A CLOSER LOOK
EDITORIAL ADVISOR : Chad T . Rodgers , MD , FAAP , CPE Impact of COVID-19 on Deaths in Arkansas
AUSTIN PORTER , DRPH ; JON GRAVELY , MPH ; JENNIFER DILLAHA , MD
A t the time of this writing , the COVID-19 pandemic has been associated with more than 4.7M deaths worldwide and more than 700,000 deaths occurring in the U . S . 1 Deaths attributed to COVID-19 would account for more than 7,700 deaths in Arkansas . 1 Within the first year of the pandemic , there were approximately 5,600 COVID-19- related deaths in the state . Using the latest available data highlighting the leading causes of deaths from the Centers for Disease Control and Prevention ( CDC ) for 2019 , deaths in Arkansas due to COVID-19 rank third after heart disease ( 8,669 ) and cancer ( 6,482 ). 2 Deaths associated with COVID-19 are determined using the definition as outlined by the Council for the State and Territorial Epidemiologists and adopted by the CDC . 3
Those tracking the pandemic trends have indicated that deaths are a lagging indicator that will typically peak after the peak in cases . 4 There have been two notable case peaks in Arkansas . The first peak occurred on January 9 , 2021 , when the seven-day rolling average ( 7-DRA ) was 3,085 new cases . The peak in mortality followed six days later , resulting in a 7-DRA of 44 deaths . The second peak , which primarily resulted from the Delta variant , occurred on August 6 , 2021 , when the 7-DRA for cases was 2,350 , resulting in a 7-DRA peak in mortality of 30 deaths ten days later .
AGE OF DECEDENTS
There were stark differences in the age groups of those who died from complications of COVID-19 during the two peaks ( Figure 1 ). Those who died in January were , on average , older compared to those who died in August . The mean age of decedents in January was 75.7 years compared to 66.6 years in August , a difference of nine years . Approximately 83 % of deaths in January were among those who were 65 years and older compared to 58 % in August . Less than 1 % of those who died in January were 18-29 years old . This proportion increased to 2.1 % in August for this age group . Decedents 30-39 years old accounted for less than 0.5 % of COVID-related deaths in January and 2.8 % in August . Among those who died in January , 2.5 % were 40-49 years old compared to
8.0 % in August . Similarly , decedents 50 – 64 years old accounted for 13.4 % of the deaths in January and 28.6 % in August . With the exception of Arkansans under the age of 18 and those 65 + years old , all other age groups saw increases in the proportion of deaths during the August peak compared to January . There are two possible explanations for these trends , vaccinations and the Delta variant .
VACCINATIONS AND DELTA VARIANT
The Delta variant was associated with a higher proportion of younger people dying from the virus , mainly because those 65 years and older were more likely to be vaccinated . 5 By the end of August , more than two-thirds of Arkansans 65 years and older were fully vaccinated . 6 This percentage drops to 47.7 % when the eligible population ( 12 years and older ) are included , indicating lower vaccination rates among the younger population . 6 The available vaccines ( Pfizer / BioNTech , Moderna , and Janssen ) have been shown to be highly effective in reducing severe illness and death . 7 , 8 In Arkansas ,
156 • The Journal of the Arkansas Medical Society www . ArkMed . org