COVID-19 Age-Mortality Curves for 2020 Are Flatter in Developing Countries Using Both Official DeathCounts and Excess Deaths

Using official COVID-19 death counts for 64 countries and excess death estimates for 41countries, this paper finds a higher share of pandemic-related deaths in 2020 were at younger ages inmiddle-income countries compared to high-income countries. People under age 65 constituted on average (1) 11 percent ofboth official deaths and excess deaths in high-income countries, (2) 40 percent of official deaths and 37 percentof excess deaths in upper-middle-income countries, and (3) 54 percent of official deaths in lower-middle-incomecountries. These contrasting profiles are due only in part to differences in population age structure. Both COVID-19and excess death age-mortality curves are flatter in countries with lower incomes. This is a result of somecombination of variation in age patterns of infection rates and infection fatality rates. In countries with very lowdeath rates, excess mortality is substantially negative at older ages, suggesting that pandemic-related precautionshave lowered non-COVID-19 deaths. Additionally, the United States has a younger distribution of deaths than countrieswith similar levels of income.