gupta: "With regard to schools, each community will have to evaluate the status of the outbreak in their particular area.

"While there are no hard and fast rules, if a particular community has had a five day sustained increase in community spread, they probably should not be opening schools until they pass through the basic gating criteria of a 14 day downward trajectory. That guidance has not changed.”

These comments come after Education Secretary Betsy DeVos on Sunday refused to say whether schools should follow guidelines from the US Centers for Disease Control and Prevention on reopening, saying those guidelines are meant to be "flexible."

"There is nothing in the data that would suggest that kids being back in school is dangerous to them," DeVos said, when asked by CNN’s Dana Bash if she can assure parents and students that schools will be safe when meeting in full-size, in-person classes -- doubling down on a similar comment she made last week.

Two experts from the World Health Organization have arrived in Beijing to work with their Chinese counterparts on tracing the origin of Covid-19, China’s Ministry of Foreign Affairs (MOFA) confirmed Monday.

"We have a basic consensus with the WHO -- that is: Source tracing is a scientific issue, and should be assessed and cooperated by scientists all over the world," MOFA spokesperson Hua Chunying said at a press conference.

"The WHO also believes that this is an ongoing process and it may concern multiple countries and localities, and the WHO will conduct similar inspections to other countries and regions based on its need."

No further details of the WHO team's schedule while in China has been released.

CNN's Kristie Lu Stout said this is what we know about the team so far:

According to the WHO, the two individuals will try to answer two critical questions: 

The visit comes at a time of fraught political tensions between the US, China and the WHO:

"We know the WHO has been under fire for its relationship with China, we know that the US under President Donald Trump is withdrawing from the WHO," Lu Stout said.

"So there's a lot of scrutiny and pressure on this two-person advance WHO team in China to see whether or not they're going to get access to data, to samples, to files from Chinese authorities to Chinese scientists as well as, critically, answers just to find out what happened."

Louisiana reported more than 1,300 new coronavirus cases Sunday -- 99% of which were spread through the community, and more than a third of which involved people aged 29 or younger, officials said. 

The numbers match wider patterns across the US, with both local and state leaders saying in recent weeks that new cases appear to be largely driven by Americans who have opted to resume gatherings and outings to bars.

Young people affected: In many states, the average age of new cases has shifted downward, with more young people testing positive than ever before. 

Mask mandates and closures: Louisiana Gov. John Bel Edwards announced a mask mandate will go into effect Monday morning following an uptick in cases. Many of the new cases are being traced to backyard get-togethers and other gatherings, the governor said. 

Bars will also be closed for on-site alcohol consumption, after at least 36 outbreaks and more than 400 cases were traced back to bars in the state.

At least 36 states now have some type of mask requirement order in place, and more than half of US states have paused or rolled back their reopening plans in efforts to contain the spread of the virus, which some experts have said is now out of control.

Read the full story:

People walk in Hong Kong on July 10. Roy Liu/Bloomberg/Getty Images

Hong Kong Health officials reported 52 new cases of Covid-19 in the city on Monday, with 41 locally transmitted infections.

Of the 52 new cases, officials said 11 were imported and 20 of the local infections come from "unknown sources."

This is the highest number of daily local cases so far in Hong Kong's "third wave," which began in early July following weeks of registering zero local transmissions.

Schools shut: Hong Kong last week announced that all schools in the city would be suspended following a surge in locally-transmitted coronavirus cases. On Monday, kindergarten, primary school and secondary schools started their summer holidays early.