COVID continues to exact heavy toll on older US adults

COVID has NOT gone away - it kills 100,000+ Americans every year

Laine Bergeson

Even after the COVID-19 public health emergency ended in May 2023, the virus continued to cause millions of illnesses and more than 100,000 deaths annually from October 2022 to September 2024, with the majority of severe outcomes and deaths concentrated among older adults, according to a new study published in JAMA Internal Medicine.

Using hospitalization data from the COVID-19 Hospitalization Surveillance Network, which covers approximately 10% of the US population, a Centers for Disease Control and Prevention research team estimated that COVID caused roughly 43.6 million illnesses, 10 million outpatient visits, 1.1 million hospitalizations, and 101,300 deaths during the 2022–23 respiratory illness season. 

In the following season, COVID-related illnesses declined to roughly 33 million, outpatient visits fell to 7.7 million, and hospitalizations dropped to 879,100. But the number of deaths in the 2023–24 respiratory season—an estimated 100,800—remained essentially the same.

Adults 65 years and older shouldered a disproportionate share of the burden. Although they make up less than 20% of the US population, older adults accounted for nearly half (47.5%) of all COVID illnesses, roughly two-thirds (67.5%) of hospitalizations, and over 80% of deaths (81.3%) during the study period. On average, approximately 1 in 100 adults aged 65 years and older were hospitalized for COVID each year.

“While COVID-19 burden estimates from October 2022 to September 2023 and from October 2023 to September 2024 indicate declines in hospitalizations and deaths compared with earlier years during the COVID-19 pandemic, a substantial burden of COVID-19 disease persisted in the US in this period,” write the authors, adding that the virus “continues to disproportionately affect people 65 years and older whose immunity may wane faster than younger adults.”

COVID still major threat to older Americans

In an accompanying commentary, David C. Grabowski, PhD, of Harvard Medical School, said the results make clear that COVID should still be viewed as a major threat to older Americans. 

“COVID-19 has had particularly devastating consequences for older adults, especially those frailest individuals receiving care in post-acute and long-term care facilities,” he writes. “Based on the findings…we can assume COVID-19 will continue to have a major impact on health care use and mortality for the foreseeable future. Moreover, this impact will continue to be concentrated among older adults.”

Grabowski emphasizes that vaccines and antiviral treatments are effective at preventing severe disease and death, particularly in high-risk groups. But uptake among vulnerable populations has lagged. Only about 30% of nursing home residents are up to date with COVID booster doses, and just 17.9% of adults are up to date. What’s more, vaccine hesitancy is common among nursing home staff, with only about 7% current on their vaccines.

Both the study and commentary emphasize the need for prevention measures, calling for a renewed focus on vaccination and increased access to antiviral treatments for high-risk populations, as well as investments in safer long-term care environments.