Current Causes of Death in Children and Adolescents in the United States

Link: https://www.nejm.org/doi/full/10.1056/NEJMc2201761

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In addition, drug overdose and poisoning increased by 83.6% from 2019 to 2020 among children and adolescents, becoming the third leading cause of death in that age group. This change is largely explained by the 110.6% increase in unintentional poisonings from 2019 to 2020. The rates for other leading causes of death have remained relatively stable since the previous analysis, which suggests that changes in mortality trends among children and adolescents during the early Covid-19 pandemic were specific to firearm-related injuries and drug poisoning; Covid-19 itself resulted in 0.2 deaths per 100,000 children and adolescents in 2020.1

Although the new data are consistent with other evidence that firearm violence has increased during the Covid-19 pandemic,5 the reasons for the increase are unclear, and it cannot be assumed that firearm-related mortality will later revert to prepandemic levels. Regardless, the increasing firearm-related mortality reflects a longer-term trend and shows that we continue to fail to protect our youth from a preventable cause of death. Generational investments are being made in the prevention of firearm violence, including new funding opportunities from the CDC and the National Institutes of Health, and funding for the prevention of community violence has been proposed in federal infrastructure legislation. This funding momentum must be maintained.

Author(s):

Jason E. Goldstick, Ph.D.
Rebecca M. Cunningham, M.D.
Patrick M. Carter, M.D.
University of Michigan, Ann Arbor, MI

Publication Date: 19 May 2022

Publication Site: New England Journal of Medicine

Covid-19 — Navigating the Uncharted

Link: https://www.nejm.org/doi/full/10.1056/nejme2002387

Excerpt:

On the basis of a case definition requiring a diagnosis of pneumonia, the currently reported case fatality rate is approximately 2%.4 In another article in the Journal, Guan et al.5 report mortality of 1.4% among 1099 patients with laboratory-confirmed Covid-19; these patients had a wide spectrum of disease severity. If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.2

Author(s): Anthony S. Fauci, H. Clifford Lane, Robert R. Redfield

Publication Date: 26 March 2020

Publication Site: New England Journal of Medicine