Covid-19 Associated with Increased All-Cause Mortality among Young Adults

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The coronavirus disease has caused a marked increase in all-cause deaths, mostly among young adults in the United States. The excess mortality reflects the full burden of the pandemic that may go un-captured due to un-coded Covid-19 and other pandemic-related deaths.

According to a new study published in the American Medical Association Journal, at least 12,000 younger adults died in the United States during a recent 5-month period than expected. Jeremy S. Faust MD, MS, an emergency medicine physician at Brigham and Women’s Hospital in Boston and Harvard Medical School, and colleagues noted wrote in a press release: 

“Although the burden of COVID-19 among hospitalized younger adults has been described, fewer data focus on mortality in this demographic, owing to lower case-fatality rates.”

Excess Mortality Occurred

The researchers, who included the incoming CDC Director Rochelle P. Walensky, MD, MPH — calculated the difference between observed and expected deaths using averages from the past five years and observed all-cause mortality and Covid-19 mortality for the period of March 1 to July 31 this year, which were available via the National Center for Health Statistics. They also assembled unintentional opioid overdose death counts for corresponding periods in 2018 for each HHS region.

According to the research findings, 76,088 all-cause deaths from March 1 to July 31, 2020, among U.S. adults aged between 25 and 44 years. This was at least 11,899 more than the expected 64,189 deaths, an incident rate ratio, and 1.19. Nationally and overall, in every U.S. Department of Health and Human Services region, excess mortality occurred in every month of the study period. There were 4,535 COVID-19 deaths recorded nationally among adults aged 25 to 44 years, accounting for 38 percent of the excess mortality. In three HHS regions, deaths due to COVID-19 exceeded 2018 unintentional opioid deaths during one month in 2020. The authors further wrote: 

“The provisional data used represent lower-bound estimates due to reporting lags, necessitating future updates […] additionally, although COVID-19 deaths exceeded unintentional opioid deaths in 2018 in some areas, it is possible that simultaneous increases in opioid deaths may have occurred during the pandemic period, making it less clear which of these two diseases represents the current leading cause of death among younger adults in areas experiencing COVID-19 surges.”

False Sense of Confidence

At the onset of the Covid-19 pandemic, most people falsely believed that the disease was mostly affecting older adults and that young people were more likely to have milder disease cases. However, according to this new research and the U.S. Centers for Disease Control and Prevention (CDC), people under age 30 accounted for more than 20% of Covid-19 cases and were seen as more likely to transmit the virus than others. This trend has continued into the winter.

While they are less likely to be hospitalized because of Covid-19 or die from it, people in their 20s, 30s and 40s can catch the virus. Some develop severe and lasting symptoms, particularly if they live with obesity, diabetes or high blood pressure hypertension. Since young people are less likely to have severe cases of Covid-19, they may have a false sense of confidence regarding their safety. They may feel that mingling with others in large groups, attending parties, not wearing masks and ignoring community pandemic guidelines will not seriously endanger them.

Seemingly Healthy People

Most young people who get Covid-19 may recover, but some do not, while many others will pass the disease to others unknowingly. Young adults must now realize they have a role to play as far as the pandemic is concerned. It is now evident that even seemingly healthy people in their 20s and 30s can catch the coronavirus, spread it to others, and suffer from severe illness resulting in lasting health problems or even death.

Personal behavior makes the whole difference. Covid-19 precautions such as mask-wearing, physical distancing, hand hygiene and self-monitoring for coronavirus symptoms effectively limit infection and spread of the disease. They are especially important for vulnerable household or community members such as chronically ill, older and immune-compromised people. The study authors conclude: 

“Young, healthy people are low on the priority list for the vaccine rollout. That means that modifying behavior now can save thousands of young lives next year.”