Many at Risk for Severe COVID-19 Have Essential Jobs

TUESDAY, Nov. 10, 2020 — Between 56.7 and 74.3 million U.S. adults are at increased risk for severe COVID-19 and are either themselves an essential worker or live with one, according to a research letter published online Nov. 9 in JAMA Internal Medicine.

Thomas M. Selden, Ph.D., and Terceira A. Berdahl, Ph.D., both from the U.S. Agency for Healthcare Research and Quality in Rockville, Maryland, used data from the 2014 to 2017 Medical Expenditure Panel Survey to estimate how many adults at increased risk for severe COVID-19 held essential jobs and could not work at home (WAH) or lived in households with essential workers.

The researchers found that 112.4 million workers (71.5 percent) were essential, and of these, only 31.2 million could WAH. Just under half (49.7 percent) of all adults (123.2 million of 248 million) were at increased risk for severe COVID-19 using the main U.S. Centers for Disease Control and Prevention guidelines (or 61 percent, using the broader CDC guidelines). Between 41 and 54.4 percent of the 112.4 million essential workers met the main and broader CDC increased-risk guidelines, respectively. Of those workers meeting the main increased-risk guidelines, 27.7 percent (34.1 million) held essential jobs and could not WAH. If other household members who were essential workers who cannot WAH were included, the number of adults at increased risk who themselves are essential workers who cannot WAH or lived with one was 56.7 million, which increased to 74.3 million using the broader CDC increased-risk definition.

“Policy makers seeking to make efficient and equitable decisions about reopening the economy and about vaccine distribution should consider the health risks not only of workers, but also of those with whom they live,” the authors write.

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