Between March 2020 and October 2021, about 700,000 people in the US died of covid, which was the third overall cause of mortality, accounting for 12.2% of all deaths, according to a new study of death certificate data published in the Journal of the American Medical Association.
While the pandemic killed people of all ages, it had a disproportionate impact on the middle aged. In 2021, covid was the leading cause of death for people ages 45 to 54, surpassing heart disease and cancer, which would otherwise be the top causes of death. While covid caused many more deaths in older age groups in absolute numbers, in no cohort was it as disruptive as it was among 45 to 54 year-olds.
A disproportionate covid impact on middle-aged people
Segmented by age, people over 85 experienced the largest number of covid casualties during 2020, with110,000 deaths. But even then, heart disease remained the leading cause of death, accounting for 210,000 deaths. For all age groups other than those 45 to 54, during both 2020 and 2021, cancer and heart disease were deadlier than covid.
But in the 45 to 54 group, not only did covid kill more people than any other cause, but it caused nearly twice as many casualties in 2021 (30,000) as it did in 2020 (17,000). Meanwhile, the number of deaths due to heart disease and cancer (both of which caused 29,000 deaths in 2020), remained unchanged.
There are likely several reasons for the increase, according to the paper’s authors, who are researchers at the National Cancer Institute in Rockville, Maryland.
The overall distribution of the disease shifted toward younger people in the second year of the pandemic, both because high mortality rates had already reduced the older population, and since vaccination campaigns started with the most vulnerable, relatively younger people remained more exposed to severe cases of covid for a longer period of time.
While the Centers of Disease Control and Prevention’s data tracks vaccine uptake in different age brackets than the study—30 to 49 and 50 to 64—the breakdown can also offer an indication about vaccine uptake in the 45-54 cohort, as vaccine hesitancy is relatively high among both groups: 37% of all unvaccinated people are between 30 and 49, compared to 32% of all vaccinated people, and 26% of unvaccinated people are between 50 and 64, compared to 24% of all vaccinated people. The low vaccine uptake, combined with relaxed containment measures for covid (such as social distancing, masking), may have led to the increase in deaths.