Category: Mortality

Traffic Safety Impact of the COVID-19 Pandemic: Fatal Crashes Relative to Pre-Pandemic Trends, United States, May–December 2020

Mary Pat Campbell

Link: https://aaafoundation.org/traffic-safety-impact-of-the-covid-19-pandemic-fatal-crashes-relative-to-pre-pandemic-trends-united-states-may-december-2020/

PDF: https://aaafoundation.org/wp-content/uploads/2022/12/22-1339-AAAFTS_Impact-of-COVID-19_Research-Brief_r3.pdf

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A total of 38,824 people died in motor vehicle crashes in the U.S. in 2020, 2,570 (7.1%) more than forecast from models developed using data from 2011 through 2019 (Figure). In April 2020—the first full month of the pandemic—the number of fatalities was much lower than what would have been expected based on pre-pandemic trends. By May 2020, however, the actual number of fatalities was similar to historical levels. The number of fatalities greatly exceeded forecasts based on pre-pandemic trends for the remainder of 2020. In May through December collectively, there were a total of 28,611 traffic fatalities nationwide, which was 3,083 (12.1%) more than expected based on pre-pandemic trends.

The increase in traffic fatalities was not uniform across crash-, vehicle-, and driver-related factors. Scenarios present in greater than expected numbers in fatal crashes in 2020 included evening and late-night hours, speeding drivers, drivers with illegal alcohol levels, drivers without valid licenses, drivers of older vehicles, drivers of vehicles registered to other people, crash involvement and deaths of teens and young adults, and deaths of vehicle occupants not wearing seatbelts. In contrast, several crash types followed pre-pandemic trends (e.g., crashes in the middle of the day; crash involvements of drivers with valid licenses; pedestrian fatalities), and a few decreased (e.g., crashes of elderly drivers; crashes during typical morning commute hours).

Author(s): Brian C. Tefft, Meng Wang

Publication Date: December 2022

Publication Site: AAA Foundation

Under Government Pressure, Twitter Suppressed Truthful Speech About COVID-19

Mary Pat Campbell

Link: https://reason.com/2023/01/02/under-government-pressure-twitter-suppressed-truthful-speech-about-covid-19/?utm_medium=email

Excerpt:

Twitter’s ban on “COVID-19 misinformation,” which Elon Musk rescinded after taking over the platform in late October, mirrored the Biden administration’s broad definition of that category in two important respects: It disfavored perspectives that dissented from official advice, and it encompassed not just demonstrably false statements but also speech that was deemed “misleading” even when it was arguably or verifiably true. In a recent Free Press article, science writer David Zweig shows what that meant in practice, citing several striking examples of government-encouraged speech suppression gleaned from the internal communications that Musk has been disclosing to handpicked journalists.

Twitter’s moderation of pandemic-related content was intertwined with government policy from the beginning. Even before Joe Biden was elected president and his administration began publicly and privately demanding that social media companies suppress speech it viewed as a threat to public health, the company’s guidelines deferred to the positions taken by government agencies such as the Centers for Disease Control and Prevention (CDC). And those rules explicitly covered “misleading information” as well as “demonstrably false” statements.

….

That July, Twitter sought to clarify “our rules against potentially misleading information about COVID-19″ (emphasis added). “For a Tweet to qualify as a misleading claim,” the company said, “it must be an assertion of fact (not an opinion), expressed definitively, and intended to influence others’ behavior.” Possible topics included “the origin, nature, and characteristics of the virus”; “preventative measures, treatments/cures, and other precautions”; “the prevalence of viral spread, or the current state of the crisis”; and “official health advisories, restrictions, regulations, and public-service announcements.”

That was a very wide net, potentially encompassing anyone who questioned the CDC’s ever-shifting guidance or criticized government policies, such as lockdowns and mask mandates, aimed at reducing virus transmission. While the intent requirement ostensibly allowed dissent as long as it was not aimed at influencing behavior, that limitation did not mean much in practice, since moderators were apt to infer the requisite intent when they encountered tweets that implicitly or explicitly deviated from the recommendations of “public health authorities and governments.”

….

Another example that Zweig cites: Last August, @KelleyKga, a self-described “public health fact checker,” responded to another Twitter user’s claim that “COVID has been the leading cause of death from disease in children” since December 2021. “What an excellent example of cherry picking!” @KelleyKga wrote. “If you narrow it down to only the specific months you specify, which include the largest Covid wave (seen across the world), AND you ignore all non-disease deaths, AND you ignore cancer, heart disease, SIDS, then COVID is ‘leading.'”

Author(s): Jacob Sullum

Publication Date: 2 Jan 2023

Publication Site: Reason

23 Tidbits About the Human Operating System

Mary Pat Campbell

Link: https://www.linkedin.com/pulse/23-tidbits-human-operating-system-nate-worrell/

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1- We Aren’t Totally Human – Almost half of the cells in our body don’t come from us. We have a universe of microorganisms, each of which brings their own DNA into the mix. From a BBC report:

“The human genome – the full set of genetic instructions for a human being – is made up of 20,000 instructions called genes.

But add all the genes in our microbiome together and the figure comes out between two and 20 million microbial genes.

Prof Sarkis Mazmanian, a microbiologist from Caltech, argues: “We don’t have just one genome, the genes of our microbiome present essentially a second genome which augment the activity of our own.

“What makes us human is, in my opinion, the combination of our own DNA, plus the DNA of our gut microbes.”

2- We share DNA with Bananas and Copied Viral DNA: Our closest genetic relative is the chimp, but we are connected to dogs and cats and even fruit flies and yes, bananas.

Author(s): Nate Worrell

Publication Date: 1 Jan 2023

Publication Site: Longevity Assistant at LinkedIn

Philadelphia surpasses 500 homicides as gun violence crisis continues

Mary Pat Campbell

Link: https://www.washingtonexaminer.com/restoring-america/fairness-justice/philadelphia-homicides-gun-violence-crisis

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Philadelphia has recorded more than 500 homicides this year as the city’s gun violence crisis continues to rise dramatically.

The city has only ever recorded this large loss of human life twice in its history, matching the record of 500 deaths during the crack cocaine epidemic in 1990.

Since Tuesday, the total has risen to 502, a 7% reduction from 2021, per the city’s dashboard .

The total in 2022 only pales slightly in comparison to last year’s record-breaking total. In 2021, Philadelphia recorded 562 homicides, with 501 of the deaths due to gun violence alone, per Axios.

Homicide victims in Philadelphia for 2022 spanned across all ages, from as young as 9 to as old as 78. The 500th homicide was a man, 35, shot in the city’s Ogontz section on Sunday afternoon, and he died hours later from his injuries, police confirmed to multiple outlets.

The demographics surrounding the homicides reflect the extent to which gun violence plagues the city. Of the 500 homicides, 30 victims were juveniles, with seven being 14 years old or younger. According to police, 84% of people killed or injured in shootings this year were black.

Author(s): Rachel Schilke

Publication Date: 21 Dec 2022

Publication Site: Washington Examiner

The Official Who Investigates Suspicious Deaths in Your Town May Be a Doctor — Or Not

Mary Pat Campbell

Link: https://khn.org/news/article/coroners-medical-examiners-doctor-or-not-death-investigations/

Excerpt:

When a group of physicians gathered in Washington state for an annual meeting, one made a startling revelation: If you ever want to know when, how — and where — to kill someone, I can tell you, and you’ll get away with it. No problem.

That’s because the expertise and availability of coroners, who determine cause of death in criminal and unexplained cases, vary widely across Washington, as they do in many other parts of the country.

….

Each state has its own laws governing the investigation of violent and unexplained deaths, and most delegate the task to cities, counties, and regional districts. The job can be held by an elected coroner as young as 18 or a highly trained physician appointed as medical examiner. Some death investigators work for elected sheriffs who try to avoid controversy or owe political favors. Others own funeral homes and direct bodies to their private businesses.

Overall, it’s a disjointed and chronically underfunded system — with more than 2,000 offices across the country that determine the cause of death in about 600,000 cases a year.

…..

Belcher’s crusade succeeded in changing some aspects of Washington’s coroner system when state lawmakers approved a new law last year, but efforts to reform death investigations in California, Georgia, and Illinois have recently failed.

Rulings on causes of death are often not cut-and-dried and can be controversial, especially in police-involved deaths such as the 2020 killing of George Floyd. In that case, Minnesota’s Hennepin County medical examiner ruled Floyd’s death a homicide but indicated a heart condition and the presence of fentanyl in his system may have been factors. Pathologists hired by Floyd’s family said he died from lack of oxygen when a police officer kneeled on his neck and back.

….

In 2009, the National Research Council recommended that states replace coroners with medical examiners, describing a system “in need of significant improvement.”

Massachusetts was the first state to replace coroners with medical examiners statewide in 1877. As of 2019, 22 states and the District of Columbia had only medical examiners, 14 states had only coroners, and 14 had a mix, according to the Centers for Disease Control and Prevention.

Author(s): Samantha Young

Publication Date: 20 Dec 2022

Publication Site: Kaiser Health News

Death of an Elder Raises Uncomfortable Questions About Adequacy of Care

Mary Pat Campbell

Link: https://www.nakedcapitalism.com/2022/12/death-of-an-elder-raises-uncomfortable-questions-about-adequacy-of-care.html

Excerpt:

Yves here. I’ve taken the liberty of changing the title of this Kaiser Health New from A Family Death During the Holidays Prompts Questions and Reflection. The piece pulls its punches, perhaps because the health care journalist author Judith Graham, who regularly writes about aging, is hesitant to come off as an advocate and/or potentially alienate future sources. But you can see she is clearly not happy with the caliber of care her father-in-law received in his final days.

I’ve heard similar stories from readers and I saw it first hand with my mother, who like Graham’s father died at 94. I would be curious if practices are better or worse with the moderately and very old in other countries, particularly in Asia. The two times my mother was hospitalized in her final year, the care was horrid. And it wasn’t as if the staff was overburdened due to Covid. My mother’s aides would call for help, and after >10 minutes of getting no answer, would then go to the nurses’ station to find them doing their nails and watching TV. They also failed to keep her well hydrated and bruised her horribly.

….

But more broadly, an anti-aged attitude was evident. No one seemed willing to work that hard to save an old woman, or even help her have a more dignified death, particularly since she didn’t look that swell. Thanks to Covid, her hair and nails hadn’t been done for over a year and she came to the hospital in flannel pajamas. Notice the photos of the father in law below. Despite the upscale sweater, watch and glass frames, I suspect his very aged skin was held against him.

BTW, according to the Social Security life expectancy table, an average women my mother’s age typically would have lived another 3.8 years. So to hell with the bigots on staff.

And this sorry picture is set to get worse with Covid, with repeat infections reducing health baselines generally and resulting in more demands on doctors, nurses and hospitals that have no ability to increase capacity in less than many years. A sicker population will also produce more prejudice against older patients, even if they are robust and have managed to stay Covid-free.

Author(s): Yves Smith, Judith Graham

Publication Date: 9 December 2022

Publication Site: naked capitalism

2022 Mortality Improvement Survey Report

Mary Pat Campbell

Link: https://www.soa.org/resources/research-reports/2022/mort-improve-survey/

Report PDF: https://www.soa.org/4ad811/globalassets/assets/files/resources/research-report/2022/mort-improve-survey.pdf

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The Committee on Life Insurance Mortality and Underwriting Surveys of the Society of Actuaries sent
companies a survey in May of 2019 on mortality improvement practices as of year-end 2018. The survey
results were released in January 2022. The survey was completed by respondents prior to the onset of
COVID-19. The present report provides an opportunity to update the results for pandemic-based changes
and compare the before and after surveys.
The 2022 survey was opened in March 2022 and closed by the end of April. Thirty-five respondent
companies participated in this survey, with 29 from the U.S. and six from Canada. This group was further
divided between direct writers (26) and reinsurers (nine).
This survey focused on the use of mortality improvement and how it has changed for financial projection
and pricing modeling following the initial stages of COVID-19. Details regarding assumptions and opinions
on mortality improvement in general were asked of the respondents.
National Association of Insurance Commissioners discussions on mortality improvement factors due to
COVID-19 for reserving purposes have taken place, but this survey was conducted before any adjustments
reacting to them.
Seventy-four percent (26 of 35) of respondents indicated using durational mortality improvement
assumptions in their life and annuity pricing and/or financial projections. Moreover, of those that used
durational mortality improvement assumptions, attained age and gender were the top two characteristics
in which assumptions varied.
Respondents were asked to indicate the different limitations when applying durational mortality
improvement assumptions. The Survey found that the most common lowest and highest attained age to
which durational mortality improvement was applied were 0 and about 100, respectively. The lowest and
highest durational mortality improvement rate ranged from -1.50% (deterioration) to 2.80%
(improvement). The time period in which the mortality improvement rates were applied ranged from 10 to
120 years, but this varied between life (10/120) and annuities (30/120). The most common time period was
20 to 30 years for life; less consensus was seen for annuities. Analysis is provided in Appendix C for
instances when highlights are shared in the body of the report.

Author(s): Ronora Stryker, Max Rudolph

Publication Date: December 2022

Publication Site: SOA Research Institute

Why Do Vaccinated People Represent Most COVID-19 Deaths Right Now?

Mary Pat Campbell

Link: https://www.kff.org/policy-watch/why-do-vaccinated-people-represent-most-covid-19-deaths-right-now/

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The waning protection from vaccines is why CDC recommends recent booster shots, and why it’s especially important for people at higher risk to stay up-to-date on boosters. Per current recommendations, most adults should have received at least 2-3 booster doses by now (including the new bivalent booster), in addition to their primary series. However, only 14% of adults overall and 31% of older adults (65 years and older) have received the latest bivalent boosters. The CDC data show that about 95% of adults who died from COVID-19 in 2022 in these jurisdictions were over age 50, and about 8 in 10 were age 65 or older, underscoring the need for older adults to stay up-to-date on recommended booster shots.

The fall in the share of deaths that are among unvaccinated people could also be explained by changes in the unvaccinated population. By this far into the pandemic, it is estimated that many unvaccinated people have had COVID-19 at least once and while hundreds of thousands of unvaccinated people have needlessly died from COVID, those who survived may have gained some immune protection against the virus that can help protect them against severe outcomes when they have subsequent infections. However, this protection from a past infection can also diminish over time, which is why it is still recommended that unvaccinated people with prior COVID-19 infections get vaccinated and stay up-to-date on boosters.

Author(s): Cynthia Cox Follow @cynthiaccox on Twitter , Krutika Amin Follow @KrutikaAmin on Twitter , Jennifer Kates Follow @jenkatesdc on Twitter , and Josh Michaud Follow @joshmich on Twitter

Publication Date: 30 Nov 2022

Publication Site: KFF

Movember 2022: Men and Drug Overdoses (and Giving Tuesday!)

Mary Pat Campbell

Link: https://marypatcampbell.substack.com/p/movember-2022-men-and-drug-overdoses

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Remember the graph I made showing the suicide trend for men crossing over from prostate cancer?

Let me layer on unintentional drug overdoses:

Yeah, it’s as bad as it looks.

While death rates due to suicide increased by about 30% over the 20-year period, death rates due to unintentional drug overdoses increased by over 500%.

None of this is really a surprise. I’ve written about the drug OD problem many times before, which had a horrible trend before the pandemic and got much, much worse during the pandemic.

Much of the increase came in 2020 and 2021 — over 30% in 2020, and 17% in 2021. These are huge increases on rates that were already bad.

Author(s): Mary Pat Campbell

Publication Date: 29 Nov 2022

Publication Site: STUMP at substack

Organ Donation and Transplants During Major US Motorcycle Rallies

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2798550

Excerpt:

Question  Is the incidence of organ donation and transplants higher during major US motorcycle rallies?

Findings  In this cross-sectional study of 10 798 organ donors and 35 329 recipients of these organs from a national transplant registry from 2005 to 2021, there were 21% more organ donors and 26% more transplant recipients per day during motorcycle rallies in regions near those rallies compared with the 4 weeks before and after the rallies.

Meaning  While safety measures to minimize morbidity and mortality during motorcycle rallies should be prioritized, this study showed the downstream association of these events with organ donation and transplants.

Author(s): David C. Cron, MD, MS1,2; Christopher M. Worsham, MD3,4,5; Joel T. Adler, MD, MPH2,6; et al

Publication Date: 28 Nov 2022

Publication Site: JAMA Internal Medicine

JAMA Intern Med. Published online November 28, 2022. doi:10.1001/jamainternmed.2022.5431

Europe faces ‘cancer epidemic’ after estimated 1m cases missed during Covid

Mary Pat Campbell

Link: https://www.theguardian.com/society/2022/nov/15/europe-faces-cancer-epidemic-after-estimated-1m-cases-missed-during-covid

Excerpt:

Experts have warned that Europe faces a “cancer epidemic” unless urgent action is taken to boost treatment and research, after an estimated 1m diagnoses were missed during the pandemic.

The impact of Covid-19 and the focus on it has exposed “weaknesses” in cancer health systems and in the cancer research landscape across the continent, which, if not addressed as a matter of urgency, will set back cancer outcomes by almost a decade, leading healthcare and scientific experts say.

A report, European Groundshot – Addressing Europe’s Cancer Research Challenges: a Lancet Oncology Commission, brought together a wide range of patient, scientific, and healthcare experts with detailed knowledge of cancer across Europe.

One unintended consequence of the pandemic was the adverse effects that the rapid repurposing of health services and national lockdowns, and their continuing legacy, have had on cancer services, on cancer research, and on patients with cancer, the experts said.

“To emphasise the scale of this problem, we estimate that about 1m cancer diagnoses might have been missed across Europe during the Covid-19 pandemic,” they wrote in The Lancet Oncology. “There is emerging evidence that a higher proportion of patients are diagnosed with later cancer stages compared with pre-pandemic rates as a result of substantial delays in cancer diagnosis and treatment. This cancer stage shift will continue to stress European cancer systems for years to come.

Author(s): Andrew Gregory

Publication Date: 15 Nov 2022

Publication Site: The Guardian UK

Maternal Mortality Rates in the United States, 2020

Mary Pat Campbell

Link: https://stacks.cdc.gov/view/cdc/113967

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This report updates a previous one that showed maternal mortality rates for 2018 and 2019 (2).
In 2020, 861 women were identified as having died of maternal causes in the United States,
compared with 754 in 2019 (3). The maternal mortality rate for 2020 was 23.8 deaths per
100,000 live births compared with a rate of 20.1 in 2019 (Table).
In 2020, the maternal mortality rate for non-Hispanic Black women was 55.3 deaths per 100,000
live births, 2.9 times the rate for non-Hispanic White women (19.1) (Figure 1 and Table). Rates
for non-Hispanic Black women were significantly higher than rates for non-Hispanic White and
Hispanic women. The increases from 2019 to 2020 for non-Hispanic Black and Hispanic women
were significant. The observed increase from 2019 to 2020 for non-Hispanic White women was
not significant.

Author(s): Donna L. Hoyert

Publication Date: 23 Feb 2022

Publication Site: CDC Stacks

DOI: https://dx.doi.org/10.15620/cdc:113967