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Dying From COVID-19: Are You Still At Risk?

By Robin Jaffin, on February 16, 2025

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The landscape of COVID-19 mortality has evolved dramatically since the start of the pandemic. In 2023, the United States saw a substantial decline in COVID-19 deaths, with the virus moving from the fourth to the tenth leading cause of death in the country.

This shift represents a 68.9% reduction in COVID-19 fatalities compared to the previous year.

According to the CDC, COVID-19 deaths decreased from approximately 246,000 in 2022 to 76,000 in 2023, marking a 69% drop. This notable decline can be attributed to a combination of factors, such as broad vaccination efforts, more effective treatment protocols, and the possibility that newer variants circulating in 2023 are less virulent than earlier strains.

Even with this positive development, it’s important to emphasize that COVID-19 still poses a serious health risk, especially for those in high-risk categories. The virus remains a significant cause of death, underlining the ongoing need for vigilance and preventive measures.

The Global Picture

Young African American woman getting flu shot during seasonal vaccination campaign. Doctor or nurse in medical face mask cleans skin on patient's arm before injecting modern Covid 19 antiviral vaccine
Photo Credit Studio Romantic via Shutterstock

Global data reveals a similar downward trend, though outcomes vary widely by region. According to Our World in Data, reported COVID-19 deaths have declined globally, yet the true toll may be underestimated due to discrepancies in testing, reporting, and healthcare infrastructure worldwide.

Mortality trends can also shift if new variants arise, local public health measures change, or seasonal factors come into play. The CDC continues to monitor COVID-19 fatalities through its provisional mortality surveillance system, providing regularly updated information to track these developments.

Despite the overall improvements, health experts continue to warn against complacency. The virus remains capable of rapid mutations, and new variants could alter current patterns. Continued surveillance, vaccination, and adherence to recommended public health practices will be vital to maintaining the downward trend in COVID-19 mortality.

Age and Health Risks

senior woman wearing mask.
Lubo Ivanko via Shutterstock.

Age is still the most significant predictor of severe COVID-19 outcomes, with the likelihood of severe illness and death rising substantially among older adults. Compared to people aged 18–29, those in the following age groups face a markedly higher risk of death:

  • 50–64 years: 25 times higher
  • 65–74 years: 60 times higher
  • 75–84 years: 140 times higher
  • 85+ years: 340 times higher

Additionally, individuals with certain underlying health issues are at increased risk, particularly those with:

  • Cardiovascular diseases
  • Diabetes
  • Chronic lung conditions
  • Cancer
  • Chronic kidney disease
  • Immunocompromised states

When multiple chronic conditions overlap, the danger of severe COVID-19 outcomes is compounded further.

Racial and Socioeconomic Disparities

The pandemic has underscored and, in many cases, worsened existing racial and socioeconomic health disparities. Certain communities continue to experience disproportionately higher rates of severe COVID-19 illness and mortality due to a range of factors, including:

  • Access to healthcare
  • Occupational hazards (essential workers in high-contact roles)
  • Crowded living situations
  • Limited transportation options
  • Higher prevalence of underlying health conditions

Research has consistently shown that Black, Hispanic, and Native American populations have faced higher rates of hospitalization and death compared to White populations. Earlier in the pandemic, Black Americans were 3.7 times more likely to be hospitalized and 2.8 times more likely to die from COVID-19 than White Americans. Socioeconomic status often magnifies these disparities, as individuals from lower-income backgrounds may have fewer healthcare resources and face greater exposure risks.

Even though overall COVID-19 mortality rates have dropped since 2022, these inequities persist. The CDC stresses the importance of targeted interventions, such as improving vaccine accessibility and addressing social determinants of health, as part of a broader effort to reduce the disproportionate impact on vulnerable communities.

It’s crucial to recognize that these disparities stem largely from systemic inequities, not inherent biological differences. Achieving health equity calls for both immediate actions—like expanded vaccination campaigns—and long-term strategies to address the social and economic conditions that drive these risks.

Impact of Vaccination Status

Giving vaccine.
Image credit Ground Picture via Shutterstock.

Vaccination remains a key factor in determining an individual’s risk of severe illness and death from COVID-19. Although overall mortality has fallen sharply, unvaccinated individuals continue to face notably higher risks of hospitalization and fatal outcomes compared to those who are fully vaccinated and boosted.

CDC data indicates that unvaccinated adults aged 65 and older are about seven times more likely to be hospitalized with COVID-19 than their fully vaccinated and boosted peers. Similarly, a study published in JAMA Network Open found that COVID-19 deaths among unvaccinated individuals were nine times higher than among those who had received at least a primary vaccine series.

While breakthrough infections do occur, most vaccinated people experience milder symptoms. Those who develop severe illness despite vaccination often have multiple underlying conditions or are immunocompromised, highlighting the need for ongoing precautions in these groups.

Vaccine effectiveness can wane over time and may be influenced by emerging variants, underscoring the importance of booster doses. Though no vaccine can eliminate risk entirely, widespread vaccination efforts have played a crucial role in the substantial reduction of COVID-19 deaths in 2023.

Long COVID and Its Implications for Mortality

Narcolepsy. Tired. Exhaustion.
Image credit Agenturfotografin via Shutterstock.

“Long COVID” refers to the persistence of symptoms for weeks or months following an initial infection. While the mechanisms behind long COVID are still being studied, mounting evidence suggests that it can affect multiple organ systems and raise the risk of long-term health complications.

  • Increased Mortality Risk: Individuals with long COVID are more likely to experience serious health outcomes, including a higher risk of death compared to those who never had COVID-19. In one study, 2.8% of long COVID patients died within a year of infection, compared to 1.2% of non-COVID-19 patients.
  • Prevalence: Research suggests that up to 80% of COVID-19 patients may have some lingering symptoms, although the severity and duration vary widely.
  • Ongoing Monitoring: The CDC estimates that long COVID contributed to 3,544 deaths in the United States from January 2020 through June 2022, underscoring the need for continued surveillance and support.

Long COVID can strain healthcare systems by increasing the number of people who require extended medical care, rehabilitation, or disability services. For the individuals affected, quality of life can be significantly diminished, making it critical to address long COVID through focused research, clinical guidelines, and social support systems.

The Role of Emerging Variants in COVID-19 Severity

New SARS-CoV-2 variants continue to shape the pandemic’s trajectory. While earlier strains like Alpha, Beta, Gamma, and Delta often correlated with higher hospitalization risks, later variants such as some Omicron lineages have shown differing patterns:

  • Higher Risks with Early Variants: Gamma, in particular, was linked to a hospitalization risk more than three times higher than ancestral strains.
  • Omicron and Beyond: The Omicron variant generally did not exhibit significantly higher hospitalization rates compared to earlier forms. Recent variants (e.g., JN.1, HV.1) appear to result in lower hospitalization risk, although their high transmissibility can still drive up total infection numbers.

Vaccination remains pivotal in lessening the impact of new variants. Although vaccine effectiveness may decline against certain strains or as time passes from the last dose, being up-to-date with boosters offers protection that significantly reduces the likelihood of severe disease and death.ting the importance of staying up-to-date with booster doses.

In Conclusion

Graphic of fighting COVID.
Image credit Lightspring via Shutterstock.

Although COVID-19 mortality rates have notably dropped from their peak—falling from the fourth to the tenth leading cause of death in the United States—this does not mean the threat has disappeared. Certain populations, such as older adults and those with preexisting health issues, remain at elevated risk of severe illness. Socioeconomic and racial disparities also persist, emphasizing the need for targeted interventions and broader structural changes.

Key factors in maintaining and furthering these positive trends include:

  1. Continuing Public Health Measures: Masking in high-risk environments, practicing good hand hygiene, and staying informed about local guidelines.
  2. Ongoing Vaccination Efforts: Encouraging booster shots, reaching underserved communities, and monitoring vaccine efficacy against emerging variants.
  3. Addressing Disparities: Implementing strategies that reduce healthcare barriers and tackle underlying social determinants of health.
  4. Surveillance of Variants: Tracking new strains to understand their severity and transmissibility.
  5. Long COVID Research and Support: Providing adequate resources and care for individuals with prolonged symptoms.

By staying vigilant and adapting our strategies, it’s possible to build on the progress seen in 2023 and continue reducing COVID-19’s impact on public health. The significant drop in mortality offers a reason for optimism but also a reminder that focused, consistent efforts are needed to protect the most vulnerable and sustain these hard-won gains.

Sources and Resources

Below is a list of potential sources referenced or alluded to in the updated article.

1. Centers for Disease Control and Prevention (CDC)

  1. CDC Provisional Mortality Data
  2. CDC COVID Data Tracker
  3. CDC on Underlying Medical Conditions
  4. CDC on COVID-19 Vaccines and Immunizations
  5. Long COVID Deaths Data

2. Our World in Data

  • Coronavirus Pandemic (COVID-19) Data

3. JAMA Network Open (Vaccination Efficacy and Mortality Studies)

  1. COVID-19 Vaccine Effectiveness / Mortality in Unvaccinated vs. Vaccinated
    • For example:
    • These or similar studies have found marked differences in hospitalization and mortality risks between vaccinated and unvaccinated populations.

4. Research on Long COVID and Mortality Risks

  1. Nature Medicine / BMJ / JAMA Articles on Long COVID
    • E.g., Al-Aly, Z., Bowe, B., & Xie, Y. (2022). Outcomes of COVID-19 survivors 12 months after infection. Nature Medicine, 28(7), 1401–1411.
      https://www.nature.com/articles/s41591-022-01795-5
    • Davis, H. E., et al. (2021). Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine, 38, 101019.
      https://doi.org/10.1016/j.eclinm.2021.101019
    • These and similar publications detail increased mortality risks and long-term health impacts in individuals with post–COVID-19 conditions.

5. Variant-Specific Hospitalization and Severity Studies

  1. CDC: SARS-CoV-2 Variant Classifications and Definitions
  2. Peer-Reviewed Studies on Variants
    • Funk, T., et al. (2021). Characteristics of SARS-CoV-2 variants of concern and variants under investigation in England. Public Health England.
    • Nyberg, T., et al. (2022). Comparative analysis of the risks of hospitalization and mortality from all variants of concern and other variants of SARS-CoV-2 in England. BMC Medicine, 20, 250.
      https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-022-02438-x
    • Such sources discuss how variants like Alpha, Beta, Gamma, Delta, and Omicron compare in terms of transmissibility and severity.

6. Disparities and Social Determinants of Health

  1. CDC: COVID-19 Racial and Ethnic Health Disparities
  2. Kaiser Family Foundation (KFF)
  3. Peer-Reviewed Analysis of Racial/Ethnic Disparities
    • Rodriguez-Diaz, C. E., et al. (2020). Risk for COVID-19 infection and death among Latinos in the United States: examining heterogeneity in transmission dynamics. Annals of Epidemiology, 52, 46-53.e2.
    • Price-Haywood, E. G., Burton, J., Fort, D., & Seoane, L. (2020). Hospitalization and mortality among Black patients and White patients with COVID-19. New England Journal of Medicine, 382, 2534–2543.

7. Additional Context and Reports

How to Use These Sources

  • CDC Dashboards and Provisional Data: For the latest national counts of cases and deaths, plus demographic breakdowns.
  • Our World in Data: For global comparisons and to see how different countries stack up in terms of cases, tests, and fatalities.
  • Peer-Reviewed Journals (JAMA, The Lancet, BMJ, Nature): For in-depth studies on vaccine effectiveness, long COVID, and variant-related outcomes.
  • KFF and Other Health Equity Resources: For data and policy analysis on racial and socioeconomic disparities in COVID-19 outcomes.

By consulting these sources, you can verify the data points mentioned in the article and gain a broader understanding of the evolving COVID-19 situation, both in the United States and worldwide.