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In second year of COVID, study finds fewer deaths but more years of life lost

A man whose mother died from COVID photographs a COVID Memorial Project installation of 20,000 American flags on the National Mall when the U.S. marked 200,000 lives lost in the COVID-19 pandemic in September of 2020. (Win McNamee/Getty Images)
A man whose mother died from COVID photographs a COVID Memorial Project installation of 20,000 American flags on the National Mall when the U.S. marked 200,000 lives lost in the COVID-19 pandemic in September of 2020. (Win McNamee/Getty Images)

A new study in the Annals of Internal Medicine shows a dramatic shift in deaths during the second year of the pandemic, when compared to the first.

While there were 75,000 fewer deaths in 2021 than there were in 2020, there were far more years of life lost to COVID-19, the research found. That’s because the median age at which people died of the illness dropped by nearly a decade, meaning many of those who succumbed were missing out on more potential years of life.

WBUR spoke with the lead author of the paper, Mark Czeisler, who is a student at Harvard Medical School, about the numbers and why there was such a big shift.

By the numbers

The researchers, from Harvard and Brigham and Women's Hospital, compared federal data from March through December of 2020 to the same period in 2021.

"And we found that in those months in 2021, there were roughly 21% fewer COVID-involved deaths. That translates to nearly 75,000 fewer deaths," Czeisler said. "However, we found 500,000 more years of life lost."

"Years of life lost" is a measure that takes into account the age at which someone died, compared to how long they might have reasonably expected to live based on typical lifespans.

"We found that the median age at which people were dying decreased by nearly a decade, down from 78 years in 2020 to 69 years in 2021. That's kind of astonishing."

Mark Czeisler

During the first year of the pandemic, many of the people who died were over the age of 75. But that trend changed significantly in the second year of the pandemic, Czeizler explained. As the median age of people dying began to fall, the researchers calculated more lost years of potential life.

"So that was a quite a dynamic shift," he said. "We found that the median age at which people were dying decreased by nearly a decade, down from 78 years in 2020 to 69 years in 2021. That's kind of astonishing."

The study found that in 2021, the number of years of life lost per COVID death increased by 36% compared to 2020.

Why the change

"There are a number of factors that could be at play," Czeisler said.

Although the paper doesn't delve into specific reasons for the drop in median age of people dying of COVID, he hypothesizes that one factor may be the large number of people over the age of 80 who died in the early months of the pandemic.

"To some extent that had to do with nursing homes and long-term care facilities [being hard hit]," Czeisler said. "It’s a morbid thought, but the quote-unquote most vulnerable who are also exposed are going to pass away first. And so then they're not going to be around during the second year [of the pandemic] to die."

Other factors likely include strong vaccination rates among older adults and their adherence to mitigation strategies like mask-wearing and social distancing.

"That likely helped keep some older adults safe in the second year of the pandemic," Czeisler said. "Finally, there might also be age-related risk differences associated with some of the coronavirus variants."

Total lives lost vs. years of life lost

The total number of deaths from COVID is an important data point, Czeisler said, but he added that years of life lost are also important to consider. One reason is the data may influence how public health experts try to prevent similar deaths in the future.

"In this case, the lower overall number of deaths due to COVID in 2021 compared to 2020 really masks the fact that there was a shift to relatively younger people dying from the disease," Czeisler said. "And understanding what goes into that is something that's very important to continue to monitor and address through medical strategies and public health policy changes."

Since the pandemic began, about 75% of all COVID-related deaths were among people 65 years of age and older.

This article was originally published on December 01, 2022.

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Gabrielle Emanuel Twitter Senior Health and Science Reporter
Gabrielle Emanuel is a senior health and science reporter for WBUR.

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