National Opinions

The delta wave is tough on kids, but deadly for the middle-aged

A lot of kids have been getting covid-19 in the U.S. this summer, thanks to the more-transmissible delta variant, the full return to in-person schooling and the unvaccinated status of virtually every American under 12. Those under 18 accounted for 28.9% of reported covid cases in the first week of September, according to the American Academy of Pediatrics, more than their 22.2% share of the population and much more than their 15.5% share of cumulative cases since the beginning of the pandemic.

Happily, though, children still seem to be accounting for a tiny share of covid deaths.

The current U.S. wave of covid deaths does not yet appear to have peaked even though cases and hospitalizations may have, and the CDC’s deaths-by-age data lag the headline numbers by several weeks. This makes it much too early to say how dangerous this latest wave has been for different age groups relative to other threats such as influenza, heart disease and car crashes. When I last made such a comparison in March, it showed covid’s 2020 toll to have been far worse for U.S. adults than just about any major cause of death in a normal year (the exception was heart disease), but much less so for children.

The 2021 covid-19 death toll for Americans under 18 is already higher than for all of 2020, even though overall covid deaths are still lower, so the relative risk numbers will clearly look different for this year. But the under-18 death toll also remains very small (241 so far this year versus 198 in 2020) and most of that increase has been among teenagers, so I would guess that while covid may turn out to be deadlier for kids this year than an average year of flu and pneumonia, it’s unlikely that it will kill nearly as many children as automobiles usually do. Also yes, there are lots of possible adverse effects of covid short of death, but American Academy of Pediatrics data on covid hospitalizations and a new U.K. Office for National Statistics study of “Long-Covid” symptoms indicate that children continue to experience both at far lower rates than other age groups.

Another thing that is clear from the changes in the distribution of covid deaths by age is that the pandemic has shifted from being most dangerous for the oldest Americans to targeting the next few age groups below them.

The vaccines surely explain most of the subsequent shift in the age distribution of covid deaths. They were first made available to senior citizens, who remain the most likely to be vaccinated (yes the age groups used here are somewhat different than above; that’s just how the CDC reports it).

Vaccinations clearly don’t explain everything. Those ages 65 through 74 have the highest vaccination rate, but have seen their share of covid deaths go up slightly since March. That’s probably because they’ve been getting out more than their elders, and also because the nursing home outbreaks that were responsible for a large share of the deaths among those 75 and older have become much less deadly thanks to high vaccination rates and regular testing at the nursing homes, as well as the sad fact that so many of the most vulnerable nursing home residents already succumbed to earlier pandemic waves.

The age groups with the biggest increases in the share of covid-19 deaths, though, are those from 35 through 64. Simply compare the numbers of covid deaths this year with those for all of 2020, meanwhile, and every age group under 55 has seen a rise in covid deaths in 2021 (which is far from over!), with the biggest jumps among those 25 through 54.

These people are less likely to be vaccinated than their elders and more likely to be exposed to covid-19 at work, at play, at home with the kids and elsewhere. They’re also far less likely to succumb to the disease if they get it, but the risks for unvaccinated adults aren’t negligible. Kids have even lower vaccination rates and probably even more opportunities to catch covid, but their immune systems are much better equipped to fight off the virus. Covid still doesn’t seem to be a huge threat to kids and very-young adults, but it definitely isn’t just an old person’s disease.