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The Younger Age Profile of COVID-19 Deaths in Developing Countries

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  • Findings have implications for confinement strategies, vaccine distribution

Young and middle-age adults in Latin America and the Caribbean have a greater chance of dying or getting seriously ill from Covid-19 than their peers in more developed regions, even as risks for other age groups are more similar, a new study by the Inter-American Development Bank shows.

The report uses data at country, city and patient levels to determine the mortality for Latin America's younger cohorts. If the region's young and middle-age adults had identical fatality and infection rates as richer countries, lockdowns that allowed them more freedom to move than older populations should be more effective in Latin America than in other countries.

The study, however, suggests this demographic advantage is less evident in reality as younger cohorts are more likely to have pre-existing conditions and live in more crowded, urban environments.

The findings also have implications for how countries determine risks when distributing the vaccine.

Younger age groups in Latin America and the Caribbean represent a significantly larger share of COVID-19 deaths relative to high-income countries. From the five developing countries with the most confirmed COVID-19 deaths, four are in Latin America. In this region, young and middle-age adults represent a larger share of each country's deaths than those cohorts do in the five high-income countries with the highest number of deaths. For example, for every 100 COVID-19 deaths in Colombia around 30 were people under the age of 60. Just 12 of every 100 COVID-19 deaths in the US correspond to people under 60.

The report shows that lower recovery rates in developing countries account for nearly all of the higher death shares among young adults, and for almost half of the higher death shares among middle-aged adults. This is driven by a higher prevalence of preexisting conditions that have been linked to more severe COVID-19 complications, and by more limited access to hospitals and intensive care units in some countries.

The paper also shows that the mortality age gap is explained by greater residential crowding and labor informality in cities.

"The high prevalence of morbidities and the limitations of healthcare services have made young and middle-age adults more vulnerable to the COVID-19 pandemic than in other regions of the world," said Juan Pablo Chauvin, a research economist at the IDB and one of the report's co-authors. "As countries determine how to best distribute their vaccines, our work suggests that in the developing world, age may not be a sufficient indicator of the COVID-19 mortality risk that a person faces. We need to also pay special attention to other factors --- such as preexisting conditions, housing conditions, and access to healthcare --- to protect lives as we move towards a much-needed economic recovery."