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Study says 460k of first million recorded US COVID deaths caused by variants – News-Medical.Net

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In a recent research paper posted to the medRxiv* preprint server, scientists from Yale School of Public Health analyzed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-linked deaths in the United States (US).

Study: One Million and Counting: Estimates of Deaths in the United States from Ancestral SARS-CoV-2 and Variants. Image Credit: Gargantiopa / Shutterstock

Background

Novel SARS-CoV-2 variants with higher virulence, transmissibility, and immune evasion have emerged due to sustained worldwide coronavirus disease 2019 (COVID-19) transmission since its emergence in Wuhan, China, at the end of 2019. In the US, over one million SARS-CoV-2-related deaths have been reported so far. In addition, SARS-CoV-2 mutants identified worldwide have shifted the course of the COVID-19 epidemic in the US several times. 

As of 12 May 2022, the World Health Organization (WHO) has described five SARS-CoV-2 variants of concern (VOCs), first found in four distinct continents. All five VOCs were more contagious than the original SARS-CoV-2 strain and spread to the US. COVID-19 vaccines produced based on the non-variant SARS-CoV-2 (i.e., non-VOC SARS-CoV-2) are weakly efficacious against Omicron and Delta VOCs infections yet extremely effective against severe illness. Notably, over the length of the US SARS-CoV-2 epidemic, the particular burden of death from each viral variant remains unknown.

About the study

The goal of the present study was to calculate the number of deaths caused by each SARS-CoV-2 mutant in the US. The scientists built an epidemiologic model to determine the number of documented COVID-19 deaths in the US attributed to each SARS-CoV-2 mutant. They used information obtained from the Centers for Disease Control and Prevention (CDC) about SARS-CoV-2-linked mortalities by jurisdiction and circulating viral variant percentages. Further, to address parameter uncertainty, the team performed a sensitivity evaluation.

The current analysis was based on the tentative numbers of SARS-CoV-2 mortality from the National Center for Health Statistics (NCHS) of CDC. This data was accessed up to 12 May 2022.

To obtain the number of documented COVID-19 deaths caused by each SARS-CoV-2 variant, the team back-distributed mortalities to determine the proportion of eventually fatal COVID-19 cases testing positive every day in each jurisdiction and then contrasted these statistics to percentages of variants between sequenced cases in the exact location and timepoint, controlling for variances in disease severity among variants.

Given the interval between the onset of symptoms, testing, and mortality, the team used lags to estimate the timing of sample procurement for new fatalities. They anticipated that sampling for testing occurred zero, one, two, or three days following the beginning of symptoms, with a correlated probability of 25% for all of these four possible lag times for the primary assessment. The researchers also hypothesized a lag between the start of symptoms and death.

Findings

The authors illustrated that 46% (460,124) of the 1,003,419 SARS-CoV-2 mortalities documented as of 12 May 2022 were attributable to WHO-designated SARS-CoV-2 variants in the US at the national level. On the other hand, 54% of all COVID-19 mortalities were attributed to non-variant SARS-CoV-2.

The researchers demonstrated the influence of the SARS-CoV-2 variants throughout the US. The variants caused a significant number of deaths in all regions. The South had the highest variant deaths per capita, with a median estimate of 158 per 100,000, while the Northeast had the fewest, with a median estimate of 111 per 100,000, by US census region. Some areas were disproportionately affected, owing to disparities in vaccination coverage, demographics, preexisting immunity, societal vulnerability, and non-pharmaceutical intervention use.

SARS-CoV-2 Alpha, with a median estimate of 39,548 deaths, Omicron (117,560), and Delta (273,801) were projected to be responsible for almost 40% of national COVID-19 deaths. Indeed, 3,628 of the COVID-19 deaths documented by NCHS could not be assigned to a SARS-CoV-2 variant since the week of mortality was not specified at the state level in the data.

Conclusions

Study findings show that SARS-CoV-2 mutants that have been discovered across the world have claimed a considerable amount of lives in the US. SARS-CoV-2 variants initially found outside the US were responsible for over 40% of COVID-19 deaths in the nation.

The current study backs up the claim that “no one is safe until everyone is safe” by demonstrating the notable effect of SARS-CoV-2 mutants on US mortality, which has emerged in the vicinity of uncontrolled circulation both locally and globally. This analysis implies that fast implementation of methods to mitigate the impact of emerging SARS-CoV-2 variants following the commencement of a viral epidemic could be beneficial. The authors noted that more efforts were needed to reduce the likelihood of novel SARS-CoV-2 variants arising, including worldwide COVID-19 vaccination, therapy, and outbreak management, apart from national public health policies.

To summarize, the present work emphasizes the risk that novel SARS-CoV-2 variants pose to Americans, a hazard exacerbated by poor global COVID-19 vaccination rates and a scarcity of therapeutics, diagnostics, and prophylactic approaches for SARS-CoV-2 infection.

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

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Whooping cough is at a decade-high level in US

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MILWAUKEE (AP) — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.

There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.

The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.

Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.

Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.

Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.

“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.

Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.

But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.

That includes his own teenage daughter.

“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.

It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.

“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”

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AP data journalist Kasturi Pananjady contributed to this report.

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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

The Canadian Press. All rights reserved.

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Scientists show how sperm and egg come together like a key in a lock

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How a sperm and egg fuse together has long been a mystery.

New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.

“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.

The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.

Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.

It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.

Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.

Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.

The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.

The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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Older patients, non-English speakers more likely to be harmed in hospital: report

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Patients who are older, don’t speak English, and don’t have a high school education are more likely to experience harm during a hospital stay in Canada, according to new research.

The Canadian Institute for Health Information measured preventableharmful events from 2023 to 2024, such as bed sores and medication errors,experienced by patients who received acute care in hospital.

The research published Thursday shows patients who don’t speak English or French are 30 per cent more likely to experience harm. Patients without a high school education are 20 per cent more likely to endure harm compared to those with higher education levels.

The report also found that patients 85 and older are five times more likely to experience harm during a hospital stay compared to those under 20.

“The goal of this report is to get folks thinking about equity as being a key dimension of the patient safety effort within a hospital,” says Dana Riley, an author of the report and a program lead on CIHI’s population health team.

When a health-care provider and a patient don’t speak the same language, that can result in the administration of a wrong test or procedure, research shows. Similarly, Riley says a lower level of education is associated with a lower level of health literacy, which can result in increased vulnerability to communication errors.

“It’s fairly costly to the patient and it’s costly to the system,” says Riley, noting the average hospital stay for a patient who experiences harm is four times more expensive than the cost of a hospital stay without a harmful event – $42,558 compared to $9,072.

“I think there are a variety of different reasons why we might start to think about patient safety, think about equity, as key interconnected dimensions of health-care quality,” says Riley.

The analysis doesn’t include data on racialized patients because Riley says pan-Canadian data was not available for their research. Data from Quebec and some mental health patients was also excluded due to differences in data collection.

Efforts to reduce patient injuries at one Ontario hospital network appears to have resulted in less harm. Patient falls at Mackenzie Health causing injury are down 40 per cent, pressure injuries have decreased 51 per cent, and central line-associated bloodstream infections, such as IV therapy, have been reduced 34 per cent.

The hospital created a “zero harm” plan in 2019 to reduce errors after a hospital survey revealed low safety scores. They integrated principles used in aviation and nuclear industries, which prioritize safety in complex high-risk environments.

“The premise is first driven by a cultural shift where people feel comfortable actually calling out these events,” says Mackenzie Health President and Chief Executive Officer Altaf Stationwala.

They introduced harm reduction training and daily meetings to discuss risks in the hospital. Mackenzie partnered with virtual interpreters that speak 240 languages and understand medical jargon. Geriatric care nurses serve the nearly 70 per cent of patients over the age of 75, and staff are encouraged to communicate as frequently as possible, and in plain language, says Stationwala.

“What we do in health care is we take control away from patients and families, and what we know is we need to empower patients and families and that ultimately results in better health care.”

This report by The Canadian Press was first published Oct. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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