October 21, 2020

excess deaths and now better survival

Some intersecting points of data have been getting press the past few days. You may have heard about it in the news. The MMWR, the CDC’s weekly epidemiological newsletter, reviewed the number of deaths from January to the first part of October. They found that, so far this year, just about 300,000 more people living in the US have died than expected, compared to the number of expected deaths based on the average from prior years. 66% of the deaths, or almost 200,000 were due to Covid-19. JAMA, the Journal of the American Medical Association, also did an analysis and found a similar rate of excess deaths. The studies showed higher death rates in Hispanic and Latinos and more unexpected deaths in young adults age 25-44. The JAMA says deaths increased 20% from January to July with only 67% documented to be from Covid-19.

Lots of theories and ideas of why excess deaths that are not attributed to Covid-19 are reported. Possibly from undiagnosed Covid-19, possibly people avoiding hospitals or Emergency Rooms to avoid Covid-19 exposure. I suspect that some people who appeared to have heart attacks or strokes may actually have had blood clots caused by SARS-CoV-2 that caused their deaths, with similar symptoms. Another recent study did not show an increase in suicide during the strictest days of social distancing. I am glad to see those numbers, but worry that, as the pandemic drags on and the economy’s recovery is kept on hold, despair will increase. We mustn’t forget each other.

With that sobering news, we hear about an alarming increase of infections throughout the nation, especially the mid-west and the south. Even here in Western Washington, the Department of Health is reminding us that we are on the verge, as well, and encourages back to basics for decreasing spread.

As cases rise, hospitalizations rise, too. Not just older people, some young ones too. An increase in deaths will follow in 2 weeks or so. However, we have learned how to manage very sick people much better than we did when the virus first arrived. The death rate was as high as high as 25% in the beginning, and now has dropped to 7.6%. A second study supports these findings.

That means we have come a long way in 7 months, physicians and nurses know much better how to manage people and keep them off ventilators, having them do tummy time breathing when they lie on their bellies, some of the meds like remdesivir and dexamethasone can help too. We also lowered the curve so that hospitals and their ICU’s did not get overwhelmed.

We just really need to continue our vigilance and not give in to pandemic burnout, more important as we moved indoors. Let’s all keep in touch with people we care about because that will help all of us live better, and feel better.

Wash your hands, cover your nose, keep safe six, call a friend.

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6942e2.htm?s_cid=mm6942e2_w

https://jamanetwork.com/journals/jama/fullarticle/2771761

https://www.npr.org/sections/health-shots/2020/10/20/925441975/studies-point-to-big-drop-in-covid-19-death-rates

http://content.govdelivery.com/bulletins/gd/WADOH-2a6b756

https://www.medrxiv.org/content/10.1101/2020.10.20.20215343v1

https://nymag.com/intelligencer/2020/10/new-studies-show-major-drop-in-covid-19-mortality-rates.html