Pediatric deaths in New York and New Jersey plummeted during the first year of Covid-19, leading the nation.
Children are the only age bracket that did not record more deaths than usual during the initial 12 months of the pandemic.
In the first year of the Covid-19 pandemic, 3.5 million US residents died from all causes combined. In a typical 12-month period around 2.9 million US residents are expected to die. This means that there was a 20% increase in all deaths nationwide from March, 2020, through February 2021. Covid-19, of course, was responsible for a vast majority of these deaths and was the 3rd leading cause of death overall in 2020 in the US.
It turns out that there were more deaths than usual in nearly every major age group in the US. While seniors had the most deaths numerically, the largest increase from normal occurred, surprisingly, among young adults.
The exception to all of this? Kids. Numerically, fewer children died in the first year of the Covid-19 pandemic than died in recent years, though we have not assessed whether that decrease was statistically meaningful. (The lower rate is certainly “statistically significant,” but pediatric deaths have been slowly declining for years, and my team hasn't checked whether the lower pediatric death rate during the first year of the pandemic was a continuation of the ongoing trend or a further improvement on top of it).*
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I spent some time looking at the numbers tonight. Something jumped out as I looked at the ten regions that the US Department of Health and Human Services divides the country up into. The region of the country that had the fewest all-cause pediatric deaths during the first year of the Covid-19 pandemic was HHS Region #2, which is New York and New Jersey. Together, New York and New Jersey recorded 16% fewer pediatric deaths in the first year of the pandemic than they had in recent years, even after correcting for the declining population. Like the rest of the nation, HHS Region #2 has had a heartening and steady decline in annual pediatric deaths over the last 20 years or more. But it looks like the first year of the pandemic was more than just a continuation of that trend, (though again, we have not yet officially confirmed that). Regardless, 1,949 children in New York and New Jersey died from March 2020 through February 2021, down from an average of 2,316 during the previous 6 years.
A 16% relative decrease in pediatric mortality is both a small and large figure, depending on how you view it. In recent years, around 392 out of every million kids in HHS Region #2 died every year. During the first year of Covid-19, just 330 per million kids died. That’s the 16% decrease (330/392=84%, or a 16% drop). Of course, you could minimize the magnitude of this all by noticing that this change “merely” translates to a 0.006% change at the population level; in other words, 0.033% of children in the HHS Region #2 died during the first year of the pandemic, instead of 0.039%. But when you run the numbers out, that adds up to 367 fewer dead kids. That’s not trivial. If the entire country had done as well as HHS Region #2, over 3,200 more children would be alive today. That’s remarkable and sad to consider.
Meanwhile, the raw data indicate that 8 other HHS regions recorded at least some decrease in child mortality rates during the first year of the pandemic, though all them were less than 10% lower than previous years. The one region that recorded what looks like a meaningful increase was HHS Region #7 (Iowa, Missouri, Nebraska, and Kansas), at around 4%.
It’s going to take some time to iron out how statistically meaningful all of these findings are. But it’s conspicuous that HHS Region #2 would happen be the place with the largest decrease in pediatric mortality during year one of the pandemic. This was a region whose adults were hit hard, and where a long shelter-in-place period was enacted. And even since re-opening, New York and New Jersey residents have been reticent to resume life as normal. Even now, there remains much less indoor dining than usual there, and working from home has continued. And, sadly, schools in the region were not open much in the first year of the pandemic, first due to delays in re-opening and then because of frequent closures when outbreaks occurred.
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Right now, I have no idea why the decrease in pediatric mortality occurred in the first year of the Covid-19 pandemic both in New York, New Jersey, or elsewhere. Was it fewer illnesses from respiratory diseases due to better hygiene and masks? Or was it something else completely? We tend to think of pandemic mitigation in terms of how many lives we might be preventing from being lost due to Covid. That’s difficult to measure, because the outcome of the counterfactual (i.e. the parallel universe in which less mitigation is done) can’t be known. But these data suggest that a non-trivial number of pediatric lives may have been saved as a result of the overall changes in our behaviors during the pandemic. Pandemic living may not be life at its best, but when Covid is factored out, it might very well turn out to be life at its safest.
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*I work with a wonderful team of researchers at Harvard and Yale studying this.