Far more Long Islanders died from COVID-19 this past summer than during the summers of 2020 and 2021, data shows, and doctors said those dying are mostly unvaccinated and vaccinated, but unboosted, people with weakened immune systems.
The increasing abandonment of mask-wearing and other precautions, coupled with highly infectious omicron variants, are pushing COVID-19 positivity rates higher, contributing to the larger death toll, experts said.
From June 1 to Sept. 21, 304 Long Islanders died of COVID-19, according to state Department of Health data. That’s 46% higher than the 208 who died in the same time period in 2021, and 67% more than the 182 who passed away in the same period in 2020, before vaccines were available. Statewide death numbers also are up.
The numbers are significant because summer — when people tend to spend more time in lower-risk outdoor settings — is when COVID-19 positivity rates and deaths typically are lowest, but this year they were lower in the late winter and early spring.
WHAT TO KNOW
- The death toll from COVID-19 on Long Island and in New York State is much higher this summer than in previous summers, state data shows. Hospitalizations also are up.
- Unvaccinated people are still at the highest risk of death by far, data shows. But vaccinated older adults and people with certain health conditions are at risk if they’re not up-to-date on boosters, experts say.
- Experts say the lack of mask-wearing and other precautions, along with highly infectious omicron variants, are helping fuel the increase.
COVID-19 hospitalizations on Long Island and statewide also have been much higher than in previous summers.
Even so, the number of COVID-19 deaths on Long Island for all of 2022 through September is lower than for the same period of time in 2021 and 2020. But there’s no way to know if a more lethal version of the virus could emerge in the future, pushing death rates up higher than expected, said Dr. Bruce Farber, chief of public health and epidemiology for Northwell Health.
Nationwide this past summer, an average of 300 to 500 Americans died every day of COVID-19, Centers for Disease Control and Prevention statistics show.
Yet there’s little sense of urgency about the consistently high death toll, said Denis Nash, a professor of epidemiology at the CUNY School of Public Health in Manhattan.
“We’ve certainly become inured to the staggering number of deaths that continue to occur over time,” he said.
Statements — or lack of attention to COVID-19 — by public officials, such as President Joe Biden on Sept. 18 declaring that “the pandemic is over,” are influencing New Yorkers to take the disease less seriously, leading to fewer people wearing masks and avoiding crowded indoor spaces, Nash said. It also may be causing some to question the need to get initial vaccines or booster shots, he said.
That, combined with more infectious variants, translates into more cases — COVID-19 positivity rates consistently have been high on Long Island for months — and more deaths than in previous summers, he said.
“Messaging is key,” Nash said. “It affects people’s individual behaviors.”
World Health Organization Director-General Tedros Adhanom Ghebreyesus responded to Biden’s remark four days later by insisting that the pandemic is not over.
"They’re both right,” said Dr. Aaron Glatt, chairman of medicine and chief of infectious diseases at Mount Sinai South Nassau hospital in Oceanside.
Unvaccinated people, and older adults and people with certain health conditions, “are the people to which we unfortunately have to say, quote, the pandemic’s not over,” Glatt said.
Someone up-to-date on boosters is highly unlikely to die, he said. But many of the vaccinated people most vulnerable to severe COVID-19 — such as older adults — have not received an additional shot recently, he said.
“If somebody got their booster last summer [in 2021] when the boosters came out and they haven’t gotten another one and they’re 85 years old, they’re going to be at much higher risk,” he said.
Immunity from vaccination or a COVID-19 infection wanes over time, and for some people with less robust immune systems, protection can go away entirely, said Dr. Sharon Nachman, chief of pediatric infectious diseases at Stony Brook Medicine. Older adults, people with certain health conditions and people taking immunosuppressive medications are particularly vulnerable, she said. For them, she said, a booster “can be lifesaving” and is just as important as the initial vaccinations.
People 50 and older with one booster dose are twice as likely to die of COVID-19 as someone with two booster doses, CDC data from July shows. Unvaccinated people are 12 times more likely to die than someone with two boosters. Yet fewer than 36% of those 50 and older eligible for a second booster have gotten one, CDC data shows.
After adults 65 and older became eligible for vaccines in early 2021, their death rates fell much more sharply than the death rates for younger adults.
Early in the pandemic, someone 75 and older was 43 times more likely to die of COVID-19 than a person in their 40s. By May 2021, they were only 11 times more likely to die, CDC statistics show.
“That group got the biggest benefit from the vaccine,” Glatt said of seniors. “When you’re preventing death in the highest-risk patients, you’re going to get a tremendous amount of benefit from that.”
But the gap today is back where it was in the spring of 2020, with people 75 and older 40 to 60 times more likely to die than people in their 40s.
One reason may be because most older people are not up-to-date on their boosters, Glatt said.
Older adults are at higher risk for other contagious diseases as well, including the flu. But “COVID is much more contagious and much more deadly" than the flu, Farber said.
There were an estimated 12,000 to 52,000 flu deaths a year during the decade before the pandemic, according to CDC data.
Modeling shows that the country is on track to see between 110,000 and 180,000 COVID-19 deaths a year, he said.
There were nearly 385,000 COVID-19 deaths in 2020, before vaccines became widely available, and about 460,000 in 2021, according to the CDC’s National Center for Health Statistics. Deaths typically rise during colder weather, when people spend more time indoors, where the risk of transmission is higher.
On Long Island, there have been 1,403 COVID-19 deaths so far this year. In all of 2021, there were 2,513 deaths, and in 2020, there were 4,712, according to state health department data.
This year's COVID-19 death rate would be much higher if it weren’t for widespread immunity from vaccinations and from previous coronavirus infections, and for treatments such as the drug Paxlovid, Farber said.
In addition, he said, “Omicron is a less virulent virus and much less deadly than delta," the dominant variant before omicron.
COVID-19 death numbers are not exact. The state’s numbers for counties are based on deaths reported by health care facilities each day and don’t include, for example, deaths at home. Any death within two weeks of a positive COVID-19 test, or a post-mortem positive result, is considered a COVID-19 death, according to the state health department.
The state also sends death certificate information to the CDC. The CDC lists any death in which COVID-19 is listed as a cause of death as COVID-related, whether it is determined to be the “underlying” or “contributing” cause, said Robert Anderson, chief of the mortality statistics branch at the National Center for Health Statistics. "Underlying" — about 90% of COVID-19 deaths in 2021 — means COVID-19 initiated the chain of events leading to death, while "contributing" means the virus may have, for example, exacerbated an existing disease and played some role in the death, he said.
Even so, Nash said, some doctors may not list COVID-19 on a death certificate, even if the virus may have helped precipitate a death from a stroke or other cause.
Nachman is concerned that many people appear to be paying little attention to COVID-19.
Young adults may not realize that even if they don’t die from COVID-19, they are at risk of long COVID, which is when symptoms, in some cases debilitating, can linger for months or years, she said. Nearly 1 in 5 U.S. adults reported having COVID-19 symptoms at least three months after their infection, according to a CDC analysis of June federal surveys. The causes of long COVID are still being studied.
There’s also the common belief, even among some people at risk for severe COVID-19, that “‘I’m just going to shake this virus off. All my friends had it and they’re fine,’ ” Nachman said.
But COVID-19 affects each person differently, she said. And vulnerability to severe COVID-19 changes over time. Someone who wasn’t highly vulnerable two years ago may be now, because of a new diagnosis of lupus, cancer, diabetes or other disease, Nachman said.
After Biden's "pandemic is over" statement, experts disagreed as to whether he was right. But whether COVID-19 is still a pandemic really is a matter of semantics, Nachman said. No matter what it’s called, she said, it will continue to be dangerous for some people — and it will continue to kill.