This is the critical point.  You have this line:

There were 132969 unused item pointers.

Which says there's 132k or so dead rows in your table.  Which means
vacuum / autovacuum isn't keeping up.  Did you try and stop the update
several times?  Each time it starts then gets killed it creates dead
rows.

Try doing a vacuum full followed by a reindex OR a cluster on this
table and see if that helps.

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