Despite higher COVID risk, active physicians had lower excess mortality than nonactive physicians

By Neha MathurReviewed by Aimee MolineuxFeb 8 2023

In a recent study published in the journal JAMA Internal Medicine, researchers calculated excess deaths due to coronavirus disease 2019 (COVID-19) among physicians in the United States of America (USA) between March 2020 and December 2021. They used data from the American Medical Association (AMA) for this analysis.

Research letter: Excess Mortality Among US Physicians During the COVID-19 Pandemic. Image Credit: SritanaN / Shutterstock

Background

In the USA, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-triggered pandemic has claimed over one million excess lives so far, i.e., the difference between the actual and expected deaths over a prespecified period. Physicians played a crucial role in providing care to COVID-19 patients throughout the pandemic, especially in the first year.

Besides work-related stress, they experienced excess mortality during the pandemic. However, studies barely investigated excess deaths among US physicians. Any future surges in COVID-19 cases might again strain hospitals, causing excess deaths in the general population. Thus, protecting physicians is also crucial to preventing excess deaths in the general population.

About the study

In the present study, researchers screened the AMA data to determine mortality among US physicians in the age group of 45 to 84 years between January 2016 and February 2020. They estimated expected deaths between March 2020 and December 2021 to calculate excess deaths among these physicians. They compared these estimates with excess deaths in the US general population.

The quasi-Poisson study model accounted for seasonality and long-term patterns within a year to arrive at these estimates. Next, the researchers annualized excess mortality estimates to excess deaths per 100,000 person-years. Finally, the researchers analyzed the study sample stratified by age and their area of expertise and also performed sensitivity analyses.

Results & conclusion

The US physician population screened during the study comprised 34.7% and 65.3% of females and males, respectively. Between March 2020 and December 2021, 622 more deaths than expected occurred among a monthly mean of 785631 physicians, corresponding to 43 excess deaths per 100000 person-years.

Among active physicians, excess death numbers rose to 70 in December 2020 before declining rapidly in 2021. However, after April 2021, US physicians suffered no statistically significant excess deaths, suggesting that the excess deaths declined with the availability of COVID-19 vaccines.

Irrespective of age, all US physicians had markedly lower excess deaths than the US general population. However, between active and nonactive US physicians, active ones had fewer excess deaths than nonactive ones even though they had a greater risk of contracting COVID-19. Accordingly, the excess deaths per 100,000 person-years in active physicians providing direct patient care was 27, while the same for nonactive physicians was 140.

Excess deaths among relatively older active physicians engaged in the direct care of COVID-19 patients were higher. Thus, public health policies should attempt to mitigate risk in this high-risk group on priority. Together, the study findings highlighted that preventive measures adopted at hospitals, such as mandatory use of personal protective equipment, adherence to infection prevention protocols, and adequate staffing, proved effective in preventing excess mortality among US physicians.