Congratulations, Minnesota, we have officially passed the 1000 deaths per million people mark, a great way to celebrate the exceptional response we have had to the epidemic, one that our Governor always reminds us has been so much better than our neighbors. Our most analogous neighbor, Wisconsin, is at a mere 885 deaths per million. And we are closing in on the national average, despite having a younger, less densely populated, lower minority percentage state. And one that is oh so healthy and with great health resources. Not to mention that we have the best data in the country, a better mitigation strategy than any of our neighbors and of course, the IB hisself in charge of it all.
Have I mentioned that the CV-19 response has caused worse outcomes in other aspects of health care? This paper deals with that topic. (Medrxiv Paper) This was a meta-review of a large number of papers assessing changes in health and health care during the epidemic. Globally the worst impacts are obviously on poorer countries and in any country, the poor and minorities suffer the greatest decline in health and health care. Serious global diseases like tuberculosis and malaria will make a major comeback and cause very high numbers of additional deaths.
And here is a more specific example, relating to heart attacks in the Detroit area. (JAMA Article) The region experienced a dramatic rise in emergency ambulance calls for heart attacks and fatalities from these. People were not getting care when having symptoms. They have a heart attack at home and die. That is the terror campaign, pure and simple.
And here is another study, from Japan, on the impact on cancer treatment. (Cell Article) The study was done at a large cancer hospital in Japan, which experienced a significant drop in both outpatient visits and cancer surgeries. The consequences are obvious, later diagnoses and later treatment means worse outcomes. We need a scorecard for all these bad things that happen as a result of responses to the epidemic.
How many people have really been infected, however you define that. This paper proposes a new method of determining that key question. (Medrxiv Paper) The flaw, likely fatal, in their method is an assumption that people lose antibody protection within 6 months, which is not accurate. If that were true, antibody surveys would underestimate the number of infected people. Not to say that there are not many issues with antibody surveys. In any event, because of that assumption, they wind up estimating a higher than typical number of total infections. They used testing data, positivity rates and antibody prevalence surveys to create a, yuk, model. One good thing, if there model is close to accurate, the IFR is quite low and we are getting closer to population immunity.
People keep trying to figure out the exact seasonal conditions that seem so conducive to CV-19 transmission. (Medrxiv Paper) The authors here examined temperature and the effect on cases, with a lag of 3 to 14 days. Higher temperatures were associated with lower numbers of cases, with a ten degree rise linked to about a 25% reduction in cases.
This is kind of an interesting paper on timeliness of death certificate reporting to the CDC. (Medrxiv Paper) The lag for deaths to become about 99% complete as of a certain week is around 5 1/2 weeks. There is a wide range across states, and those using an electronic filing system are faster. I would say from late summer on Minnesota has been very quick but before that something was going on with many deaths being filed going back weeks or months. We will see if the same thing happens with this wave. The authors obviously want it faster since that would help keep the hysteria level high and they don’t deal with the issues of inappropriate attribution. For some reason they also don’t do a comparison to prior years. I think that would be very useful so that we could see how the speed this year compares with other years.