MILWAUKEE (SPECTRUM NEWS) — After seeing decreasing case counts for much of late June, Wisconsin’s coronavirus cases are on the rise again. But this spike looks different from earlier levels. Here, we take a look at how the demographics of Wisconsin’s COVID-19 cases have shifted, and what that means for the state moving forward.

On the whole, Wisconsin has been seeing high daily case rates — and not just because of increased testing, since the percentage of total tests that return positive results has also been increasing. As of Tuesday, July 7, the Wisconsin Department of Health Services reports there have been over 32,500 positive cases in the state. 

Archival data from the DHS shows that the 20- to 29-year-old age group in particular has seen a sharp incline in recent months.

Since the end of April, this age group has doubled its share of confirmed COVID-19 cases. On April 20, they made up just 12% of all cases in Wisconsin; as of Monday, that number had risen to 24%. 

About half of Wisconsin’s positive cases have now come from people under the age of 40. This marks a change from the pandemic’s earlier months, when older adults were driving more case numbers.

“When the Safer at Home order was lifted, then we started to see this gradual increase in cases,” says Nasia Safdar, medical director for infection control at UW Health. “The median age of people that are testing positive now is much lower than it was in the beginning of the pandemic.”

Similar demographic shifts have occurred across the country. Current hotspot states like Texas, Florida, and California have seen growing proportions of young people in their coronavirus case rates. 

Many have attributed the rise in young adult cases to social gatherings as states like Wisconsin began to ease up on earlier restrictions. Winnebago County officials sounded the alarm weeks ago about high rates of positive tests in young adults. For Milwaukee County, the two age groups with the highest total case numbers are people in their 20s and 30s. 

In Dane County, where residents in their 20s make up about 1,100 of the health department’s nearly 2,500 cases, officials scaled back reopening measures for bars and restaurants after cases spiked in June. The health department reported that 57% of cases in its most recent two-week data snapshot came from young adults in the 18 to 25 age range, and 239 cases were tied to clusters at bars and restaurants. 

“What seems to be driving it is gathering in public places where it's not always possible to mask or do adequate physical distancing,” Safdar says. “Those places are particularly challenging because if you want to have a conversation, you have to lean forward to hear people; you can’t wear a mask when you're drinking or eating; and then physical space is often pretty limited.”

Some had also raised concerns that widespread protests in the wake of George Floyd’s killing would be another driver for a surge of infections in young people. It's hard to say for sure, but Safdar says there doesn't appear to be the case so far. Last week, health officials in Madison noted that contact tracing only showed a very small number of cases linked to demonstrations, with only 12 people who tested positive confirming they had attended a protest.

In this stretch since April, infections related to long-term care facilities like nursing homes and assisted living centers have come to make up a smaller portion of Wisconsin’s overall caseload, according to DHS data. On April 27, infections from residents and staffers of these facilities made up 8% of the state’s cases, and on July 6 these only represented 4% of all cases.

Nationally, long-term care facility cases make up 11% of all U.S. cases, according to The New York Times. 

Health care workers are also making up a smaller share of positive cases, dropping from 17% of all Wisconsin cases as of April 20 to just 9% as of Monday.

One thing that hasn’t changed over this period is that in Wisconsin, people of color — especially Black and Latino communities — have been hit especially hard by COVID-19, according to DHS data. 

Since April 27, Black Wisconsinites have come to make up a smaller share of cases and deaths, while Latino residents have grown to represent a bigger portion. For both of these groups, though, the current share of cases — 17% for Black residents and 29% for Hispanic or Latino residents — is disproportionate to their share of the state’s total population, which is about 7% for each group according to Census Bureau data.

“Not just in Wisconsin, but everywhere, it's been pretty clearly shown that the risk of outcomes is worse, the likelihood of getting COVID is higher, and they're engaged more often in activities that increase risk like essential work,” Safdar says.

Even as overall case numbers have been climbing again in Wisconsin, though, the proportion of severe cases remains lower than in April.

Now, about 11% of reported COVID-19 cases have required hospitalization, compared to 23% as of April 27. Monday was the third day in a row that Wisconsin reported no coronavirus deaths. Part of this change is probably because more of the infections are affecting younger, generally healthier age groups, Safdar says.

“Of course, 20- to 30-year-olds can also get complications from COVID. It's not all a low-risk group. But that's probably why we're not seeing hospitalizations yet,” she says. “But eventually, if this trend continues, then there will be transmission to other ages, and then they may require hospitalization.”

So, even if we aren’t seeing huge numbers of hospitalizations or deaths now, that could quickly change. Safdar predicts that until a vaccine is available, the rise and fall of COVID-19 cases will be closely tied to human behavior.

At a June 26 briefing, infectious disease expert Dr. Anthony Fauci and other members of the White House coronavirus task force urged Americans — especially young adults —​ to continue following safety guidelines. 

“A risk for you is not just isolated to you,” Fauci said. “Because if you get infected you are part, innocently or inadvertently, of propagating the process of a pandemic. The chances are if you get infected, you will infect someone else."