Question How many cases of COVID-19 in the US have occurred among people experiencing homelessness?
Findings In this cross-sectional study of 64 US jurisdictional health departments, 26 349 cases of COVID-19 among people experiencing homelessness were reported at the state level and 20 487 at the local level. The annual incidence rate of COVID-19 was lower among people experiencing homelessness than in the general population at state and local levels.
Meaning The findings suggest that incorporating housing and homelessness status in infectious disease surveillance may improve understanding of the burden of infectious diseases among disproportionately affected groups and aid public health decision-making.
Author(s): Ashley A. Meehan, MPH1; Isabel Thomas, MPH1,2; Libby Horter, MPH1,3; et al
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.
“More people die from hands, fists, feet, than rifles. Guess we should ban limbs now…,” reads the May 25 post. Underneath, a graphic titled “Number of murder victims in the Unites States in 2020 by weapon used” shows rifle deaths at 455 and deaths from “personal weapons (hands, fists, feet, etc.)” as 662. The post includes a link to a website called Statista.
FBI data from 2020 does show that more people died from injuries sustained from other people’s fists, feet and hands than from rifles. But there’s a little more you should know about that data before you use it to draw conclusions.
Author(s): Jeff Cercone of Austin American-Statesman
Those odds can be gauged from a study by researchers at the National Institutes of Health, published by the Centers for Disease Control. They tracked more than 1 million vaccinated adults in America over most of last year, including the period when the Delta variant was surging, and classified victims of Covid according to risk factors such as being over 65, being immunosuppressed, or suffering from diabetes or chronic diseases of the heart, kidney, lungs, liver or brain.
The researchers report that none of the healthy people under 65 had a severe case of Covid that required treatment in an intensive-care unit. Not a single one of these nearly 700,000 people died, and the risk was miniscule for most older people, too. Among vaccinated people over 65 without an underlying medical condition, only one person died. In all, there were 36 deaths, mostly among a small minority of older people with a multitude of comorbidities: the 3 percent of the sample that had at least four risk factors. Among everyone else, a group that included elderly people with one or two chronic conditions, there were just eight deaths among more than 1.2 million people, so their risk of dying was about 1 in 150,000.
Those are roughly the same odds that in the course of a year you will die in a fire, or that you’ll perish by falling down stairs. Going anywhere near automobiles is a bigger risk: you’re three times more likely during a given year to be killed while riding in a car, and also three times more likely to be a pedestrian casualty. The 150,000-to-1 odds of a Covid death are even longer than the odds over your lifetime of dying in an earthquake or being killed by lightning.
Compared with the unvaccinated, fully vaccinated people overall had a much lower chance of testing positive for the virus or dying from it, even through the summer’s Delta surge and the relaxation of pandemic restrictions in many parts of the country. But the data indicates that immunity against infection may be slowly waning for vaccinated people, even as the vaccines continue to be strongly protective against severe illness and death.
“The No. 1 take-home message is that these vaccines are still working,” said Dr. David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. “If you saw these data for any disease other than Covid, what everyone’s eyes would be drawn to is the difference between the unvaccinated and fully vaccinated lines.”
The data shows notable differences in breakthrough death rates by age and slight differences in both case and death rates by vaccine brand, trends that experts say are important to consider as tens of millions of Americans weigh whether to get a booster shot.
I will put a few facts in front of you, and you think it through: – The population age 85+ in the U.S. in 2020 was 6.3 million – Through July 2021, there were a little over 180K COVID deaths for that group – That’s about 3% of the age 85+ population
Do you think only 3% of the age 85+ population is vulnerable to COVID?
Pretty much all of them are “vulnerable”. The mortality rate for people age 85 (much less older) was 7.3% for females and 9.5% for males in the most recently available tables. It only goes up from there.
There is a huge difference in mortality by age for just non-pandemic years, and it’s also true for COVID.
There may be a few hardy souls with a base risk similar to the middle-aged without vaccines, but the percentage is not high.
The vaccines have been having an effect in cutting risk.
My late wife spent the last two and half years of her life in a nursing home with a form of early onset dementia. While she was in her fifties, almost everyone else there was elderly. In each of the three winters she was in the home, the place was closed to visitors at some point because of flu. This added heartbreak to heartbreak, but it was entirely reasonable. Nearly three in four flu deaths in the last pre-pandemic season occurred among seniors. Someone aged 65 or more who contracted the flu had a chance of dying of it of about one in 120. (By contrast, while more than 85% of the breakthrough deaths are among those over 65, the COVID death rate for fully vaccinated seniors is one in about 25,000.)
That is to say that the risk of death from flu in a nursing home was almost a thousand times as large as the risk of death from COVID to the overall vaccinated population, and the risk of dying from the flu if you caught it as a senior was more than 200 times greater than the risk from COVID if you are currently disease-free, similarly aged and fully vaccinated.
Nomograms are a trending term in evidence-based medicine, and COVID-19 research is no exception. In this context, a nomogram is usually a web-based tool, a graphic interface, or an on-line calculator in which patient data on several variables is entered as input, and a single summary statistic is calculated as output, such as the likelihood of successful response to treatment. Many medical researchers and data scientists have put forward nomograms derived from multivariate clinical progression models, to assist in decisions about COVID-19 triage.
Is this enthusiasm for reducing complex clinical decisions to the use of multivariate calculators a leap forward in personalized medicine, enabled by modern computing? There is a sketchy “black box” side to all this, to say nothing of the risk of incorporating statistical design errors or untenable inferential claims into a nomogram being rolled out for immediate, untested use in the middle of pandemic. So let’s treat the history of the “number needed to treat” as a “teachable moment” in the history of nomograms in medicine. What have we learned so far?