Observed to Expected Excess Mortality for the United States, Updated October 24, 2020

This week’s refresh of the excess mortality count from the CDC (last updated October 21 [I think]). The federal agency identified over 289,000 excess deaths across the country since the start of this year (about 15,000 more than last week’s estimate). The overall excess mortality rate increased from 11.1% last week to 11.4% this week. Data from CDC’s National Center for Health Statistics, updated October 21, 2020

The Missing Piece — SARS-CoV-2 Testing and School Reopening

“Available guidance documents typically instruct schools to gain access to testing by contacting local public health departments, and few schools appear to have solidified a strategy — especially one that extends beyond testing of symptomatic persons. [..] Most reopening plans instead focus on screening for Covid-19 symptoms. Yet recent research indicates that symptom screening alone will not enable schools to contain Covid-19 outbreaks. Because an estimated 40% of Covid-19 cases are asymptomatic and 50% of transmissions occur from asymptomatic persons, we believe that screening testing is critical. [..] SARS-CoV-2 testing presents at least three challenges for schools. The first is … Read More

Covid-19 Molecular Diagnostic Testing — Lessons Learned

“On February 4, 2020, the U.S. secretary of health and human services declared that emergency use of diagnostics for SARS-CoV-2 was justified, triggering emergency authority for the Food and Drug Administration (FDA) to grant an emergency use authorization (EUA) for a device if it reasonably believes that it may be effective, rather than waiting to grant full approval when it has reasonable assurance that the device is safe and effective. This mechanism expedites access to accurate diagnostic tests during emergencies, when information gaps and false results may adversely affect patient care and public health decision making. The EUA process enabled … Read More

Policy Lessons from Our Covid Experience

“As the country reopens, it’s important to assess how we can be better prepared to stave off such enormous economic losses during the next wave or the next epidemic. In my view, a few key policy changes will be critical. First, expertise on pandemic-related policy and strategy should be located closer to the center of power. I believe that the type of pandemic-preparedness office (the Office of Pandemics and Emerging Threats) that now resides only in the Department of Health and Human Services (HHS) also needs to be reestablished as part of the National Security Council (NSC). [..] Since the … Read More

Tribal Truce — How Can We Bridge the Partisan Divide and Conquer Covid?

“Masks have become a flash point in our culture wars: as a symbol of either a commitment to public health or an infringement on basic liberties, the mask encapsulates the politicization of science. But since human behavior — including wearing or shunning masks — will determine the pandemic’s ultimate toll, communication strategies that bridge our partisan divide over science may prove as important as any novel therapeutic. Beyond the near complete failure of U.S. federal leadership in combating the pandemic, one significant problem, according to Harvard epidemiologist Marc Lipsitch, has been the absence of consistent communication from nonpartisan experts. During … Read More

The COVID-19 Pandemic and the $16 Trillion Virus

“Recessions feed on themselves. Workers not at work have less to spend, and thus subsequent business revenue declines. The federal government offset much of the initial loss owing to the shutdown, which has averted what would likely have been a new Great Depression. But the virus is ongoing, and thus full recovery is not expected until well into the future. The Congressional Budget Office projects a total of $7.6 trillion in lost output during the next decade. [..] To date, approximately 200,000 deaths have been directly attributable to COVID-19; many more will doubtless occur. In the US, approximately 5000 COVID-19 … Read More

Observed to Expected Excess Mortality for the United States, Updated October 17, 2020

This week’s refresh of the excess mortality count from the CDC (last updated October 14 [I think]). The federal agency identified over 274,000 excess deaths across the country since the start of this year (about 2,000 more than last week’s estimate). The overall excess mortality rate decreased slightly from 11.2% last week to 11.1% this week. Data from the CDC’s National Center for Health Statistics, updated October 14, 2020

Large Meta-analysis Digs Into Obesity’s COVID-19 Risks

“As the toll from coronavirus disease 2019 (COVID-19) mounted in the pandemic’s early months, it soon became apparent that people with diabetes and hypertension, among other factors, were at heightened risk of severe disease. But obesity didn’t attract as much attention, according to nutrition scholar Barry Popkin, PhD, of the University of North Carolina (UNC) at Chapel Hill. [..] If you contract the novel coronavirus, “You have more than double the likelihood of going into the hospital if you’re obese and 50% more likelihood of dying,” Popkin said in a recent interview with JAMA. “Those 2 statistics really shook me.” … Read More

Sensible Medicine—Balancing Intervention and Inaction During the COVID-19 Pandemic

“Sensible medicine is an approach to treatment that seeks a balance along the spectrum of the strength of evidence and the pace of knowledge translation. On one hand, a hawkish interventionist has little doubt about the effectiveness of a new treatment and rapidly adopts it into practice. There is a tendency to favor adoption of the new, acceptance of less rigor in research methods and results, and a glance away from subconscious biases. This contrasts with the medical nihilist who is highly skeptical of new evidence and hopes to intervene even less. The medical nihilist is certain of the futility … Read More

Suboptimal US Response to COVID-19 Despite Robust Capabilities and Resources

“As measured by the GHS [Global Health Security] Index, the US was better positioned than most other countries to respond to COVID-19. The Index includes 140 questions that assess national capacities or abilities among 6 categories: (1) prevention of the emergence, release, or spread of pathogens; (2) early detection and reporting for epidemics of potential international concern; (3) rapid response to and mitigation of the spread of an epidemic; (4) sufficient and robust health system to treat affected patients and protect health workers; (5) commitments to improving national capacity, financing plans to address gaps, and adhering to global norms; and … Read More