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Mortality Rates Rise in Older People During the Omicron Wave


Despite strong vaccination levels among older people, Covid killed them at much higher rates this winter during the Omicron wave than last year, taking advantage of the long delays since their last vaccination and the variant’s ability to circumvent immune defenses.

The wave of death in older people this winter belied the relative softness of the Omicron variant. As in six months of the Delta wave, nearly all Americans aged 65 and over died in four months of the Omicron surge, although the Delta variant tends to cause more serious illness for any person.

While the overall per capita death toll from Covid-19 has fallen, older people still make up an overwhelming share of those rates.

“This is not just an unvaccinated pandemic,” said Andrew Stokes, an assistant professor of global health at Boston University who studies age patterns of Covid deaths. “There is an extraordinarily high risk among older adults, even those with primary vaccine series.”

While Covid deaths have always been concentrated in older people, they have tended to more elderly people than at any point since vaccines became widely available in 2022.

This surge in the pandemic has intensified the pressure on the Biden administration to protect older Americans. paramedics encouraging anyone aged 50 and over to get a second booster in recent weeks, and Introducing new models dispensing antiviral pills.

Elderly people and their doctors said that in much of the country, the support campaign was indifferent and erratic. Patients, many of whom have trouble driving or accessing the Internet, often have to maneuver through a labyrinthine healthcare system to get potentially life-saving antiviral drugs.

Covid deaths nationwide in recent weeks have averaged below 400 per day, close to pandemic lows. But the death gap between older and younger people has widened: Middle-aged Americans, who suffered the bulk of pandemic deaths last summer and fall, are now taking advantage of new stores of immune protection in the population, as Covid deaths are once again centered around the elderly. people.

And the new wave of Omicron subvariables may pose additional threats: Hospitalizations in younger age groups remain relatively low, while admission rates among people 70 and older in the Northeast have climbed to a third of the rising peak of the winter Omicron wave.

A geriatrician and professor of medicine at Harvard Medical School, Dr. “I think we’re going to see death rates increase,” said Sharon Inouye. “It will become increasingly risky for older adults as their immunity declines.”

Harold Thomas Jr., 70, of Knoxville, Tenn., is one of many older Americans whose immunity has been compromised because he did not receive a booster shot. The Covid States Project, an academic group, predicted in the near future Among people 65 and older, 13 percent were unvaccinated, 3 percent had a single Moderna or Pfizer vaccine, and 14 percent were vaccinated but not supplemented.

Mr. Thomas said that when the vaccines first arrived, the state health department gave the apartment community injections for older people, making the vaccines “available”. But he was unaware of such an effort for booster doses. On the contrary, he recalled that a government official raised public suspicion when boosters were made available.

“The government was unsure of the supporting shot,” he said. “If they’re not sure and they were the ones who brought it up, why should I?” Mr Thomas said Covid had recently killed a former boss and hospitalized an older family friend.

Deaths have fallen from the heights of the winter wave, in part due to increased immunity levels from past infections, experts said. There’s also a scarier reason for older people: Many of the most vulnerable Americans have been killed by Covid over the winter, and the virus now has fewer targets in this age group.

But scientists have warned that many older Americans remain susceptible. Geriatricians have urged nursing homes to arrange home vaccinations or have additional vaccinations to protect them.

In the long run, the scientists said, policymakers must address the economic and medical ailments that affect older Americans, especially of color, otherwise Covid will continue to shorten their lives so much.

Dr. “I don’t think we should see the premature death of older adults as a way to end the pandemic,” Stokes said. “There are still large numbers of vulnerable older adults – living with comorbid conditions or living in multi-generational households – highly vulnerable.”

This year’s model of Covid deaths recreated the dynamics in 2020 before vaccines were introduced, where the virus killed older Americans at significantly higher rates. Dr. Stokes and his collaborators found that early in the pandemic, death rates rose steadily with each passing age. last study.

This changed last summer and fall during the Delta surge. Older people were vaccinated faster than other groups: NovemberThe immunization rate among Americans aged 65 and older was about 20 percent higher than those in their 40s. And critically, these older Americans received the vaccine relatively recently, giving them strong levels of lasting protection.

As a result, older people suffered from Covid at lower rates than before vaccines were available. Dr. According to Stokes’ latest study, the death rate among people aged 85 and older last fall was about 75 percent lower than it was in the winter of 2020.

At the same time, the virus has ravaged younger and less vaccinated Americans, and many of them have returned to face-to-face work. Death rates in the late 30s for white people more than tripled last fall compared to the previous winter. Mortality rates for Black people in the same age group have more than doubled.

The rebalancing of Covid deaths was so evident that total deaths among Americans aged 80 and over returned to pre-pandemic levels in 2021. work published online in February. The reverse was true for middle-aged Americans: life expectancy in this group, which had fallen more than in the same age range in Europe, fell further in 2021.

“In 2021, you’re seeing the death toll of the pandemic change younger,” said Ridhi Kashyap, lead author of this study and a demographer at Oxford University.

When the highly contagious Omicron variant took over, the researchers said, it’s been a long time since the last Covid vaccines for older Americans, weakening their immune defenses.

As of mid-May, more than a quarter of Americans 65 and older had not received their last dose of vaccine in a year. And more than half of people in this age group have not been vaccinated in the past six months.

The Omicron variant was better than previous versions of the virus at circumventing already weakened immune defenses, reducing the effectiveness of vaccines against infection and more serious diseases. This was especially true for older people whose immune systems responded less aggressively to vaccines in the first place.

For some people, even three doses of vaccine appear to become less protective over time against Omicron-related hospitalizations. a study Recently published in The Lancet Respiratory Medicine It found that this trend holds for people with weakened immune systems, a category where older Americans are more likely to fall. Sara Tartof, lead author of the study and epidemiologist at Kaiser Permanente in Southern California, said that about 9 percent of people 65 and older in the study were immunocompromised, compared with 2.5 percent of adults under 50 years of age.

Dr. Stokes said that during the Omicron wave, Covid death rates for older Americans were once again much higher than for younger ones. Older people also accounted for an overwhelming portion of the excess deaths – the difference between the number of people who actually died and the number expected to die if the pandemic had never occurred.

D., an emergency room physician at Brigham and Women’s Hospital in Boston. Jeremy Faust was found in a hospital. last study That extreme deaths during the Omicron wave are more intense in people aged 65 and over than in the Delta surge. Overall, the study found that there were more deaths in Massachusetts during the first eight weeks of Omicron than during the 23-week period dominated by Delta.

As older people began to die at higher rates, Covid deaths included higher rates of vaccinated people. In March, about 40 percent of people who died from Covid were vaccinated, according to an analysis of figures from the Centers for Disease Control and Prevention.

Fewer older Americans became infected during the pandemic than younger people, resulting in lower levels of innate immunity. As of February, roughly one-third of people 65 and older showed previous evidence of infection, compared with nearly two-thirds of adults under 50.

Cases of long-ago Covid do not prevent future infections, but reinfected people are less likely to become seriously ill.

The drop in Covid measures this winter, combined with the high contagion of Omicron, has left the elderly more exposed, the scientists said. It is unclear how his own behavior has changed. A previous workA study from scientists at Marquette University suggested that while older people in Wisconsin once wore masks at higher rates than younger people, that difference actually disappeared by mid-2021.

Antiviral pills are now applied more, but it’s hard to know who benefits from them. The winter rise in Covid death rates among older Americans calls for a more urgent policy response, scientists said.

Harvard Medical School’s Dr. Inouye said she is still waiting for a notification from her mother’s assisted living facility about the availability of second booster vaccines, even as reports of staff being infected are starting to come in. But still, the director of the facility said a second booster shot was impossible without government guidance.

Eventually, his family had to arrange a trip to a pharmacy on their own for a second boost.

“It seems that the responsibility now falls entirely on the individual,” he said. “It’s not like it’s made easy for you.”



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