New York City experienced the largest increases in non-respiratory deaths, notably from heart disease and diabetes.…10/12/20, JAMA article reports that from March 1-August 1, 74,989 died due to disruption or cessation of normal US health system as requested and financed by federal government.…Overlooked is that: “People with dementia are dying not just from the virus but from the very strategy of isolation that’s supposed to protect them,” per 9/16/20 Washington Post article. “In recent months, doctors have reported increased falls, pulmonary infections, depression and sudden frailty in patients who had been stable for years.”
Oct. 18, 2020, “One-third of excess deaths in US during pandemic were not due to the coronavirus: Study,” Washington Examiner, Michael Lee
“A new study found that a third of excess deaths in the United States during the COVID-19 pandemic could not be directly attributed to the coronavirus.“ Although total US death counts are remarkably consistent from year to year,US deaths increased by 20% during March-July 2020. COVID-19 was a documented cause of only 67% of these excess deaths,” the study, published on the Journal of the American Medical Association’s website said. “Some states had greater difficulty than others in containing community spread, causing protracted elevations in excess deaths that extended into the summer.”
One reason for the high amount of excess deaths not attributable to COVID-19 has been disruptions in health services caused by lockdowns.
“Excess deaths attributed to causes other than COVID-19 could reflect deaths from unrecognized or undocumented infection with severe acute respiratory syndrome coronavirus 2 or deaths among uninfected patients resulting from disruptions produced by [government ordered and financed rules leading into] the pandemic,” the study’s authors noted.
The American Medical Association study, which has yet to be peer-reviewed, found that between March and August, the U.S. recorded 1,336,561 deaths, a “20% increase over expected deaths.” It noted that “of the 225,530 excess deaths, 150,541 (67%) were attributed to COVID-19.”
Deaths from heart disease and Alzheimer’s disease and dementia saw statistically significant increases,the study noted.
Those results largely echo those of a September Washington Post analysis of excess dementia deaths….
“More than 134,200 people have died from Alzheimer’s and other forms of dementia since March. That is 13,200 more U.S. deaths caused by dementia than expected,compared with previous years,” the Post reported….
“People with dementia are dying not just from the virus but from the very strategy of isolation that’s supposed to protect them,”the Post continued. “In recent months, doctors have reported increased falls, pulmonary infections, depression and sudden frailty in patients who had been stable for years.”
According to the AMA study, much of the country’s excess deaths can be attributed to just a few states.
“The 10 states with the highest per capita rate of excess deaths were
New York, New Jersey, Massachusetts, Louisiana, Arizona, Mississippi, Maryland, Delaware, Rhode Island, and Michigan,” the study said.
“The increase in absolute deaths in these states relative to expected values ranged from 22% in Rhode Island and Michigan to 65% in New York,” the study continued. “Three states with the highest death rates (New Jersey, New York, and Massachusetts) accounted for 30% of US excess deathsbut had the shortest epidemic.”
The authors noted the study has limitations, including a “reliance on provisional data”and “inaccuracies in death certificates.”
Concerns over the health implications of lockdowns have grown in recent months. Joel Zinberg, a practicing surgeon at Mount Sinai Hospital and an associate clinical professor of surgery at the Icahn School of Medicine, noted in July that excess deaths due to causes outside of the coronaviruscould be one of the unintended consequences of government responsesto the pandemic.
“Deaths from chronic, non-emergent conditions also increased as patients put off maintenance visits and their medical conditions deteriorated,” Zinberg said. “Five states with the most Covid-19 deaths from March through April (Massachusetts, Michigan, New Jersey, New York, and Pennsylvania), experienced large proportional increases in deaths from non-respiratory underlying causes, including diabetes (96 percent), heart diseases (89 percent), Alzheimer’s disease (64 percent), and cerebrovascular diseases (35 percent).
New York City—the nation’s Covid-19 epicenter during that period—experienced the largest increases in non-respiratory deaths, notably from heart disease (398 percent) and diabetes(356 percent).”
“Cancer diagnoses were delayed for months as patients were unable to obtain ‘elective; screening procedures,” he continued. “For some, this will result in more advanced disease. Diagnosed cancer cases—normally treated with surgery or inpatient medical treatments—were treated with outpatient treatments instead. While some oncologists rationalized that the results might be just as good, physicians were clearly deviating from the standard of care.”
Zinberg also noted how the economic recession brought on by lockdowns could endanger public health.
“The lockdowns led to wide unemployment and economic recession, resulting in increased drug and alcohol abuse and increases in domestic abuse and suicides. Most studies in a systematic literature review found a positive association between economic recession and increased suicides,” Zinberg said. “Ten times as many people texted a federal government disaster mental-distress hotline in April 2020 as in April 2019.”
Dr. Anthony Fauci, the leading White House infectious disease expert, has also expressed opposition to new lockdown efforts.
He warned against calls for a national lockdown in an interview set to be released Sunday, saying the pandemic would have to get “really, really bad” before he would support the measure. He also noted that the country is “fatigued with restrictions.””…
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Added: From study linked above, 33% of excess US deaths, 74,989, March-July 2020 weren’t from Covid, but were due to government ordered disruption and cessation of normal US healthcare system. For the record, hospitals were given financial incentive to report that deaths were caused by or with Covid. This kind of information is often mentioned in scientific studies.
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“Connecticut and North Carolina were excluded due to missing data.“
Oct. 12, 2020, “Excess Deaths From COVID-19 and Other Causes, March-July 2020,“ JAMA Research Letter
Death data for 2014-2020 and population counts for the 50 states and the District of Columbia were obtained from the National Center for Health Statistics3,4 and US Census Bureau,5 respectively. Death counts from March 1, 2020, through August 1, 2020, were taken from provisional, unweighted data released on September 9, 2020.3 Connecticut and North Carolina were excluded due to missing data.A hierarchical Poisson regression model, described elsewhere,1 was used to predict expected deaths based on historic norms. COVID-19 deaths included those in which COVID-19 was cited as an underlying or contributing cause. Data for deaths not attributed to COVID-19 were only available for underlying causes of death, including Alzheimer disease, heart disease, and 10 other grouped causes, defined elsewhere.1 Reopening dates were obtained from the New York Times.6
To confirm the validity of observed increases in non–COVID-19 deaths, the Joinpoint regression program (version 4.8.0.1; Statistical Research and Applications Branch, National Cancer Institute) was used to specify the weeks (joinpoints) when slopes changed (as measured by the annual percentage change [APC]) and their statistical significance (2-sided test, .05 threshold). To estimate dispersion in the epidemic curve for each state, the number of consecutive weeks during which 90% of excess deaths occurred (ED90) was calculated. All calculations were performed in SAS (version 9.4; SAS Institute) and R (version 3.6.1; The R Foundation).
Between March 1 and August 1, 2020,1 336 561 deaths occurred in the US, a 20% increase over expected deaths (1 111 031 [95% CI, 1 110 364 to 1 111 697]). The 10 states with the highest per capita rate of excess deaths were New York, New Jersey, Massachusetts, Louisiana, Arizona, Mississippi, Maryland, Delaware, Rhode Island, and Michigan. The states with the highest per capita rate of excess deaths changed from week to week (Video). The increase in absolute deaths in these states relative to expected values ranged from 22% in Rhode Island and Michigan to 65% in New York (Table). Three states with the highest death rates (New Jersey, New York, and Massachusetts) accounted for 30% of US excess deaths but had the shortest epidemics (ED90 < 10 weeks). States that experienced acute surges in April (and reopened later) had shorter epidemics that returned to baseline in May,whereas states that reopened earlier experienced more protracted increases in excess deaths that extended into the summer (Figure).
Of the 225 530 excess deaths, 150 541 (67%) were attributed to COVID-19. Joinpoint analyses revealed an increase in deaths attributed to causes other than COVID-19, [74,989] with 2 reaching statistical significance. US mortality rates for heart disease increased between weeks ending March 21 and April 11 (APC, 5.1 [95% CI, 0.2-10.2]), driven by the spring surge in COVID-19 cases. Mortality rates for Alzheimer disease/dementia increased twice, between weeks ending March 21 and April 11 (APC, 7.3 [95% CI, 2.9-11.8]) and between weeks ending June 6 and July 25 (APC, 1.5 [95% CI, 0.8-2.3]), the latter coinciding with the summer surge in sunbelt states.
Although total US death counts are remarkably consistent from year to year, US deaths increased by 20% during March-July 2020. COVID-19 was a documented cause of only 67% of these excess deaths. Some states had greater difficulty than others in containing community spread, causing protracted elevations in excess deaths that extended into the summer. US deaths attributed to some noninfectious causes increased during COVID-19 surges. Excess deaths attributed to causes other than COVID-19 could reflect deaths from unrecognized or undocumented infection with severe acute respiratory syndrome coronavirus 2 or deaths among uninfected patients resulting from disruptions produced by [government dictates during] the pandemic. Study limitations include the reliance on provisional data, inaccuracies in death certificates, and assumptions applied to the model.
Accepted for Publication: September 15, 2020.
Corresponding Author: Steven H. Woolf, MD, MPH, Center on Society and Health, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, 830 E Main St, Ste 5035, Richmond, VA 23298-0212 (steven.woolf@vcuhealth.org).
Published Online: October 12, 2020. doi:10.1001/jama.2020.19545
Author Contributions: Drs Woolf and Chapman had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Woolf, Chapman, Sabo, Weinberger.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Woolf, Sabo.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: All authors.
Administrative, technical, or material support: Chapman.
Supervision: Woolf, Chapman.
Conflict of Interest Disclosures: Dr Weinberger reported receiving personal fees from Pfizer, Merck, Affinivax, and GlaxoSmithKline outside the submitted work and being the principal investigator for a research grant from Pfizer to Yale University. No other disclosures were reported.
Funding/Support: Drs Woolf and Chapman and Ms Hill received partial funding from grant UL1TR002649 from the National Center for Advancing Translational Sciences. Drs Woolf and Chapman also received partial funding from grant R01AG055481 from the National Institute on Aging. Dr Weinberger was funded by grant R01AI137093 from the National Institute of Allergy and Infectious Diseases.
Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Additional Contributions: We thank Cassandra Ellison, MFA, art director for the Virginia Commonwealth University Center on Society and Health, for her assistance with graphic design; she was not compensated beyond her salary.
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