Early in the COVID-19 pandemic, 622 more US physicians died than expected, but no excess deaths occurred after April 2021, when vaccines were broadly available, finds a study yesterday in JAMA Internal Medicine.
Stanford University researchers led the analysis of American Medical Association monthly death data from January 2016 to February 2020 among active and nonactive physicians aged 45 to 84 years. The team used this model to estimate expected deaths from March 2020 to December 2021 and then calculated excess deaths.
Older working physicians most at risk
From March 2020 to December 2021, 4,511 physicians died, representing 622 excess deaths among a monthly average roster of 785,631 physicians, and 43 excess deaths per 100,000 person-years. Of the physicians who died, 65.3% were men.
Of note, however, physicians of all age-groups had substantially lower excess death rates than the general population. There was a steep age gradient among working physicians providing direct patient care, with 10 excess deaths per 100,000 person-years in the youngest age-group and 182 in the oldest.
The findings suggest that personal protective equipment use, vaccine requirements, infection prevention protocols, adequate staffing, and other workplace-based protective measures were effective.
Nonworking physicians had the highest excess death rate (140 per 100,000 person-years), compared with 27 among active physicians providing direct patient care and 22 among active physicians not providing direct patient care. Among all active physicians, excess deaths peaked at 70 per 100,000 person-years in December 2020 and then rapidly declined. No excess deaths occurred after April 2021.
"The findings suggest that personal protective equipment use, vaccine requirements, infection prevention protocols, adequate staffing, and other workplace-based protective measures were effective in preventing excess mortality," the researchers wrote.
The authors noted that their findings could be underestimates due to unreported physician deaths and older physicians choosing early retirement.
"During COVID-19 surges, these conditions may strain hospitals, resulting in excess deaths in the general population," they wrote. "Preventing excess deaths among physicians is an important component of mitigating excess deaths in the general population."