A Blog by Jonathan Low

 

Sep 17, 2021

The Reason Covid Deaths Are Trending Younger

That age cohort is most likely to be vaccine resistant, as well as more vulnerable medically. JL

John Kamp and Paul Overberg report in the Wall Street Journal:

Younger age groups have represented a growing share of deaths since vaccines became available, a trend that has continued into the summer’s Delta surge. People in their 30s are four times as likely to die from infections as people ages 18 to 29. High vaccination rates among the elderly, who are more vulnerable to severe Covid-19 outcomes, are restraining the overall increase in deaths. The change is shifting a larger share of deaths to younger populations with lower vaccination rates.

A surge in Covid-19 deaths caused by the highly contagious Delta variant is hitting working-age people hard while highlighting the risks for people who remain unvaccinated.

Federal data show Covid-19 deaths among people under 55 have roughly matched highs near 1,800 a week set during last winter’s surge. These data show weekly tallies for overall Covid-19 deaths, meanwhile, remain well under half of the pandemic peak near 26,000 reached in January.

U.S. Covid-19 Death TollAfter falling this spring, the Covid-19 death tollis rising due to the spread of the Delta variant.Daily death toll (7-day moving average)Source: Johns Hopkins University
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The Delta-driven Covid-19 surge is the first major case surge to spread through a partially vaccinated U.S. population. High vaccination rates among the elderly, who are more vulnerable to severe Covid-19 outcomes, are restraining the overall increase in deaths, some researchers say. The change is shifting a larger share of deaths to younger populations with lower vaccination rates, underscoring the need to get more people inoculated to curb the pandemic, they say.

“We don’t want anyone to die from a vaccine-preventable disease,” said Samuel Scarpino, managing director of Pathogen Surveillance at the Rockefeller Foundation’s Pandemic Prevention Institute.


The seven-day average for newly reported Covid-19 deaths each day recently eclipsed 1,600, up from an average that briefly moved below 220 a day in early July. With roughly 660,000 known Covid-19 deaths to date, the U.S. is on track to soon top the estimated 675,000 deaths that the Centers for Disease Control and Prevention has linked to the 1918-19 flu pandemic.

Deaths have been concentrated among the unvaccinated, federal data show. The CDC released studies on Friday showing that unvaccinated Americans were 4.6 times as likely to be infected, 10 times as likely to be hospitalized and 11 times as likely to die.

At Tampa General Hospital, about 90% of recent Covid-19 patients were unvaccinated, said Peggy Duggan, chief medical officer at the facility, which is one of Florida’s largest hospitals with more than 1,000 beds. Many patients who did get the shots have compromised immune systems due to organ transplants or cancer treatment, Dr. Duggan said.

Tampa General’s recent Covid-19 patients in intensive care were 46 years old on average, far below the average during prior surges when vulnerable seniors were often hospitalized, Dr. Duggan said. The hospital’s death rate for Covid-19 patients hasn’t changed, sticking around 7%.

“These are working people, they’re people with families and children they’re still raising,” Dr. Duggan said.

Younger age groups have represented a growing share of deaths since vaccines became available, a trend that has continued into the summer’s Delta surge.

Age is a major risk factor for people with Covid-19. People in their 30s are four times as likely to die from infections as people ages 18 to 29, according to the CDC. For people ages 75 to 84, the risk of death is 220 times as high.

Older Americans still account for the most Covid-19 deaths, but their higher vaccination rates have helped hold down the numbers. About 54% of the overall U.S. population and 63% of eligible people ages 12 and above are fully vaccinated, while the average among nursing homes is 84% for their residents, federal data show.

This is yielding benefits in places hit hardest by deadly Covid-19 waves earlier in the pandemic. While the Delta surge set off nursing-home outbreaks again, and workers who chose not to get the vaccine prompted employers and officials to issue mandates for these facilities, residents’ deaths haven’t reached the levels seen earlier in the pandemic.

Despite gains in protecting seniors, the Delta surge has presented major risks to other groups. CDC data continue to show that, compared with non-Hispanic whites, Black and Hispanic people face almost three times the risk of hospitalization and more than twice the risk of death. The rates among Native Americans are even higher. Rates among Asian people are comparable to those of non-Hispanic whites. The disparities stem from factors including pre-existing health conditions, access to healthcare and occupational exposure, public-health experts say.

A measure of daily Covid-19 deaths divided into new hospitalizations from two weeks earlier—covering a gap that clinicians say captures the time it takes for many deaths to occur—shows some turbulence since Delta began driving up cases this summer. This metric counts all Covid-19 deaths, including the roughly one-third that occur outside hospitals, meaning it doesn’t precisely reflect the rate at which hospitalized patients die.

Surviving Severe Covid-19Although not all Covid-19 deaths occur inhospitals, a comparison suggests that theodds of surviving hospitalization haveplateaued.Covid-19 deaths as a percentage of Covid-19hospitalizations two weeks earlierSource: CDCNote: Some deaths occur outside hospitals.
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Measuring deaths against hospitalizations shows a decline in deaths after the mass vaccination effort began, reflecting what some health-experts say is more exposure among younger people and improvements in care, but that decline stopped in the spring.

Estimating the overall share of Covid-19 cases that become deadly is difficult, because testing captures only a portion of actual cases. A measure known as the case-fatality ratio, which looks at the number of known cases that become known deaths, appears to be heading lower, some public-experts said.

But because deaths tend to lag three to five weeks behind cases, the death toll may yet grow even as new cases are leveling off. The concentration of those fatalities among unvaccinated people demonstrates how important the shots are to ending the pandemic, said Jodie Guest, vice chair of the epidemiology department at Emory University’s Rollins School of Public Health.

“We cannot accept this as our endemic level, and we have the tools to keep this from being our endemic level,” Dr. Guest said.


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