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Study: 35% of excess deaths in pandemic's early months tied to causes other than COVID-19 – EurekAlert

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IMAGE: In March and April of 2020, mortality rates from (clockwise from top left) heart disease, diabetes, Alzheimer’s disease and stroke spiked in states that also had the most COVID-19 deaths:…
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Credit: (Courtesy of JAMA)

RICHMOND, Va. (July 1, 2020) — Since COVID-19’s spread to the United States earlier this year, death rates in the U.S. have risen significantly. But deaths attributed to COVID-19 only account for about two-thirds of the increase in March and April, according to a study published Wednesday in the Journal of the American Medical Association.

Researchers at Virginia Commonwealth University and Yale University found that, from March 1 to April 25, the U.S. saw 87,001 excess deaths — or deaths above the number that would be expected based on averages from the previous five years. The study, “Excess Deaths from COVID-19 and Other Causes, March-April 2020,” showed that only 65% of the excess deaths that occurred in March and April were attributed to COVID-19, meaning more than one-third were linked to other causes.

In 14 states, including two of the most populated — California and Texas — more than half of the excess deaths were tied to an underlying cause other than COVID-19, said lead author Steven Woolf, M.D., director emeritus of VCU’s Center on Society and Health.

This data, Woolf said, suggests the COVID-19 death counts reported to the public underestimate the true death toll of the pandemic in the U.S.

“There are several potential reasons for this under-count,” said Woolf, a professor in the Department of Family Medicine and Population Health at VCU School of Medicine. “Some of it may reflect under-reporting; it takes awhile for some of these data to come in. Some cases might involve patients with COVID-19 who died from related complications, such as heart disease, and those complications may have been listed as the cause of death rather than COVID-19.

“But a third possibility, the one we’re quite concerned about, is indirect mortality — deaths caused by the response to the pandemic,” Woolf said. “People who never had the virus may have died from other causes because of the spillover effects of the pandemic, such as delayed medical care, economic hardship or emotional distress.”

Woolf and his team found that deaths from causes other than COVID-19 rose sharply in the states that had the most COVID-19 deaths in March and April. Those states were Massachusetts, Michigan, New Jersey, New York — particularly New York City — and Pennsylvania. At COVID-19’s peak for March and April (the week ending April 11), diabetes deaths in those five states rose 96% above the expected number of deaths when compared to the weekly averages in January and February of 2020. Deaths from heart disease (89%), Alzheimer’s disease (64%) and stroke (35%) in those states also spiked.

New York City’s death rates alone rose a staggering 398% from heart disease and 356% from diabetes, the study stated.

Woolf said he and his team suspect that some of these were indirect deaths from the pandemic that occurred among people with acute emergencies, such as a heart attack or stroke, who may have been afraid to go to a hospital for fear of getting the virus. Those who did seek emergency care, particularly in the areas hardest hit by the virus, may not have been able to get the treatment they needed, such as ventilator support, if the hospital was overwhelmed by the surge.

Others may have died from a chronic health condition, such as diabetes or cancer, that was exacerbated by the effects of the pandemic, said Woolf, VCU’s C. Kenneth and Dianne Wright Distinguished Chair in Population Health and Health Equity. Still others may have struggled to deal with the consequences of job loss or social isolation.

“We can’t forget about mental health,” Woolf said. “A number of people struggling with depression, addiction and very difficult economic conditions caused by lockdowns may have become increasingly desperate, and some may have died by suicide. People addicted to opioids and other drugs may have overdosed. All told, what we’re seeing is a death count well beyond what we would normally expect for this time of year, and it’s only partially explained by COVID-19.”

Woolf and his co-authors, Derek Chapman, Ph.D., Roy Sabo, Ph.D., and Latoya Hill of VCU, and Daniel M. Weinberger, Ph.D., of Yale University, state that further investigation is needed to determine just how many deaths were from COVID-19 and how many were indirect deaths “caused by disruptions in society that diminished or delayed access to health care and the social determinants of health (e.g., jobs, income, food security).”

Woolf, also a family physician, said this paper’s results underscore the need for health systems and public officials to make sure services are available not only for COVID-19 but for other health problems. His study showed what happened in the states that were overwhelmed by cases in March and April. Woolf worries that the same spikes in excess deaths may now be occurring in other states that are being overwhelmed.

“The findings from our VCU researchers’ study confirm an alarming trend across the U.S., where community members experiencing a health emergency are staying home — a decision that can have long-term, and sometimes fatal, consequences,” said Peter Buckley, M.D., interim CEO of VCU Health System and interim senior vice president of VCU Health Sciences. “Health systems nationwide need to let patients know it is safe and important to seek care in a health emergency, whether it’s through telehealth or in person.”

Woolf, who serves in a community engagement role with the C. Kenneth and Dianne Wright Center for Clinical and Translational Research, said resources should be available for those facing unemployment, loss of income and food and housing insecurity, including help with the mental health challenges, such as depression, anxiety or addiction, that these hardships could present.

“Public officials need to be thinking about behavioral health care and ramping up their services for those patients in need,” Woolf said. “The absence of systems to deal with these kinds of other health issues will only increase this number of excess deaths.”

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The research team from VCU and Yale received funding for this study from the National Center for Advancing Translational Sciences and the National Institute of Allergy and Infectious Diseases. Both entities are part of the National Institutes of Health.

About VCU and VCU Health

Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 217 degree and certificate programs in the arts, sciences and humanities. Thirty-eight of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 11 schools and three colleges. The VCU Health brand represents the VCU health sciences academic programs, the VCU Massey Cancer Center and the VCU Health System, which comprises VCU Medical Center (the only academic medical center in the region), Community Memorial Hospital, Children’s Hospital of Richmond at VCU, MCV Physicians and Virginia Premier Health Plan. For more, please visit http://www.vcu.edu and vcuhealth.org.

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Brandon must roll back reopening: Liberals – Winnipeg Free Press

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Manitoba Liberal Leader Dougald Lamont says the public must receive more detailed information about COVID-19 cases in Manitoba. (The Canadian Press files)

Manitoba Liberal Leader Dougald Lamont said the province needs to dial back its reopening strategy in Brandon, which has a cluster of 40 COVID-19 cases, with about half involving workers at the Maple Leaf pork plant.

Currently, Manitoba is in Phase Four of its reopening strategy, which allows for more people to sit in bars and restaurants as long as they can maintain a two-metre distance, and a greater number of people can gather at indoor and outdoor events, for example. There is no mask mandate in the province, but people are advised to wear one in crowded indoor places.

Lamont said Brandon should revert to earlier stages of the phased-in reopening plan because he worries there is a risk of greater community transmission.

On Sunday, chief provincial public health officer Dr. Brent Roussin said a small number of the cases in Brandon may have been transmitted in the community, but most involve people who are close contacts of each other.

Eighteen workers at the Maple Leaf Foods plant in Brandon have tested positive for COVID-19. (Tim Smith / Brandon Sun files)

Eighteen workers at the Maple Leaf Foods plant in Brandon have tested positive for COVID-19. (Tim Smith / Brandon Sun files)

A second cluster is located in the Steinbach area.

Lamont said the government should be willing to roll back the reopening plan in any COVID-19 hot spot in the province, instead of sticking to one plan for such a large geographic area.

He also said the government’s pandemic communications strategy creates confusion and does a disservice to the public when information about outbreaks is not specific. For example, Roussin won’t specifically say the Maple Leaf plant is involved. Instead, he refers to a business in Brandon.

The government argues it doesn’t want to stigmatize groups of people. It refused to be specific even after the media had reported that the outbreak is at the meat plant.

Lamont said safety must be the “paramount concern.”

“People fill in what they don’t know with rumours and speculation,” he said.

Lamont said many of the workers at the Brandon meat plant come from foreign countries such as Mexico and the Philippines, live together in close quarters and cannot self-isolate. He suggested the City of Brandon should look at setting up an isolation centre to help contain the spread of the virus.

 

He said the Tory government all but declared the pandemic over in Manitoba by encouraging people to travel and businesses to reopen quickly. He pointed out that people don’t know where to travel if they are not specifically told by the government where an outbreak is occurring, other than in specific health regions, which are vast places.

On Sunday, Roussin did say changes would be made this week in terms of information posted on the provincial COVID-19 website. Data will be broken down by health districts within each health authority. Currently they are listed under one of the five authorities.

“This will allow us to break down case numbers in more detail while continuing to ensure the privacy of Manitobans,” he said.

 

 

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PMH tallies 32 new COVID cases over the weekend – Brandon Sun

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RUTH BONNEVILLE

Manitoba’s chief provincial health officer, Dr. Brent Roussin, holds a press conference at the Legislative Building on Friday. Roussin hosted a weekend press conference for the first time in a while on Sunday. (RUTH BONNEVILLE / WINNIPEG FREE PRESS)

The province reported 51 new COVID-19 cases in Manitoba over the weekend—16 on Saturday and 35 on Sunday—including a total of 32 in the Prairie Mountain Health region.

The 35 new overall cases revealed on Sunday marks the second-highest one-day jump since the start of the pandemic.

Of the 20 new PMH cases announced on Sunday, Dr. Brent Roussin, the province’s chief public health officer, announced in a rare weekend news conference that at least seven of these cases are connected to a single business in Brandon.

Although Roussin mentioned that the seven affected individuals are self-isolating, and that there was no evidence of workplace transmission, he would not name the specific business in question when asked.

However, this announcement follows a week where at least 10 workers from the Maple Leaf Foods pork processing plant in Brandon have tested positive for the virus.

And as of Sunday evening, UFCW Local 832 president Jeff Traeger told the Sun that eight additional positive cases of COVID-19 were discovered at Maple Leaf Brandon over the weekend, bringing their total amount of known cases up to 18.

“These new cases strengthen our call on Maple Leaf Brandon to close for a one-week period until all test results are in, and the situation is under control,” Traeger wrote in this email. 

Over the weekend, several other businesses in the Wheat City closed their doors or significantly reduced their services due to concerns that one of their workers might have contracted COVID-19. This includes Marino’s Pizza, the McDonald’s restaurant on Victoria Avenue and the Shoppers Drug Mart also located on Victoria.

Employees from a local Walmart and a Tim Hortons restaurant on Highway 1 also tested positive for COVID-19 last week, prompting the latter establishment to shut down so it can be thoroughly sanitized.

In general, Roussin said on Sunday that this growing cluster in Brandon was approaching and may have exceeded 40 people.

Otherwise, this batch of new cases over the weekend brings Manitoba’s total number of lab-confirmed positive and probable positive cases up to 542.

Sunday’s COVID-19 data also shows that six people are currently hospitalized, with three individuals being in intensive care.

Overall, the province is now contending with 182 active cases in Manitoba, with 352 individuals having recovered from the virus.

Manitoba’s COVID-19 related death rate remains at eight.

While Roussin admits that the recent spike in new cases is discouraging, he implores Manitoba to remain vigilant and stick to the essentials of good social distancing: vigorous hand-washing, avoiding crowded indoor spaces and staying at home if you feel ill.

“Our concern has never gone away,” he said. “We’ve had to find ways to continue to articulate to Manitobans that we have to be careful. And certainly, as we see these numbers go up, we’re going to increase that messaging.”

An additional 756 laboratory tests were completed on Saturday, bringing the total number of tests completed since early February to 100,830.

» kdarbyson@brandonsun.com

» Twitter: @KyleDarbyson

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Manitoba sees 35 new cases of coronavirus Sunday – Winnipeg – Global News

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The province’s top doctor confirmed 35 new cases of COVID-19 in Manitoba Sunday.

Dr. Brent Roussin held the rare Sunday press conference amid a recent spike in COVID-19 cases in Manitoba, including 16 new infections on Saturday.

While many of Sunday’s cases appear linked to known clusters in the Southern Health health region and the city of Brandon or are close contacts of a previously announced case, the province said in its COVID-19 update, there may be a small number of cases of unknown acquisition in those areas.

However, public health officials are still investigating where those cases were contracted.

A total of 542 people have contracted the novel coronavirus in Manitoba. Six people are in hospital — three of them in intensive care. Of the 542 infections, 182 cases are still active, while 352 people have recovered. Eight people have died.

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16 new cases of COVID-19 reported in Manitoba Saturday

The latest data show 20 of the new cases are in the Prairie Mountain Health region, 10 are in the Southern Health, four are in the Winnipeg health region and one is in the Interlake-Eastern health region.

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The current five-day COVID-19 test positivity rate is 1.45 per cent.

Many of the recent cases, including the majority of Saturday’s new infections, are connected to a cluster in Brandon — as of Friday, 34 people have been infected in the city.

Roussin could not provide the exact number of cases linked to the Brandon cluster, but said it is approaching 40 or may have exceeded it.

Those cases are all linked to one person who returned to Brandon from eastern Canada and did not properly self isolate.

The western Manitoba city’s Maple Leaf Foods plant has seen at least 10 workers infected with the virus, but Roussin and the company say the employees were not infected at work.

Seven of the new cases are workers at a business in Brandon, but Roussin would not expand when asked which business.

However, the union that represents workers at the pork plant, United Food and Commercial Workers Local 832, said eight more employees have tested positive for COVID-19 — bringing the total to 18.

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A McDonald’s restaurant in Brandon closed its doors Saturday after an employee tested positive for the virus — the employee had last worked at the 2626 Victoria Avenue location on Friday from 6 a.m. to 2 p.m., McDonald’s Canada said in a statement.

Another restaurant also closed Sunday after a Marino’s Pizza employee was exposed to a person who has since tested positive, but the restaurant employee does not have the virus.

© 2020 Global News, a division of Corus Entertainment Inc.

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