How ‘excess deaths’ show COVID’s real impact, and point to better ways of combating pandemics

Link: https://nationalpost.com/health/how-excess-deaths-show-covids-real-impact-and-point-to-better-ways-of-combating-pandemics

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Canada saw about 42 excess deaths per 100,000 people by the fall of 2020, according to calculations from Ode’s team at Oxford.

In comparison, there were 132 per 100,000 in the U.S. during 2020, 100 in England and Wales, 33 in Germany and 175 excess deaths per 100,000 in Poland.

Perhaps most interesting were the minority of countries that have managed to keep the coronavirus at bay with a variety of public health measures.

Australia saw a three per cent decrease in excess deaths in 2020, New Zealand a six per cent reduction, while deaths in Taiwan, South Korea and Singapore were flat or lower, according to Karlinsky’s list. His source data were slightly different than those used in the Oxford study, but all the excess-death monitoring projects, including ones run by the Economist magazine and Financial Times newspaper, generally line up.

Author(s): Tom Blackwell

Publication Date: 9 April 2021

Publication Site: National Post

Life expectancy decreased in 2020 across the EU

Link: https://ec.europa.eu/eurostat/web/products-eurostat-news/-/edn-20210407-1

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Life expectancy at birth has been increasing over the past decade in the EU: official statistics reveal that life expectancy has risen, on average, by more than two years per decade since the 1960s. However, the latest available data suggest that life expectancy stagnated or even declined in recent years in several EU Member States.

Moreover, following the outbreak of the COVID-19 pandemic last year, life expectancy at birth fell in the vast majority of the EU Member States with available 2020 data. The largest decreases were recorded in Spain (-1.6 years compared with 2019) and Bulgaria (-1.5), followed by Lithuania, Poland and Romania (all -1.4).

Publication Date: 7 April 2021

Publication Site: EuroStat

COVID-19 Pandemic-Related Excess Mortality and Potential Years of Life Lost in the U.S. and Peer Countries

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We find that, among similarly large and wealthy countries, the U.S. had among the highest excess mortality rates in 2020, and younger people were more likely to have died due to the pandemic in the U.S. than younger people in other countries. With a much higher rate of death among people under age 75, the U.S. had the highest increase in premature deaths due the pandemic in 2020. Before the pandemic, the U.S. already had the highest premature death rate of peer nations, by far. We find that per capita premature excess death rate in the U.S. was over twice as high as the next closest peer country, the U.K. The higher rate of new premature deaths in the U.S. compared to peer countries was driven in part by racial disparities within the U.S. Looking at age differences in excess mortality by race, we find that American Indian and Alaska Native (AIAN), Hispanic, Black, and Native Hawaiian and Other Pacific Islander (NHOPI) people in the U.S. were more likely to have died at younger ages during the pandemic in 2020 than non-elderly White or Asian adults in the U.S.

Author(s): Krutika Amin, Cynthia Cox

Publication Date: 7 April 2021

Publication Site: Peterson-KFF Health System Tracker

Study: U.S. had 23% more deaths than expected in 2020 due to pandemic

Link: https://www.upi.com/Health_News/2021/04/02/coronavirus-excess-deaths-study/7781617369688/

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The United States saw 23% more deaths than expected between March 1, 2020, and the start of this year, due primarily to the effects of the COVID-19 pandemic, which suggests the official number of U.S. coronavirus deaths is an undercount, according to an analysis published Friday by JAMA found.

More than 2.8 million people died nationally between when the first confirmed cases of the coronavirus were identified and Jan. 2, the data showed.

That’s roughly 522,000 more than would be expected for the 10-month period, based on figures from 2014 through 2019.

These excess deaths were higher than the number of publicly reported COVID-19 deaths across the country, researchers said.

Author(s): Brian P. Dunleavy

Publication Date: 2 April 2021

Publication Site: UPI

TRUST THE SCIENCE: THE BLUE STATE SURGE IS REAL

Link: http://www.newgeography.com/content/007004-trust-science-the-blue-state-surge-real

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What did make a big difference, it turns out, is not so much the severity of lockdowns but pre-existing conditions. The likely cause here can be best identified as “exposure density” brought on by crowded housing, transit, and office environments.

That helps explain why, after New York City’s suburbs were hit hard in the first wave, the current surge has hit the outer boroughs, where a much higher share of workers have had little choice but to continue taking the subway or other transit.

Nationwide, urban exposure to the pandemic also reflects their greater inequality. Higher rates of poverty and overcrowded housing accentuate the worst effects of the pandemic, which tore through impoverished parts of New YorkHoustonLos Angeles CountyChicago’s poor south side, and similar areas. The Bronx, for example, has suffered an 80 percent worse death rate than denser yet wealthier Manhattan, while Brooklyn’s rate is 50 percent worse than Manhattan’s.

Author(s): Joel Kotkin, Wendell Cox

Publication Date: 6 April 2021

Publication Site: New Geography

Excess Deaths From COVID-19 and Other Causes in the US, March 1, 2020, to January 2, 2021

Link: https://jamanetwork.com/journals/jama/fullarticle/2778361

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Between March 1, 2020, and January 2, 2021, the US experienced 2 801 439 deaths, 22.9% more than expected, representing 522 368 excess deaths (Table). The excess death rate was higher among non-Hispanic Black (208.4 deaths per 100 000) than non-Hispanic White or Hispanic populations (157.0 and 139.8 deaths per 100 000, respectively); these groups accounted for 16.9%, 61.1%, and 16.7% of excess deaths, respectively. The US experienced 4 surge patterns: in New England and the Northeast, excess deaths surged in the spring; in the Southeast and Southwest, in the summer and early winter; in the Plains, Rocky Mountain, and far West, primarily in early winter; and in the Great Lakes, bimodally, in the spring and early winter (Figure). Excess deaths were increasing in all regions at the end of 2020. The 10 states with the highest per capita rate of excess deaths were Mississippi, New Jersey, New York, Arizona, Alabama, Louisiana, South Dakota, New Mexico, North Dakota, and Ohio. New York experienced the largest relative increase in all-cause mortality (38.1%). Deaths attributed to COVID-19 accounted for 72.4% of US excess deaths.

Joinpoint analyses revealed an increase in weekly mortality from non–COVID-19 causes, including heart disease from March 15 to April 11, 2020 (APC, 4.9 [95% CI, 0.7-9.3]), and October 11, 2020, to January 2, 2021 (APC, 1.1 [95% CI, 0.8-1.4]); Alzheimer disease/dementia from March 15 to April 11, 2020 (APC, 7.1 [95% CI, 2.4-12.0]), May 31 to August 15, 2020 (APC, 1.2 [95% CI, 0.7-1.6]), and September 6, 2020, to January 2, 2021 (APC, 1.3 [95% CI, 1.1-1.5]); and diabetes from March 8 to April 11, 2020 (APC, 6.5 [95% CI, 2.8-10.3]), May 31 to July 11, 2020 (APC, 2.6 [95% CI, 0.2-5.0]), and October 18, 2020, to January 2, 2021 (APC, 2.2 [95% CI, 1.6-2.8]).

Author(s): Steven H. Woolf, MD, MPH1Derek A. Chapman, PhD1Roy T. Sabo, PhD2et al

Publication Date: 2 April 2021

Publication Site: JAMA

Provisional Mortality Data — United States, 2020

Link: https://www.cdc.gov/mmwr/volumes/70/wr/mm7014e1.htm

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During January–December 2020, the estimated 2020 age-adjusted death rate increased for the first time since 2017, with an increase of 15.9% compared with 2019, from 715.2 to 828.7 deaths per 100,000 population. COVID-19 was the underlying or a contributing cause of 377,883 deaths (91.5 deaths per 100,000). COVID-19 death rates were highest among males, older adults, and AI/AN and Hispanic persons. The highest numbers of overall deaths and COVID-19 deaths occurred during April and December. COVID-19 was the third leading underlying cause of death in 2020, replacing suicide as one of the top 10 leading causes of death (6).

The findings in this report are subject to at least four limitations. First, data are provisional, and numbers and rates might change as additional information is received. Second, timeliness of death certificate submission can vary by jurisdiction. As a result, the national distribution of deaths might be affected by the distribution of deaths from jurisdictions reporting later, which might differ from those in the United States overall. Third, certain categories of race (i.e., AI/AN and Asian) and Hispanic ethnicity reported on death certificates might have been misclassified (7), possibly resulting in underestimates of death rates for some groups. Finally, the cause of death for certain persons might have been misclassified. Limited availability of testing for SARS-CoV-2, the virus that causes COVID-19, at the beginning of the COVID-19 pandemic might have resulted in an underestimation of COVID-19–associated deaths.

This report provides an overview of provisional U.S. mortality data for 2020. Provisional death estimates can give researchers and policymakers an early indication of shifts in mortality trends and provide actionable information sooner than the final mortality data that are released approximately 11 months after the end of the data year. These data can guide public health policies and interventions aimed at reducing numbers of deaths that are directly or indirectly associated with the COVID-19 pandemic and among persons most affected, including those who are older, male, or from disproportionately affected racial/ethnic minority groups.

Author(s): Farida B. Ahmad, Jodi A. Cisewski, Arialdi Miniño, Robert N. Anderson

Publication Date: 31 March 2021

Publication Site: CDC

Analysis of Excess Deaths During the COVID-19 Pandemic in the State of Florida

Link: https://ajph.aphapublications.org/doi/10.2105/AJPH.2020.306130

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Objectives. To determine the number of excess deaths (i.e., those exceeding historical trends after accounting for COVID-19 deaths) occurring in Florida during the COVID-19 pandemic.

Methods. Using seasonal autoregressive integrated moving average time-series modeling and historical mortality trends in Florida, we forecasted monthly deaths from January to September of 2020 in the absence of the pandemic. We compared estimated deaths with monthly recorded total deaths (i.e., all deaths regardless of cause) during the COVID-19 pandemic and deaths only from COVID-19 to measure excess deaths in Florida.

Results. Our results suggest that Florida experienced 19 241 (15.5%) excess deaths above historical trends from March to September 2020, including 14 317 COVID-19 deaths and an additional 4924 all-cause, excluding COVID-19, deaths in that period.

Conclusions. Total deaths are significantly higher than historical trends in Florida even when accounting for COVID-19–related deaths. The impact of COVID-19 on mortality is significantly greater than the official COVID-19 data suggest.

Author(s): Moosa Tatar, Amir Habibdoust, Fernando A. Wilson

Publication Date: 10 March 2021

Publication Site: American Journal of Public Health

Florida COVID numbers face new scrutiny

Link: https://www.yahoo.com/lifestyle/florida-covid-numbers-face-new-scrutiny-090058319.html

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The impact of the pandemic in Florida “is significantly greater than the official COVID-19 data suggest,” the researchers wrote. They came to that conclusion by comparing the number of estimated deaths for a six-month period in 2020, from March to September, to the actual number of deaths that occurred, a figure known as “excess deaths” because they exceed the estimate.

There were 400,000 excess deaths across the United States in 2020, a spike closely correlated to the coronavirus pandemic.

The lack of testing early in the pandemic may also have undercounted COVID-19 deaths, explains Daniel Weinberger, an epidemiologist at the Yale School of Public Health who has also studied the coronavirus and excess deaths.

The issue was further complicated because each state has its own death-counting methodology. “Some states classify a death as due to COVID if a positive molecular test was obtained, while other states allow the death to be classified as due to COVID if there is a suspicion that it was caused by COVID (even without a molecular test),” Weinberger wrote in an email to Yahoo News.

Author(s): Alexander Nazaryan

Publication Date: 30 March 2021

Publication Site: Yahoo News

Sharp Reductions in COVID-19 Case Fatalities and Excess Deaths in Peru in Close Time Conjunction, State-By-State, with Ivermectin Treatments

Link: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3765018

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On May 8, 2020, Peru’s Ministry of Health approved ivermectin (IVM) for the treatment of COVID-19. A drug of Nobel Prize-honored distinction, IVM has been safely distributed in 3.7 billion doses worldwide since 1987. It has exhibited major, statistically significant reductions in case mortality and severity in 11 clinical trials for COVID-19, three with randomized controls. The indicated biological mechanism of IVM is the same as that of antiviral antibodies generated by vaccines—binding to SARS-CoV-2 viral spike protein, blocking viral attachment to host cells.

Mass distributions of IVM for COVID-19 treatments, inpatient and outpatient, were conducted in different timeframes with local autonomy in the 25 states (departamentos) of Peru. These treatments were conducted early in the pandemic’s first wave in 24 states, in some cases beginning even a few weeks before the May 8 national authorization, but delayed four months in Lima. Analysis was performed using Peruvian public health data for all-cause deaths and for COVID-19 case fatalities, as independently tracked for ages 60 and above. These daily figures were retrieved and analyzed by state. Case incidence data were not analyzed due to variations in testing methods and other confounding factors. These clinical data associated with IVM treatments beginning in different time periods, April through August 2020, in each of 25 Peruvian states, spanning an area equivalent to that from Denmark to Italy and Greece in Europe or from north to south along the US, with a total population of 33 million, provided a rich source for analysis.

For the 24 states with early IVM treatment (and Lima), excess deaths dropped 59% (25%) at +30 days and 75% (25%) at +45 days after day of peak deaths. Case fatalities likewise dropped sharply in all states but Lima, yet six indices of Google-tracked community mobility rose over the same period. For nine states having mass distributions of IVM in a short timeframe through a national program, Mega-Operación Tayta (MOT), excess deaths at +30 days dropped by a population-weighted mean of 74%, each drop beginning within 11 day after MOT start. Extraneous causes of mortality reductions were ruled out. These sharp major reductions in COVID-19 mortality following IVM treatment thus occurred in each of Peru’s states, with such especially sharp reductions in close time conjunction with IVM treatments in each of the nine states of operation MOT. Its safety well established even at high doses, IVM is a compelling option for immediate, large scale national deployments as an interim measure and complement to pandemic control through vaccinations.

Author(s): Juan J Chamie-Quintero, Jennifer Hibberd, David Scheim

Publication Date: 27 January 2021

Publication Site: SSRN

CDC death data as of 17 March 2021 U.S. Dashboards

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I review national-level U.S. mortality data from 2020 into 2021 (last updated 3/17/2021, weekly data through the week ending 3/6/2021), using the CDC’s own dashboards.

Breakdown by total numbers, states, age group, racial/ethnic group, non-COVID major causes.

CDC excess mortality dashboards: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm

Author(s): Mary Pat Campbell

Publication Date: 18 March 2021

Publication Site: Meep’s Math Matters at YouTube