Rich countries had almost one million excess deaths in 2020

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Almost one million extra deaths, likely related to the COVID-19 pandemic, occurred in 29 high-income countries in 2020, according to an analysis of mortality data. All of the countries studied — except for Denmark, New Zealand and Norway — had more deaths than expected last year, particularly among men. The excess deaths, which totalled 979,000, were concentrated among people over the age of 75, followed by those aged 65 to 74. The highest numbers of excess deaths were in the U.S., U.K. and Italy (Canada has not yet reported numbers for 2020). In most countries, the number of excess deaths was higher than the number of reported deaths from COVID-19. A separate study estimated that the number of COVID-19 deaths in the U.S. was underestimated by 20 per cent.

The BMJ, May 19, 2021

PLOS Medicine, May 20, 2021

Racial disparities not related to socioeconomic status

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People of colour, and those who do not speak English, experienced worse COVID-19 outcomes than white people regardless of their socioeconomic status, according to a study in the U.S. cities of Minneapolis and St. Paul. The researchers suggest that other factors, such as job type, genetics, testing access and systemic racism may play a role in the disparities. Another study in West Virginia supports that suggestion — it found that communities with a higher Black population had testing rates six times lower than the state average, which could result in the virus spreading faster and more widely.

Journal of General Internal Medicine, May 18, 2021

Annals of Epidemiology, April 2, 2021

Emergency department visits fell, but outcomes were no worse, during first wave

Visits to hospital emergency departments in Ontario for common conditions such as appendicitis, miscarriage, gallbladder attacks and ectopic pregnancy fell dramatically during the early stages of the pandemic, but despite fewer visits there was no increase in adverse outcomes, such as patients showing up sicker, or increased rates of death. There are generally two theories about what caused the decrease — an actual drop in the conditions, or the emergency departments are being underused. But the researchers have a third idea — that the departments were actually being overused before the pandemic, and many people with mild conditions were able to either get better on their own, or use telemedicine to manage the issue.

Canadian Medical Association Journal, May 25, 2021

Risk of long-term conditions after COVID-19 infection

About 14 per cent of people infected with COVID-19 developed at least one new medical condition that required care after they had recovered from the virus — five per cent higher than those who were not infected — according to a large-scale study in the U.S. The long-term conditions included chronic respiratory failure, heart rhythm problems, amnesia, diabetes, anxiety and fatigue. The risk was higher among older people, those with pre-existing conditions, and those who were admitted to hospital for COVID-19. However, younger adults, those with no pre-existing conditions, and those who recovered at home were also at risk for new conditions several months after initial infection.

The BMJ, May 19, 2021

Rogue antibodies cause damage in severe COVID-19 cases

While most of the antibodies our immune system generates in response to COVID-19 help us to fight off the disease, rogue versions that attack our own tissues and cells, known as autoantibodies, are a major cause of some of the more severe symptoms of the virus. In some people with COVID-19, autoantibodies attack healthy tissue in the brain, blood vessels, platelets, liver and the gastrointestinal tract, and even target and interfere with immune system proteins that are trying to fend off the infection. The more autoantibodies present, the more severe the symptoms of the disease will be. While many of the damaging autoantibodies were generated by the COVID-19 infection, some people may have also had pre-existing autoantibodies that made them more susceptible to infection in the first place.

Nature, May 19, 2021

Large numbers of people take immunosuppressant drugs that could interfere with vaccines

About three per cent of people in the U.S. are taking medications that weaken their immune system, such as chemotherapy drugs or steroids like prednisone. This could leave them more vulnerable to severe COVID-19 infections and hospitalization, and there is some evidence that these drugs could also make vaccines against COVID-19 less effective. The researchers say better guidelines are needed to help people taking these drugs protect themselves from infection as public health restrictions are lifted.

JAMA Network Open, May 20, 2021

Dentists had lower infection rates than other health-care workers

Dentists in the U.S. have a lower rate of COVID-19 infection than other frontline health-care workers like doctors and nurses, according to a new study. The infection rate for dentists is 2.6 per cent, compared with rates that ranged from 3.3 per cent to 35.3 per cent for other professions. The researcher attribute the lower infection rate to pre-appointment screening and good infection control procedures.

Journal of the American Dental Association, May 25, 2021

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