The Younger Age Profile of COVID-19 Deaths in Developing Countries

This paper examines why a larger share of COVID-19 deaths occurs among young and middle-aged adults in developing countries than in high-income countries. Using novel data at the country, city, and patient levels, we investigate the drivers of this gap in terms of the key components of the standard Susceptible-Infected-Recovered framework. We obtain three main results. First, we show that the COVID-19 mortality age gap is not explained by younger susceptible populations in developing countries. Second, we provide indirect evidence that higher infection rates play a role, showing that variables linked to faster COVID-19 spread such as residential crowding and labor informality are correlated with younger mortality age profiles across cities. Third, we show that lower recovery rates in developing countries account for nearly all of the higher death shares among young adults, and for almost half of the higher death shares among middle-aged adults. Our evidence suggests that lower recovery rates in developing countries are driven by a higher prevalence of preexisting conditions that have been linked to more severe COVID-19 complications, and by more limited access to hospitals and intensive care units in some countries.