A lot to catch up on, and a bunch of updated charts coming.
Why do I keep going on and on about needing better hospitalization data? Because of information like that in this article. (JTN Article) There is no question that in Minnesota as elsewhere we have a bunch of “with” not because of CV-19 hospitalizations, a lot of remdesivir and observation stays and a lot of low and false positive hospitalizations. The state could tell us this, they don’t want to because it isn’t consistent with their messaging.
And then are issues about coding accuracy. (JAMA Article) The authors examined adoption of the new ICD code for CV-19 after it was issued in April 2020 using a large hospital database and compared known PCR test results with the use of the code for certain hospitalizations. There were 4965 patients with a positive PCR test result and all but 99 of them had the CV-19 code on their hospitalization. There were 46942 patients with negative tests, but somehow 451 of them managed to be coded as CV-19. Hmmm.
This paper examined other studies of the effect of school closures. (Medrxiv Paper) Only ten studies were considered adequately done to be included. These studies covered 146 countries. They reached wildly varying conclusions, with three finding no effect, including the two studies that the authors viewed as the most methodologically sound. The authors suggest caution before using school closings to limit transmission. Too late for a little caution.
This study falls in the category of “well, what did you expect”. It explores the level of serious distress at two point of the epidemic. (JAMA Article) Over 1300 adults were surveyed on feelings and sources of stress. 13% reported serious distress, a little less than in a similar survey in April. People aged 18-29 and those with low income were most likely to report serious distress. These levels of distress are likely resulting in more alcohol and drug abuse, overdoses and more mental health problems.
Another paper looks at characteristics of nursing home residents who died of CV-19 and there are a lot of those residents. (JAMA Article) Death within 30 days after a positive test was the primary outcome. Increasing age was strongly correlated with greater risk of death. Diabetes and chronic kidney disease were also associated with greater mortality risk. Greater cognitive impairment was also heavily connected to higher likelihood of death.
Yet another study finding a lasting adaptive immune response. (Medrxiv Paper) The study was conducted among health care workers with no or mild symptoms and found that the adaptive immune response in the form of antibodies lasted at least four months. The response was similar to that in patients with more severe disease.
An interesting Facebook post from an ER physician. Lot of common sense here. (FB Post)