Category: Mortality

State Surgeon General Dr. Joseph A. Ladapo Issues New mRNA COVID-19 Vaccine Guidance

Mary Pat Campbell

Link: https://content.govdelivery.com/accounts/FLDOH/bulletins/3312697

Guidance: https://floridahealthcovid19.gov/wp-content/uploads/2022/10/20221007-guidance-mrna-covid19-vaccines-doc.pdf?utm_medium=email&utm_source=govdelivery

Analysis: https://floridahealthcovid19.gov/wp-content/uploads/2022/10/20221007-guidance-mrna-covid19-vaccines-analysis.pdf?utm_medium=email&utm_source=govdelivery

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Today, State Surgeon General Dr. Joseph A. Ladapo has announced new guidance regarding mRNA vaccines. The Florida Department of Health (Department) conducted an analysis through a self-controlled case series, which is a technique originally developed to evaluate vaccine safety.

This analysis found that there is an 84% increase in the relative incidence of cardiac-related death among males 18-39 years old within 28 days following mRNA vaccination. With a high level of global immunity to COVID-19, the benefit of vaccination is likely outweighed by this abnormally high risk of cardiac-related death among men in this age group. Non-mRNA vaccines were not found to have these increased risks.

As such, the State Surgeon General recommends against males aged 18 to 39 from receiving mRNA COVID-19 vaccines. Those with preexisting cardiac conditions, such as myocarditis and pericarditis, should take particular caution when making this decision.

Author(s): Joseph A. Ladapo

Publication Date: 7 Oct 2022

Publication Site: Florida Dept of Health

Reductions in US life expectancy during the COVID-19 pandemic by race and ethnicity: Is 2021 a repetition of 2020?

Mary Pat Campbell

Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9432732/

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Abstract:

COVID-19 had a huge mortality impact in the US in 2020 and accounted for most of the overall reduction in 2020 life expectancy at birth. There were also extensive racial/ethnic disparities in the mortality impact of COVID-19 in 2020, with the Black and Latino populations experiencing reductions in life expectancy at birth over twice as large as that of the White population. Despite continued vulnerability of these populations, the hope was that widespread distribution of effective vaccines would mitigate the overall mortality impact and reduce racial/ethnic disparities in 2021. In this study, we quantify the mortality impact of the COVID-19 pandemic on 2021 US period life expectancy by race and ethnicity and compare these impacts to those estimated for 2020. Our estimates indicate that racial/ethnic disparities have persisted, and that the US population experienced a decline in life expectancy at birth in 2021 of 2.2 years from 2019, 0.6 years more than estimated for 2020. The corresponding reductions estimated for the Black and Latino populations are slightly below twice that for Whites, suggesting smaller disparities than those in 2020. However, all groups experienced additional reductions in life expectancy at birth relative to 2020, and this apparent narrowing of disparities is primarily the result of Whites experiencing proportionately greater increases in mortality in 2021 compared with the corresponding increases in mortality for the Black and Latino populations in 2021. Estimated declines in life expectancy at age 65 increased slightly for Whites between 2020 and 2021 but decreased for both the Black and Latino populations, resulting in the same overall reduction (0.8 years) estimated for 2020 and 2021.

Author(s): Theresa Andrasfay, Noreen Goldman

Publication Date: 31 Aug 2022

Publication Site: PLOS ONE

Citation: Andrasfay T, Goldman N. Reductions in US life expectancy during the COVID-19 pandemic by race and ethnicity: Is 2021 a repetition of 2020? PLoS One. 2022 Aug 31;17(8):e0272973. doi: 10.1371/journal.pone.0272973. PMID: 36044413; PMCID: PMC9432732.

Drowning Prevention: How the American Academy of Pediatrics is failing our children

Mary Pat Campbell

Link: https://authenticpediatrics.substack.com/p/drowning-prevention-how-the-american

Excerpt:

In June 2021 I co-authored an article with drowning prevention parent advocate Nicole Hughes on the subject of water competency in 1-4 year old children and which national swim lesson program methodology aimed to teach this highest risk age group survival skills to best protect against an unplanned submersion.

The purpose of this article was to provide parents and primary care pediatricians with a direct comparison of popular formal swim lesson curriculums of the American Red Cross, YMCA, and Infant Swim Resource (ISR) to inform them on which program better aligns with the parent’s goals for water competency for their young child.

A secondary objective of this commentary was to highlight the methodology of survival swim as a type of formal swim program that in many ways appears superior for this high risk age group due to its ability to teach independent back floating and swim float swim without flotation devices. Despite being the only prominent formal swim lesson program that does this for the under 4 year olds, the AAP without any evidence has come out guns blazing against it.

This is evidenced by the recent parent article in JAMA Pediatrics which states: “Teaching children to swim is important, and the American Academy of Pediatrics has recommended swim lessons as early as age 1 year to provide another protection layer. However, infant swim classes such as Infant Swimming Resource have not been shown to lower the risk of drowning. As an alternative, families may seek out parent-child water play classes to gain familiarity and comfort with being around water together.”

Yet despite the lack of data on benefit vs. harm for each type of formal swim lessons, the AAP feels justified to advocate against ISR survival swim while advocating for Mommy and Me group swim lessons with the goal of comfort over survival.

One year after the publication of our article, the American Academy of Pediatrics authors of the 2019 Policy on Drowning Prevention submitted a Letter to the Editor to Contemporary Pediatrics criticizing our article to which we responded in an Author Response. For unexplained reasons neither letter was published by the journal of record.

Due to the importance of advancing this conversation to better understand the likely benefit and lack of harm of survival swim as a crucial layer of drowning prevention protection, I will publish both the AAP Letter to Editor and Author Response below. It is my hope that you read both. When reading, please do so within the context of an AAP that willingly advocates for non-pharmacological interventions (NPI) such mandatory masking of children for prevention of COVID-19 – stating that there is no evidence that it causes harm or developmental delays while willingly advocating against ISR survival swim – stating that it is harmful and lacks evidence of benefit without any such evidence to make either claim.

Author(s): Todd R Porter

Publication Date: 1 Oct 2022

Publication Site: Authentic Pediatrics at substack

Guns Aren’t a Public Health Issue

Mary Pat Campbell

Link: https://reason.com/video/2022/09/30/guns-arent-a-public-health-issue/

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The takeaway from the story of Dickey, Rosenberg, and the 1993 gun study at the center of the piece is that the congressman was correct to begin with. The CDC shouldn’t be studying gun violence.

Titled “Gun Ownership as a Risk Factor for Homicide in the Home” and published in The New England Journal of Medicine, the 1993 study looked at 388 people who had been killed in their homes and matched them to 388 neighbors of similar age, sex, and race. One hundred and seventy-four of the victims lived in houses where at least one gun was present versus only 139 of the matched controls.

With scary music and breathless claims, the video tells viewers that if you had a gun in your house, you were 200 percent more likely to be killed with a gun in your home and 400 percent more likely to kill yourself. 

These are both exaggerations and misstatements of the study results. It didn’t address suicide risk at all, nor gun homicides. It found households in which a resident had been murdered at home by any means had a 25 percent greater frequency of having a gun, not 200 percent. But this doesn’t mean owning a gun increases your risk of being killed by 25 percent. 

This is a classic statistical error known as the “base rate fallacy” and is particularly important when studying rare events, like people murdered in their homes. Suppose 10 people are murdered in their homes, and five of those homes had guns. A matched set of 10 people who were not murdered in their homes found only four homes had guns. So there are 25 percent more guns in the homes of murder victims than matched nonmurder victims (Five vs. four).

But what if you put those 20 people in the context of another million, none of whom were murdered in their homes, half of whom had guns in their homes and half of whom didn’t. The rate for gun owners to be murdered at home becomes five out of 500,009, while the rate for non-gun owners becomes five out of 500,011. So now we find that the risk is 0.0004 percent higher.

In other words, being murdered in your home means you have a 25 percent higher chance of having a gun, but having a gun means you have only a 0.0004 percent greater chance of being murdered in your home. Those are not the same thing.

The finding that owning a gun made study subjects less safe was also a conclusion selected from much stronger statistical results that didn’t fit the authors’ political views and, thus, weren’t mentioned in the study. Yes, 25 percent more victims’ homes had guns than control homes, but 38 percent more victims had controlled security access to their property. Why not lobby against gates as a public health matter? Twenty times as many victims had gotten in trouble at work because of drinking, so why worry about guns when drinking at work is two orders of magnitude more dangerous? Renting and living alone were far more dangerous than having a gun. Victims were less likely than controls to own a rifle or a shotgun, so why not a government program to trade in handguns for long guns?

Author(s): JOHN OSTERHOUDT AND AARON BROWN

Publication Date: 30 Sept 2022

Publication Site: Reason

The amazing power of “machine eyes”

Mary Pat Campbell

Link: https://erictopol.substack.com/p/the-amazing-power-of-machine-eyes

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Today’s report on AI of retinal vessel images to help predict the risk of heart attack and stroke, from over 65,000 UK Biobank participants, reinforces a growing body of evidence that deep neural networks can be trained to “interpret” medical images far beyond what was anticipated. Add that finding to last week’s multinational study of deep learning of retinal photos to detect Alzheimer’s disease with good accuracy. In this post I am going to briefly review what has already been gleaned from 2 classic medical images—the retina and the electrocardiogram (ECG)—as representative for the exciting capability of machine vision to “see” well beyond human limits. Obviously, machines aren’t really seeing or interpreting and don’t have eyes in the human sense, but they sure can be trained from hundreds of thousand (or millions) of images to come up with outputs that are extraordinary. I hope when you’ve read this you’ll agree this is a particularly striking advance, which has not yet been actualized in medical practice, but has enormous potential.

Author(s): Eric Topol

Publication Date: 4 Oct 2022

Publication Site: Eric Topol’s substack, Ground Truths

Texas Maternal Death Data to Be Published Post-Midterms

Mary Pat Campbell

Link: https://www.governing.com/now/texas-maternal-death-data-to-be-published-post-midterms

Excerpt:

Texas health officials have missed a key window to complete the state’s first major updated count of pregnancy related deaths in nearly a decade, saying the findings will now be released next summer, most likely after the Legislature’s biennial session.

The delay, disclosed earlier this month by the Department of State Health Services, means lawmakers won’t likely be able to use the analysis, covering deaths from 2019, until the 2025 legislative cycle. The most recent state-level data available is nine years old.

In a hearing this month with the state’s Maternal Mortality and Morbidity Review Committee, DSHS commissioner Dr. John Hellerstedt said the agency wanted to better align its methodology with that of other states, and that there hadn’t been enough staff and money to finish the review for a scheduled Sept. 1 release.

….

Ortique said the state has already identified 149 potential maternal deaths in 2019, of which 118 have been analyzed by the committee to see if they were pregnancy-related. Six newly identified deaths may be added to that group, she said. The numbers cover deaths during the pregnancy through one year after giving birth.

The state has published a maternal death report every other year since 2014, often based on preliminary data updated later. For example, the maternal death report in 2018 identified 29 deaths in 2012 that were not included in the previous report. The committee also released updating findings from its most recent report, studying deaths from 2013, at the Sept. 2 meeting.

Out of 175 potential maternal deaths in 2013, 70 have since been determined to be pregnancy-related.

Author(s): Julian Gill and Jeremy Blackman, San Antonio Express-News

Publication Date: 14 Sept 2022

Publication Site: Governing

Death Is Anything but a Dying Business as Private Equity Cashes In

Mary Pat Campbell

Link: https://khn.org/news/article/funeral-homes-private-equity-death-care/

Excerpt:

Private equity firms are investing in health care from cradle to grave, and in that latter category quite literally. A small but growing percentage of the funeral home industry — and the broader death care market — is being gobbled up by private equity-backed firms attracted by high profit margins, predictable income, and the eventual deaths of tens of millions of baby boomers.

The funeral home industry is in many ways a prime target for private equity, which looks for markets that are highly fragmented and could benefit from consolidation. By cobbling together chains of funeral homes, these firms can leverage economies of scale in purchasing, improve marketing strategies, and share administrative functions.

According to industry officials, about 19,000 funeral homes make up the $23 billion industry in the U.S., at least 80% of which remain privately owned and operated — mostly mom and pop businesses, with a few regional chains thrown in. The remaining 20%, or about 3,800 homes, are owned by funeral home chains, and private equity-backed firms own about 1,000 of those.

….

Robertson said the funeral home industry is different from other sectors that private equity firms might consider investing in, describing it as a calling comparable to working in hospice care. Foundation Partners is fortunate their backers understand the service part of the industry, as well as the financials, he said. “Private equity firms aren’t necessarily known for having deep compassion for people. They’re more known for their financial returns,” he said. “To get both is really important.”

Foundation Partners owns Tulip Cremation, an online service that allows people to order a cremation with just a few clicks — and without having to set foot in a funeral home. Tulip currently operates in nine states where Foundation Partners has funeral homes. The company expects the service to eventually operate nationally.

Author(s): Markian Hawryluk

Publication Date: 22 Sept 2022

Publication Site: Kaiser Health News

S&P Global’s Proposed Capital Model Changes and its Implication to U.S. Life Insurance Companies

Mary Pat Campbell

Link: https://www.soa.org/sections/financial-reporting/financial-reporting-newsletter/2022/september/fr-2022-09-sun/

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Life technical risks measure the possible losses from deviations from the best estimate assumptions relating to life expectancy, policyholder behavior, and expenses. The life technical risks are captured through mortality, longevity, morbidity, and other risks. The methodology for calculating the capital adequacy for these four risk categories remains unchanged under the proposed method, apart from the recalibration of capital charges or the consolidation of defining categories within each risk. Comparing to the current GAAP based model, charges have materially increased across all categories partly due to higher confidence intervals, with notable exceptions of longevity risk, with reduced charges across all stress levels (changes applicable to U.S. life insurers are illustrated in Tables A2 to A5 in the Appendix linked at the end of this article). Please note that S&P’s current capital model under U.S. statutory basis does not have an explicit longevity risk charge. However, this article focuses on comparison to current GAAP capital model[1] that is closer to the new capital methodology framework.

For mortality risk, lower rates are charged for smaller exposures (net amount at risk (NAR) $5 billion or less) with the consolidation of size categories, but higher rates are charged for NAR between $5 billion and $250 billion, with an average increase of 49 percent for businesses under $400 billion NAR. A new pandemic risk charge (Table A3 in the Appendix linked at the end of this article) will further increase mortality related risk charges to be 109 percent higher than original mortality charges under confidence level for company rating of AA, and 93 percent higher for confidence level for company rating of A, respectively, on average (Figure 1). The disability risk charge rates increased moderately for most products, across all eight product types such that the increase of disability premium risk charges is 6 percent under confidence level for AA, and 2 percent for A, respectively. In addition, the proposed model introduced a new charge on disability claims reserve, ranging from 13.7 percent of total disability claims reserves for AAA, to 9.6 percent for BBB. However, the proposed model provides lower capital charge rates in longevity risk and lapse risk.

Author(s): Yiru (Eve) Sun, John Choi, and Seong-Weon Park

Publication Date: September 2022

Publication Site: Financial Reporting newsletter of the SOA

5 Worst States for Working-Age Deaths in August

Mary Pat Campbell

Link: https://www.thinkadvisor.com/2022/09/27/5-worst-states-for-working-age-deaths-in-august/

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The number of deaths of working-age Americans was lower in August than in August 2021, but it was still much higher than it was in August 2019, before the COVID-19 pandemic began.

Death figures for the period from July 31 through Aug. 27 are just starting to firm up. But very early figures show that at least 53,655 U.S. residents ages 25 through 64 died from COVID-19 and all other causes during that four-week period.

The number of deaths was down sharply from 77,847 in August 2021, but it was still up 6.1% from the total of 50,590 for August 2019.

Author(s): Allison Bell

Publication Date: 27 Sept 2022

Publication Site: Think Advisor

COVID-19: Audit Cites ‘Distortion, Suppression Of Facts’ In Nursing Home Reporting Under Cuomo

Mary Pat Campbell

Link: https://dailyvoice.com/new-york/northsalem/news/covid-19-audit-cites-distortion-suppression-of-facts-in-nursing-home-reporting-under-cuomo/828102/

Excerpt:

The state Health Department intentionally “misled the public” regarding the number of COVID-19 deaths in nursing homes under former New York Gov. Andrew Cuomo’s administration, according to a scathing audit from the Comptroller Thomas P. DiNapoli.

When the COVID-19 pandemic swept through New York, the Department of Health was not prepared to respond to the infectious disease outbreaks in nursing homes, according to the audit, which helped lead to the inaccurate virus-related death count in facilities.

Auditors found that health officials undercounted the death toll in nursing homes by at least 4,100 residents and at times more than 50 percent, despite claims from the former governor, who said the state was doing well in protecting seniors.

Author(s): Zak Failla

Publication Date: 17 March 2022

Publication Site: New York Daily Voice

John Hancock to Pilot 50-Cancer Detection Test

Mary Pat Campbell

Link: https://www.thinkadvisor.com/2022/09/20/john-hancock-to-pilot-50-cancer-detection-test/

Excerpt:

John Hancock wants to find out what happens when life insurance insureds get a blood test that might reveal early signs of about 50 different types of cancer.

The Boston-based Manulife subsidiary is working with Munich Re and other reinsurers to offer a pilot program that will pay either 50% or 100% of the cost of Grail’s Galleri cancer screening test for insureds in the John Hancock Vitality wellness program.

John Hancock will not get individual test results for the insureds who use the pilot program, nor will the program results affect the participants’ coverage, premiums or Vitality points.

Author(s): Allison Bell

Publication Date: 20 Sept 2022

Publication Site: Think Advisor

Covid Still Kills, but the Demographics of Its Victims Are Shifting

Mary Pat Campbell

Link: https://khn.org/news/article/covid-still-kills-but-the-demographics-of-its-victims-are-shifting/

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Californians age 75 and older made up 53% of covid deaths through July in 2022, up from 46% in 2020 and 2021. Only about 6% of the state’s residents are 75 and older. And white Californians 75 and older outnumber Latinos in that age group about 3 to 1.

In the initial vaccination rollout, California prioritized seniors, first responders, and other essential workers, and for several months in 2021 older residents were much more likely to be vaccinated than younger Californians.

“Now, the vaccination rates have caught up pretty much with everybody except for kids, people under 18,” Brewer said. “You’re seeing it go back to what we saw before, which is that age remains the most important risk factor for death.”

Author(s): Phillip Reese

Publication Date: SEPTEMBER 21, 2022

Publication Site: KFF