Elderly mortality surged during the Omicron wave

Despite receiving strong levels of vaccination among the elderly, Covid killed them at a much higher rate than last year during the Omicron wave this winter.

This winter wave of death in the elderly believed in the relatively mildness of the Omicron subspecies. Approximately the same number of Americans over the age of 65 died in 4 months of the Omicron wave and 6 months of the Delta wave, but the Delta variant tends to cause more serious illness for one person. did.

Covid mortality per capita is declining overall, but older people still dominate.

“It’s not just an unvaccinated pandemic,” said Andrew Stokes, an assistant professor of global health at Boston University who studies the age pattern of Covid’s death. “Even those who have the primary vaccine series are still at very high risk among the elderly.”

Covid deaths have always been concentrated in the elderly, but since the vaccine became widely available, it will be more biased towards the elderly in 2022 than at any other time.

The pandemic sway put pressure on the Biden administration to protect older Americans. Health authorities In the last few weeks, we encourage everyone over the age of 50 to get a second booster Introducing a new model Distribution of antiviral drugs.

But in many countries, booster campaigns remain lethargic and disorganized, the elderly and their doctors said. Many patients struggling to drive or go online often need to operate a maze-like medical system to administer potentially life-saving antiviral drugs.

Covid’s deaths nationwide in recent weeks are close to the lowest pandemic levels, averaging below 400 per day. However, the mortality gap between the elderly and the young is widening. Middle-aged Americans, who suffered most of the pandemic deaths last summer and fall, are benefiting from new stores of population immunoprotection as Covid’s deaths once again gather around the elderly. Man.

And the new wave of Omicron subvarieties could create additional threats. Hospitalizations for younger age groups remain relatively low, but hospitalization rates for people over the age of 70 in the northeast have risen to one-third of the towering peaks of winter Omicron waves.

Dr. Sharon Inouye, a geriatrician and professor of medicine at Harvard Medical School, said: “As immunity weakens, it becomes more and more dangerous for the elderly.”

Harold Thomas Jr., 70, in Knoxville, Tennessee, is one of many older Americans who may have weakened immunity due to lack of booster shots. Covid States Project, an academic group, Recently estimated Among people over the age of 65, 13% have not been vaccinated, 3% have received a single dose of Moderna or Pfizer, and an additional 14% have been vaccinated, but boost immunization. Not.

When the vaccine first arrived, Thomas said the State Health Department made the vaccine “convenient” by administering shots in the community of his apartment for the elderly. But he was unaware of such efforts for booster doses. On the contrary, he recalled state officials who publicly questioned when boosters became available.

“The government wasn’t sure about booster shots,” he said. “If they weren’t sure about it and they put it out, why would I take it?” Thomas said Covid recently killed his ex-boss and his older family. He said he had his friend hospitalized.

Experts say that the height of the winter waves has reduced deaths, partly due to increased levels of immunity from past infections. There are also glittering reasons for the elderly. Many of the most vulnerable Americans were killed by Covid in the winter, reducing the target of the virus in that age group.

But scientists have warned that many older Americans remain vulnerable. To protect them, Elderly Housing with Care has called on nursing homes to organize domestic vaccinations or require additional shots.

In the long run, scientists have addressed economic and medical illnesses that have affected older Americans, especially non-whites, so that Covid does not continue to shorten much of their lives. Said you need to.

“I don’t think we should treat the premature death of older people as a way to end the pandemic,” Dr. Stokes said. “There are still many very vulnerable and sensitive older people living with comorbidity or living in multi-generational households.”

This year’s Covid mortality pattern recreates the dynamics of the virus killing a significantly higher percentage of older Americans from 2020, before the vaccine was introduced.In the early days of the pandemic, mortality increased steadily with age, and Dr. Stokes and his collaborators said. Recent research..

During the Delta surge, it changed last summer and fall. Older people were vaccinated earlier than the other groups. NovemberThe vaccination rate for Americans over the age of 65 was about 20 percentage points higher than that for those in their 40s. And critically, those older Americans were vaccinated relatively recently, leaving them with a strong level of residual protection.

As a result, older people suffered from Covid at a lower rate than before the vaccine was available. According to a recent study by Dr. Stokes, mortality rates last fall were about 75 percent lower than in the winter of 2020 among people over the age of 85.

At the same time, the virus attacked young, poorly vaccinated Americans, many returning to face-to-face work. The mortality rate of whites in their late 30s has more than tripled compared to last fall. The mortality rate of blacks in the same age group has more than doubled.

The rebalancing of deaths from Covid was so pronounced that in 2021 overall deaths returned to pre-pandemic levels among Americans over the age of 80. Studies posted online During February. The opposite was true for middle-aged Americans. Life expectancy for the group, which had already increased life expectancy over the same age group in Europe, fell further in 2021.

“By 2021, the impact of a pandemic shift on mortality will appear younger,” said Ridhi Kashyap, lead author of the study and demographer at Oxford University.

By the time the highly contagious variant of Omicron was inherited, researchers said that more older Americans had weakened their immune defenses long after their last Covid vaccination. rice field.

As of mid-May, more than a quarter of Americans over the age of 65 had not received the latest vaccination within a year. And more than half of the people in that age group haven’t been fired in the last six months.

Omicron variants were superior to previous versions of the virus in that they evaded the already weakened immune defenses and reduced the effectiveness of the vaccine against infections and more serious illnesses. This was especially true for older people whose immune system did not respond very aggressively to the vaccine in the first place.

For some, even three vaccinations appear to reduce defense over time against Omicron-related hospitalizations.Investigation Recently published in The Lancet Respiratory Medicine We have found that this tendency is seen in people with weakened immune systems. This is the category in which older Americans are likely to be categorized. Saratartov, the lead author of the study and an epidemiologist at Kaiser Permanente in Southern California, said that about 9% of people over the age of 65 in the study were immunocompromised, compared to adults under the age of 50. 2.5% said they had immunodeficiency.

During the Omicron wave, Covid’s mortality rate was dramatically higher for older Americans than for younger Americans, according to Dr. Stokes. Older people also accounted for the overwhelming proportion of excess death. The difference between the number of people who actually died and the number of people who were expected to die if the pandemic did not occur.

Dr. Jeremy Faust, an emergency physician at Brigham and Women’s Hospital in Boston, Recent research The excessive death was more concentrated in people over the age of 65 during the Omicron wave than in the delta surge. Overall, the study found that Massachusetts had more deaths during the first eight weeks of Omicron than during the 23-week period Delta ruled.

As older people began to die at a higher rate, so did the proportion of vaccinated people in Covid’s death. Approximately 40 percent of people who died of Covid in March were vaccinated, according to a numerical analysis from the Centers for Disease Control and Prevention.

Older Americans infected during a pandemic are less likely than younger ones and have lower levels of innate immunity. As of February, about one-third of people over the age of 65 showed evidence of a previous infection, compared to about two-thirds of adults under the age of 50.

Older cases of Covid cannot prevent future infections, but reinfected people are less likely to become seriously ill.

According to scientists, the decline in Covid precautions this winter, coupled with the high infectivity of Omicron, has exposed older people more. It is unknown how their own behavior has changed.Ann Previous researchScientists at the University of Marquette suggested that older people in Wisconsin once wore masks at a higher rate than younger people, but the gap had virtually disappeared by mid-2021.

Antiviral drugs are now More doseHowever, it is difficult to know who is benefiting from them. Scientists said the winter surge in Covid mortality among older Americans called for a more urgent policy response.

Dr. Inoue of Harvard Medical School said he was waiting for notification of the deployment of a second booster shot from his mother’s ancillary living facility, despite reports of staff being infected. But still, the director of the facility said a second booster shot drive would not be possible without state guidance.

Eventually, her family had to arrange a trip to the pharmacy herself for the second booster.

“Now it seems that responsibility is entirely on the individual,” she said. “It hasn’t been easier for you.”