To examine whether the age distribution of COVID-19 deaths and the share of deaths in nursing homes changed in the second versus the first pandemic wave.
We considered all countries that had at least 4000 COVID-19 deaths occurring as of November 25, 2020, at least 200 COVID-19 deaths occurring in the first wave period, and at least 200 COVID-19 deaths occurring in the second wave period; and which had sufficiently detailed information available on the age distribution of these deaths. We also considered countries with data available on COVID-19 deaths of nursing home residents for the two waves.
MAIN OUTCOME MEASURES:
Change in the second wave versus the first wave in the proportion of COVID-19 deaths occurring in people <50 years old among all COVID-19 deaths and among COVID019 deaths in people <70 years old; and change in the proportion of COVID-19 deaths in nursing home residents among all COVID-19 deaths.
Data on age distribution in eligible locations were available for 11 countries. Individuals <50 years old tended to have a larger share in the total COVID-19 deaths in the second wave than in the first wave in western European countries and the USA, but the absolute difference did not exceed 0.5% in any country. The proportion of deaths in individuals <50 years old was higher in Turkey and Ukraine, but it decreased in the second wave. Separate data on nursing home COVID-19 deaths for first and second waves were available for 9 countries. With the exception of Australia, the share of COVID-19 deaths that were accounted by nursing home residents decreased in the second wave, and the decrease was significant and substantial (relative risk estimates: 0.28 to 0.78) in 7/9 countries.
In the examined countries, age distribution of COVID-19 deaths has been fairly similar in the second versus the first wave, but the contribution of COVID-19 deaths in nursing home residents to total fatalities has decreased in most countries in the second wave.
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