COVID and The Young

The CDC just approved vaccines from Americans aged 5-11. That’s great news! But today, I want to talk about another age group: mine.

A few months ago I wrote a post summarizing data for COVID-19 deaths among people in their 30s and 40s. While we have primarily thought of COVID as a disease impacting the elderly (and indeed in the aggregate, it is), there have been major health consequences for those under 65 too. Including major health consequences for the age group 30-49 (which I believe is the age range of all our bloggers here at EWED).

I wanted to update that data because a few new things have come to light. First, I highly recommend reading a recent paper by my friend Julian Reif and co-authors. They estimate the number of Years of Life Lost and Quality-Adjusted Years of Life Lost for different age groups from COVID-19. Their data runs through mid-March 2021, so before vaccines probably had much of a chance to impact the aggregate death numbers (though vaccines were being rolled out at the time).

Here’s their main result: while most of the deaths from COVID were among those aged 65 and older (80% through March 2021), most of the life lost in terms of years was for Americans under 65 (54% of QALYs). And even for very young adults, the risk in terms of years of life lost was not minimal. A comparison from the paper: “Adults aged 85 years or older faced 70 times more excess risk for death than those aged 25 to 34 years but only 3.9 times more individualized loss of QALYs per capita.” Compared to the 35-44 age group, the relevant factor is 2.8 times more individualized loss for the 85+ group.

It’s a great paper, but it only goes through March. What has happened since March 2021? While 80% of the COVID deaths up through March 2021 were among the elderly (65 and older), since April 2021 only 60% of the COVID deaths have been among the elderly. Part of this is because deaths are down among the elderly, but it’s also because deaths are up for the non-elderly. The table is my attempt to show this effect, looking at the period from March-September in both 2020 and 2021 (data is current as of October 27, so the September 2021 data is still not complete, but instructive).

For the oldest Americans, COVID deaths fell by 50%. That’s great! But for younger Americans, COVID deaths roughly doubled. Not good!

But here is what is even more disturbing about the recent COVID death data: for younger age cohorts, August and September 2021 were by far the worst months of the pandemic. For the age group 30-49, so far 36 percent of COVID deaths were recorded in July-September 2021 (and remember, that number is incomplete, and I am excluding October 2021). More shockingly, the 14,482 deaths in this group in Summer 2021 is more than triple the amount last summer (just over 4,000 deaths). Similar patterns can be found for all age groups under 65.

To some, this is puzzling. Why would deaths be higher now when vaccines are widely available? And indeed, vaccination rates are pretty high for these groups: 70% age 25-39 and 78% age 40-49 have at least one dose. That’s pretty good!

But keep in mind what that means: there are still 30 million unvaccinated in the 25-49 age group, or about 22 million in the 30-49 age group I’ve been focusing on (CDC doesn’t give breakdowns by single years, so my categories aren’t consistent).

So with millions unvaccinated in these age groups, it should not be surprising that thousands are still dying. Most importantly, when we break down the deaths by vaccination status, the differences for this age group are staggering: crude death rates from COVID are 30-40 times higher for the unvaccinated in the 30-49 age group in recent weeks.

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Finally, we might ask: aren’t a few thousand deaths out of millions of young people nothing to be too concerned about? Perhaps, although given that the risk of side effects from vaccines is low, it still makes sense to get vaccinated even to avoid a 4 per 100,000 risk. But should we care about it at a social level?

I would say absolutely yes. In the 12 months from October 2020 through September 2021, there have been 30,746 COVID deaths among the 30-49 age group, and a total of 37,205 respiratory deaths in total over this time period (including pneumonia and flu). First, we can compare this to a typical year. For the time period from 2009-2019, this age group typically had 5,000-6,000 respiratory deaths of all kinds, with 7,000 being the high (in 2009). So the number of respiratory deaths is something like 5-7 times a normal year.

And what of all causes of death? For the 30-49 age group, the following table shows the leading causes of death for 2019. COVID deaths are easily the number two cause of death for this group given the past 12 months of data. It could even rival the top cause, accidents, if the next few months are as bad as Summer 2021 (deaths have fallen lately, which is great). We care a lot socially about automobile accidents, suicide, and murder (cancer and heart disease too, which typically aren’t thought to afflict this age group). We strongly encourage people to take steps (both small and large ones) to lower the risk of theses deaths. The case for encouraging vaccinations is strong, both compared to the risks of COVID and how deadly it is for this age group compared with other causes of death.

Leading causes of death for Age Group 30-49 for 2019 from the CDC WONDER database

One thought on “COVID and The Young

  1. apeacefultree November 3, 2021 / 12:00 pm

    Those numbers are concerning – I’m surprised at the comparison between summer 2021 and 2020. Are people just more nonchalant?

    Like

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