Polio Is Back in the US and UK. Here’s How That Happened

Link: https://www.wired.com/story/polio-is-back-in-the-us-and-uk-heres-how-that-happened/

Excerpt:

Start with the vaccine formula—or formulas, actually, because there are two. They were born from a ferocious mid-20th century rivalry between scientists Jonas Salk and Albert Sabin. Salk’s formula, the first to be approved, is injected; it uses an inactivated version of the virus, and protects against developing disease, but does not stop viral transmission. Sabin’s formula, which came a few years later, used an artificially-weakened live virus. It does block transmission, and—because it is a liquid that gets squirted into a child’s mouth—it is cheaper to make and easier to distribute, since it doesn’t require trained healthcare workers or careful disposal of needles. Those qualities made the Sabin oral version, known as OPV, the bulwark of polio control, and eventually the main weapon in the global eradication campaign.

The oral vaccine had a unique benefit. Wild-type polio is actually a gut virus: It locks onto receptors in the intestinal lining and replicates there before migrating to the nerve cells that control muscles. But because it’s in the gut, it also passes out of the body in feces and then spreads to other people in contaminated water. The Sabin vaccine takes advantage of that process: The vaccine virus replicates in a child, gets pooped out, and spreads its protection to unvaccinated neighbors.

Yet that benefit concealed a tragic flaw. Once out of every several million doses, the weakened virus reverted to the neurovirulence of the wild type, destroying those motor neurons and causing polio paralysis. That mutation would also make a child who harbored the reverted virus a potential source of infection, rather than protection. That risk is what caused rich nations to abandon the oral version: In 1996, when wild polio was no longer occurring in the US, the oral vaccine caused about 10 cases of polio paralysis in children. The US switched to the injectable formula, known as IPV, in 2000, and the UK followed in 2004.

Polio vaccination requires several doses to create full protection, and once that occurs, children are protected against both wild-type and vaccine-derived versions of the virus. So the international vaccination campaign continued to rely on OPV, arguing that the risk would diminish as more children received protection. That was a reasonable gamble when the effort was new and health authorities thought it would take 10 to 12 years to achieve eradication. But thanks to funding shortfalls, political and religious unrest, and the Covid pandemic—which imposed a slowdown not just on eradication activities but on all childhood vaccines—it’s now been 34 years, and the job is not done. Meanwhile, last year in 20 countries there were a total of 688 cases of paralysis of what’s called “circulating vaccine-derived poliovirus,” and only six cases of wild-type polio, in three nations.

Author(s): MARYN MCKENNA

Publication Date: 24 Aug 2022

Publication Site: Wired

2020-2021 Excess Deaths in the U.S. General Population by Age and Sex

Link: https://www.soa.org/resources/research-reports/2022/excess-death-us/

Full report: https://www.soa.org/4a55a7/globalassets/assets/files/resources/research-report/2022/excess-death-us.pdf

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Excerpt:

The data used for this analysis was provided by the CDC as of August 17, 2022 and includes incurred deaths
by week, beginning on December 29, 2019 and going through July 2, 2022. For 2020, the CDC defines Week
1 as ranging from December 29, 2019 through January 4, 2020 and Week 52 as ranging from December 19,
2020 through December 26, 2020, so when reporting on 2020 results, this convention is used. The year
2021 begins on December 27, 2020 and runs through January 2, 2022. For the purposes of this analysis, the
start of the COVID-19 active period is March 22, 2020.
Due to the delay in reporting, the actual deaths have been completed based on factors that vary by age
and sex. These are shown below along with the expectations that are based on the five-year trend after
adjusting for seasonality.

These data are as of August 17, 2022 and exclude deaths that occurred after July 2, 2022. Figure 1 shows
that, for most months, the total A/E ratio is much greater than 100%, while the A/E ratio excluding COVID19 deaths is also greater than 100% by a few percent.

Author(s): Rick Leavitt, ASA, MAAA

Publication Date: August 2022

Publication Site: Society of Actuaries Research Institute

5 Worst States for Working-Age Death Increases in July

Link: https://www.thinkadvisor.com/2022/09/12/5-worst-states-for-working-age-death-increases-in-july/

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Excerpt:

Early government mortality numbers show that the number of U.S. deaths has stayed very high this summer, both for members of the general population and for working-age people.

For all U.S. residents, for the period from July 3 through Aug. 27, the number of deaths recorded in the U.S. Centers for Disease Control and Prevention’s FluView reports was 426,881, according to the report released Friday, which included data sent to the CDC by Sept. 3.

The “all cause” total for the general population was down just 0.8% from the total for the comparable period in 2021, and it was 22% higher than the total for the comparable period in 2019, before the COVID-19 pandemic began.

For U.S. residents ages 25 through 64, the all-cause death total during that same period was 113,665, according to early, weighted data in the CDC’s Weekly Counts of Deaths by Jurisdiction and Age reports, as of Sept. 8.

Author(s): Allison Bell

Publication Date: 12 Sept 2022

Publication Site: Think Advisor

Tracking covid-19 excess deaths across countries

Link: https://www.economist.com/graphic-detail/coronavirus-excess-deaths-tracker?utm_campaign=a.coronavirus-special-edition&utm_medium=email.internal-newsletter.np&utm_source=salesforce-marketing-cloud&utm_term=2022042&utm_content=ed-picks-article-link-5&etear=nl_special_5&utm_campaign=a.coronavirus-special-edition&utm_medium=email.internal-newsletter.np&utm_source=salesforce-marketing-cloud&utm_term=4/2/2022&utm_id=1119326

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As covid-19 has spread around the world, people have become grimly familiar with the death tolls that their governments publish each day. Unfortunately, the total number of fatalities caused by the pandemic may be even higher, for several reasons. First, the official statistics in many countries exclude victims who did not test positive for coronavirus before dying—which can be a substantial majority in places with little capacity for testing. Second, hospitals and civil registries may not process death certificates for several days, or even weeks, which creates lags in the data. And third, the pandemic has made it harder for doctors to treat other conditions and discouraged people from going to hospital, which may have indirectly caused an increase in fatalities from diseases other than covid-19.

One way to account for these methodological problems is to use a simpler measure, known as “excess deaths”: take the number of people who die from any cause in a given region and period, and then compare it with a historical baseline from recent years. We have used statistical models to create our baselines, by predicting the number of deaths each region would normally have recorded in 2020 and 2021.

Many Western countries, and some nations and regions elsewhere, regularly publish data on mortality from all causes. The table below shows that, in most places, the number of excess deaths (compared with our baseline) is greater than the number of covid-19 fatalities officially recorded by the government. The full data for each country, as well as our underlying code, can be downloaded from our GitHub repository. Our sources also include the Human Mortality Database, a collaboration between UC Berkeley and the Max Planck Institute in Germany, and the World Mortality Dataset, created by Ariel Karlinsky and Dmitry Kobak.

Publication Date: last updated 13 May 2022

Publication Site: The Economist

Personal Income Rose in 2021, But Growth Varied by State

Link: https://www.pewtrusts.org/en/research-and-analysis/articles/2022/05/13/personal-income-rose-in-2021-but-growth-varied-by-state

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Total personal income climbed in every state during the second year of the COVID-19 pandemic as the economy continued to recover, with Idaho and South Dakota experiencing the strongest gains. Americans’ earnings from work, which account for the bulk of personal income, recorded the sharpest annual increase in over two decades. Federal aid and other public assistance also added to states’ gains, surpassing 2020’s elevated levels.

Total personal income rose across states in 2021 as the economy largely followed an upward trajectory after severe losses early in the pandemic. Nationally, the sum of personal income from all sources was up 3.1% from 2020, after accounting for inflation.

Author(s): Mike Maciag, Joanna Biernacka-Lievestro & Joe Fleming

Publication Date: 13 May 2022

Publication Site: Pew Trust

What We’ve Learned — and Failed to Learn — from a Million COVID Deaths

Link: https://www.governing.com/now/what-weve-learned-and-failed-to-learn-from-a-million-covid-deaths

Excerpt:

The pandemic is not done. The number of new infections — surely an undercount due to unreported home tests — again tops 75,000 per day. The number of hospitalizations has climbed 20 percent over the past two weeks. The Biden administration has warned there could be 100 million more Americans infected by early next year. Yet Congress seems unwilling to provide more money for basic responses such as tests and vaccines, even as it becomes increasingly clear that even mild cases can lead to dangerous long-term damage.

Yet there are positive developments to consider as well. Vaccinations and certainly boosters are not where they should be, but three out of four Americans have received at least a single dose and two-thirds are fully vaccinated. The Commonwealth Fund has estimated that, absent vaccines, an additional 2.3 million Americans would have died, and 17 million more would have been hospitalized. Public health measures such as masking have largely fallen out of favor, but they helped prevent a death toll that could have been even more terrible.

“A million is way too many people, but as a result of the work that has been done, through public health and vaccination, it’s a number that’s a lot lower than it might have been,” says David Fleming, a distinguished visiting fellow at the Trust for America’s Health. “If we did not do those things, we would not be looking at the 1 million death threshold, we’d be looking at the 3 million death threshold.”

Author(s): Alan Greenblatt

Publication Date: 12 May 2022

Publication Site: Governing

The 5 Highest-Population States’ Current COVID-19 Mortality Picture

Link:https://www.thinkadvisor.com/2022/02/07/the-5-highest-population-states-current-covid-19-mortality-picture/

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Excerpt:

Life insurers had hoped that vaccination campaigns, social distancing efforts and the effects of past COVID-19 infections on people’s immune systems would start to reduce the impact of the pandemic on people with commercial life insurance and other commercial insurance products.

While the fall 2021 surge was underway, information about deaths and life insurance claims emerged slowly. Some life insurers suggested that the fall surge seemed to be spiking hard but ending quickly.

Now, Unum GroupLincoln FinancialMetLife and other life insurers are saying that the fall surge did cause big increases in the ratio of death benefits to life insurance premiums. At Unum, for example, the ratio increased to 98.3% in the latest quarter, from 71.7% in the fourth quarter of 2019, before the pandemic began.

Author(s): Allison Bell

Publication Date: 7 Feb 2022

Publication Site: Think Advisor

U.S. Has Far Higher Covid Death Rate Than Other Wealthy Countries

Link:https://www.nytimes.com/interactive/2022/02/01/science/covid-deaths-united-states.html

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Excerpt:

“We’ve finally started getting to a stage where most of the population has been exposed either to a vaccine or the virus multiple times by now,” said Dr. David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. Referring to American and European death rates, he continued, “I think we’re now likely to start seeing things be more synchronized going forward.”

Still, the United States faces certain steep disadvantages, ones that experts worry could cause problems during future Covid waves, and even the next pandemic. Many Americans have health problems like obesity and diabetes that increase the risk of severe Covid.

Author(s): Benjamin Mueller and Eleanor Lutz

Publication Date: 1 Feb 2022

Publication Site: NYT

Annual Report on the Insurance Industry

Link:https://home.treasury.gov/system/files/311/FIO-2021-Annual-Report-Insurance-Industry.pdf

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Excerpt:

Catastrophe losses of $61 billion in 2020 were notably more severe than in 2019, with a record number of
catastrophic events in the United States in 2020.46 Despite the more severe catastrophic event
losses, lower losses in personal and commercial auto and workers’ compensation lines kept total
loss and loss adjustment expenses flat from 2019 to 2020. Reserve development was again
favorable in 2020, adding to underwriting profits. Figure 24 shows losses from catastrophic
events in the United States since 2016, and Figure 25 shows reserve development over the same
period.47 The expense ratio decreased very slightly from 2019 to 2020.

Publication Date: September 2021

Publication Site: Federal Insurance Office

America’s pandemic is now an outlier in the rich world

Link:https://www.economist.com/graphic-detail/2021/09/27/americas-pandemic-is-now-an-outlier-in-the-rich-world

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Excerpt:

America is recording nearly 2,000 covid-19 deaths a day, according to a seven-day average compiled by Johns Hopkins University. That is only 40% below the country’s January peak. But the true death toll is even worse. The Economist’s excess-deaths model, which estimates the difference between the actual and the expected number of deaths recorded in a given period, suggests that America is suffering 2,800 pandemic deaths per day, with a plausible range of 900 to 3,300, compared with 1,000 (150 to 3,000) in all other high-income countries, as defined by the World Bank. Adjusting for population, the death rate is now about eight times higher in America than in the rest of the rich world.

Publication Date: 27 Sept 2021

Publication Site: The Economist

Inequality in Mortality between Black and White Americans by Age, Place, and Cause, and in Comparison to Europe, 1990-2018

Link:https://www.nber.org/papers/w29203

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Excerpt:

Although there is a large gap between Black and White American life expectancies, the gap fell 48.9% between 1990-2018, mainly due to mortality declines among Black Americans. We examine age-specific mortality trends and racial gaps in life expectancy in rich and poor U.S. areas and with reference to six European countries.
Inequalities in life expectancy are starker in the U.S. than in Europe. In 1990 White Americans and Europeans in rich areas had similar overall life expectancy, while life expectancy for White Americans in poor areas was lower. But since then even rich White Americans have lost ground relative to Europeans. Meanwhile, the gap in life expectancy between Black Americans and Europeans decreased by 8.3%.
Black life expectancy increased more than White life expectancy in all U.S. areas, but improvements in poorer areas had the greatest impact on the racial life expectancy gap. The causes that contributed the most to Black mortality reductions included: Cancer, homicide, HIV, and causes originating in the fetal or infant period.
Life expectancy for both Black and White Americans plateaued or slightly declined after 2012, but this stalling was most evident among Black Americans even prior to the COVID-19 pandemic. If improvements had continued at the 1990-2012 rate, the racial gap in life expectancy would have closed by 2036. European life expectancy also stalled after 2014. Still, the comparison with Europe suggests that mortality rates of both Black and White Americans could fall much further across all ages and in both rich and poor areas.

Author(s): Hannes Schwandt, Janet Currie, Marlies Bär, James Banks, Paola Bertoli, Aline Bütikofer, Sarah Cattan, Beatrice Zong-Ying Chao, Claudia Costa, Libertad Gonzalez, Veronica Grembi, Kristiina Huttunen, René Karadakic, Lucy Kraftman, Sonya Krutikova, Stefano Lombardi, Peter Redler, Carlos Riumallo-Herl, Ana Rodríguez-González, Kjell Salvanes, Paula Santana, Josselin Thuilliez, Eddy van Doorslaer, Tom Van Ourti, Joachim Winter, Bram Wouterse & Amelie Wuppermann

DOI 10.3386/w29203

WORKING PAPER 29203

Publication Date: September 2021

Publication Site: NBER

COVID-19-Associated Orphanhood and Caregiver Death in the United States

Link:https://pediatrics.aappublications.org/content/pediatrics/early/2021/10/06/peds.2021-053760.full.pdf

Graphic:

Excerpt:

Methods: We quantified COVID-19-associated caregiver loss and orphanhood in the US and for
each state using fertility and excess and COVID-19 mortality data. We assessed burden and rates
of COVID-19-associated orphanhood and deaths of custodial and co-residing grandparents,
overall and by race/ethnicity. We further examined variations in COVID-19-associated
orphanhood by race/ethnicity for each state.


Results: We found that from April 1, 2020 through June 30, 2021, over 140,000 children in the
US experienced the death of a parent or grandparent caregiver. The risk of such loss was 1.1 to
4.5 times higher among children of racial and ethnic minorities, compared to Non-Hispanic
White children. The highest burden of COVID-19-associated death of parents and caregivers
occurred in Southern border states for Hispanic children, Southeastern states for Black children,
and in states with tribal areas for American Indian/Alaska Native populations.

Author(s): Hillis SD, Blenkinsop A, Villaveces A, et al.

Publication Date: 2021, accessed 12 Oct 2021

DOI: 10.1542/peds.2021-053760

Citation: Hillis SD, Blenkinsop A, Villaveces A, et al. COVID-19-associated orphanhood and
caregiver death in the United States. Pediatrics. 2021; doi: 10.1542/peds.2021-053760

Publication Site: Pediatrics