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Coronavirus response | UI research suggests pandemic hit middle-aged harder in Year 2 | Coronavirus

CHAMPAIGN — With so much focus on the increased risk of serious illness and death that COVID-19 has posed for older adults, many younger and middle-aged adults may have been feeling much safer than they actually were.

With the pandemic nearing the end of its third year, researchers at the University of Illinois delved into numbers of excess deaths during the first two years — 2020 and 2021 — by age group and gender, and found the second year was more fatal to adults ages 25-54 than the first year was.

“This middle-aged group was affected,” said Sheldon Jacobson, a UI computer-science professor. “They may not acknowledge it, they may not like it, but the data is saying they were affected.”

Research he conducted with Dr. Janet Jokela, interim executive associate dean of the Carle Illinois College of Medicine, and graduate student Ian Ludden also found that for adults 65 and older, Year 2 of the pandemic was less deadly than Year 1.

“We certainly know that COVID-19 has had a tremendous impact on people 65 and older,” Jacobson said.

What gets less attention is the “disturbing” impact on younger and middle-aged adults, he said: “They had much more risk than they realized.”

In the second year of the pandemic, those in their prime working years were dying at a rate 5 to 15 percent higher than the first year, he said.

That Year 2 increase for this 25-54 age group came on top of a 20 to 50 percent higher risk of death during the first year of the pandemic compared with five years that preceded it, 2015-19.

“That is why Year 2 was so deadly for the 25-54-year group,” Jacobson said.

He, Jokela and Ludden used provisional mortality reports from the Centers for Disease Control and Prevention and compared the risk of death for 22 age and gender subgroups in 2021 compared with 2015-19 and repeated the comparison for the first full 12 months of the pandemic, April 2020 to March 2021, to the next full 12 months, April 2021 to March 2022.

They found risk of death for most subgroups was significantly higher in 2021 than in 2015-19, both with and without deaths involving COVID-19.

One possible factor in older adults being harder hit in Year 1 than in Year 2 may be the success of vaccines in preventing hospitalizations and deaths, with vaccination rates higher in the 65-and-older population than among the middle-aged, according to the researchers.

Another possible factor affecting older age groups is “displaced deaths” — meaning some who died in Year 1 of the pandemic, before vaccines were available, may have died in Year 2 from other factors, they said.

Delays in care may have been a contributing factor in deaths affecting adults 25-54, the researchers said.

They cite a CDC estimate of 1.125 million excess deaths in the U.S. from the start of the pandemic through June 1, with 901,000 involving COVID-19 and 224,000 attributed to other causes.

While the mechanisms behind non-COVID-19 excess deaths aren’t precisely known, the researchers wrote, it is known that the 2020 lockdowns exacerbated mental illness, drug-overdose deaths reached unprecedented levels and preventive health and cancer screenings were delayed, as were treatments for acute cardiovascular conditions.

Bottom line, Jokela said, “is we don’t know for sure why these excess deaths occurred.”

But what the data tells her is how critically important it is to have robust public-health and lab and testing infrastructures in place to deal with pandemics down the road.

“We’re still in this pandemic,” she said.

Jacobson said he and Jokela are currently waiting on the next round of data from the CDC for 2022, expected in mid-2023, to continue their research.

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