Excess Deaths not including COVID-19 in Florida, Texas, and other states increased in early April
photo by Jakub Orisek courtesy of pixabay.com
Examining this CDC “data dashboard” of weekly excess deaths shows that there were significant increases in early April even in states that did not report significant numbers of COVID-19 deaths.
Looking at Florida, for example, there was a 2.1-7.6% excess of deaths (of any cause) totalling 4,562 for the week ending April 11– when only an average of 36 deaths a day (252 a week) due to the virus were reported. This suggests that there may have been a dramatic undercount of deaths due to COVID-19 during that period– or else something unexplained was killing about 5% more Floridians than usual that week.
If we examine New Jersey for this period, we find that over 200% more people died than normal in the week ending April 11. If we exclude COVID-19, the graphs still show 57-68% more people than normal died. This suggests that people either died from the virus that were uncounted, or else people died from not going to the emergency room even when they didn’t have the virus. For example, people could have died of heart attacks because they didn’t go to the hospital with chest pains due to fear of the virus.
I can’t go into this in detail because of time limitations today, but you can examine the data yourself and you will see that states reporting few deaths from the virus had unexplained increases in total death rates starting in early April. States that reported a lot of virus deaths, like New Jersey, had large increases in death rates that were unexplained.
Your take-home assignment today is to look at the larger states, like California, Texas, Illinois, and so on, and ask yourself– did some states have higher death rates than expected since April? Why? Was it undiagnosed COVID-19 in places where there wasn’t testing for political reasons? After all, in blue states, people could be tested for political reasons, but the tests would have turned out negative anyway… and a death is only counted as being from the virus if someone suspects it, tests for it, and puts it on the death certificate.
photo courtesy of Gerd Altmann (geralt) via pixabay.com
From the New York Times on July 9:
At a clinic in Corona, a working-class neighborhood in Queens, more than 68 percent of people tested positive for antibodies to the new coronavirus. At another clinic in Jackson Heights, Queens, that number was 56 percent. But at a clinic in Cobble Hill, a mostly white and wealthy neighborhood in Brooklyn, only 13 percent of people tested positive for antibodies.
The novel coronavirus has hit poor people and people of color harder than anyone else during this pandemic. New York City experienced a wave of infections from March through May, mostly brought in by visitors from Europe. Overall, the city showed some 20% positive results on antibody testing. Upper-class neighborhoods were not affected as much as lower-class places. People who had to continue coming to work, travelling on the subway and on buses, and coming home to crowded households, were hit the hardest.
People who are of African-American and Caribbean-American ethnicity, Hispanic, and Native Americans and people from the Marshall Islands, were hit hardest of all. A third of the population of the Marshall Islands– 30,000 people– migrated to the United States over the last thirty to fifty years (partly because unemployment there was as high as 40%.) Most of them are permanent non-citizen residents of the US; many settled in Arkansas, Washington State, and Oregon.
Many people from the Marshall Islands were forced to relocate after their homelands (the Bikini Atoll in particular) were rendered uninhabitable by radioactive contamination from atomic testing. Many of these people, poor and uneducated, took jobs working in meatpacking plants. Now they are suffering from frequent infection with SARS-COV-2 and are often getting sick or dying as a result. In northwest Arkansas, Marshall Islanders represent 3% of the population and half of the deaths.
COVID-19 affects non-white people more than anyone else. Well-to-do, mostly white, people, can work from home or have moved to their second homes in rural areas. Poor people have lost their jobs or work in “essential” but poorly-paid industries; they also live in crowded households and are unable to isolate. The result is more infections. They also have more co-morbidities like high blood pressure and diabetes, so they get sicker. When they do get sick, they don’t have as much health insurance. They have to go to hospitals in poorer parts of the city that have a lower quality of care. So they die more often.
Nowhere is this disparity as great as with Native Americans and Marshall Islanders.
The bottom line is that, in the US, poor people of color are being hit the hardest by COVID-19. Poorer parts of the world are also more affected; South America and India are the worst off.
The system is failing, and it is failing the hardest for poor people. The federal government must take this into account when allocating resources to help with this pandemic– but it won’t. There is no better argument for not re-electing Republicans in November.
photo by Jakub Orisek courtesy of pixabay.com
Texas had only 20-23 deaths a day on average at the end of May. Now it is seeing a 7-day average of 60 deaths a day, and the last two days had 90 and 119. Florida, which averaged 32 a day at the end of May, now averages 48– and it had 63 on July 7 and 48 yesterday (Florida’s daily case average has increased more than ten-fold in the last 6 weeks.) Arizona, which averaged 12 deaths a day at the end of May, is averaging 32 now– and had 101 on July 7 and 40 yesterday. California had 83 deaths on July 6, 111 deaths on July 7 and 145 yesterday (pushing the 7-day average to 77)– after a low point of 56 average on June 8 and 60 average on June 28.
These are the four biggest states with increasing outbreaks at the moment. All have posted record new case days during the last week. All are now pushing record new deaths and 7-day averages. Data comes from the New York Times interactive pages on coronavirus counts. Here is a piece in the Miami Herald on the same subject.
This comes with a Pro Publica report yesterday noting a dramatic increase in deaths at home in Houston. The Pro Publica piece begins with a description of a case that occurred on June 22, in which a 54 year-old woman with diabetes died suddenly at home after complaining of chest pain and fatigue to her daughter. She noticed that her mother was breathing rapidly and called 911. Then the mother stopped breathing altogether. The daughter tried to do CPR (without really knowing how) but when the ambulance arrived, the mother was already dead. She had not been suspected of having COVID-19 before she died; she had no headache, fever, or cough. An autopsy found that she had the virus.
In June, Houston ambulances responded to 300 cases in which the patient was already dead when they arrived– 75 more than in either of the previous two Junes. On July 3, they had 18 such calls in a single day. Something similar happened at the height of the outbreak in New York City, where 300 calls a day were for cardiac arrests; only 65 calls a day were recorded last year at the same time. The Pro Publica piece ends with a discussion of the risks for post-traumatic stress disorder in the survivors as well as the ambulance technicians.
The Houston woman whose mother died suddenly says she and her siblings are in a constant state of panic now. She wants to take CPR classes after trying and failing to revive her mother. Her father is grieving alone– and she can’t face being in the same house where her mother died.
The number of new cases per day for the country as a whole hit a nadir between May 26 and June 9. Since then, the rate of new cases has tripled. Deaths over the whole country peaked at an average just above 2,000 a day the third week of April, then dropped to around 600 by the end of June. New deaths hit a daily low of 292 on June 21 and 270 on June 27, then 209 on July 5 and 242 on July 6. On July 7, there were 922 deaths reported, on July 8, 897, and this morning, 867. Suddenly, rates are going back up again.
So, to the erstwhile leader of our country who claims that deaths have plummeted: just wait. They’ll start dying soon enough.
Post-script: the rate of new coronavirus cases in Tulsa, Oklahoma has been increasing since the ill-omened rally for the Republican presidential candidate. Since June 20, there have been 8.459 new cases reported in Oklahoma and the total of cases has almost doubled; the rate of new cases per day has doubled in the last three weeks. The number of people currently hospitalized has more than doubled (see COVID tracking project data for Oklahoma.)
photo by Manfred Antranias Zimmer courtesy of pixabay.com
The Vedic period (1500-500 BCE) was characterized by a transition from dominance of a post-animist religion in which specific gods began to play a larger part in the story of religion.
Animism is a form of religion, thought to be the most primitive, in which every object, both animate and inanimate, has an inner “god” or “spirit” that “animates” it and gives it specific characteristics. Thus, a stone has an inner spirit that causes it to behave like a stone. A place, such as a meadow or a mountain, also has an inner spirit. Even non-material objects, such as words and concepts, have their own spirits.
Dravidian religions were post-animist, but continued the worship of sacred trees and animals. They subscribed to belief in a Mother Goddess and had a complex metaphysical system. Shakti (or Parashakti) or Devi (or Mahadevi) is the Hindu version of the Dravidian Mother Goddess. Harappan (Indus Valley) civilizations included a female figure in many small sculptures that were found in Harappan ruins. There is a possibility that worship of the Mother Goddess involved human sacrifice with the blood of the victim offered to obtain fertility for the crops.
Wikipedia says that the scholar Lockard stated: “Hinduism can be seen historically as a synthesis of Aryan beliefs with Harappan and other Dravidian traditions that developed over many centuries.”
The Aryan religions probably included the gods Indra (supreme god), Agni (fire god), and Varuna (sky god.) They also probably included the ethical concepts of satya (truthfulness) and rta (the concept of the natural order.)
The Dravidian and Aryan religions were synthesized into the historical Vedic religion, which is memorialized in the Rig Veda. The language of the Rigveda is Sanskrit, which is separated from the Iranian language and evolved from the hypothetical proto-Indo-Iranian language. After separation, the Iranians evolved a religion called Zoroastrianism (from the prophet Zoroaster or Zarathustra.) In the early Iranian religion, Zoroaster preached a form of dualism in which Ahura Mazda was the supreme deity and was all good– opposed to Angra Mainyu, all evil. This religion was memorialized in the Avestas, the foundational Zoroastrian religious documents.
In the Rigveda, the gods are numerous, beginning with Indra. Agni is the second most important and is closely associated with Indra. Soma or Chandra is the Moon god and is also the name of a drink made from the juice of a plant, for which preparation instructions are given in the text (the exact source of this plant is uncertain as it is not described, but it may have been ephedra sinica– the source of ephedrine.) The Rigveda includes hymns to at least 33 major gods and goddesses, in addition to numerous minor deities. Many of these divine personages have indistinct or overlapping identities. Some are personifications of concepts or natural forces. Others are associated with heavenly bodies.
That’s as far as I’ve gotten in the last few days. To be continued. I was distracted by a Pro Publica article about sudden deaths in Houston– see next post.
photo by David Mark courtesy of pixabay.com
This town and its hospital was the subject of an article in Medpage Today dated July 5. The hospital is called Texas County Memorial Hospital, and it has been in trouble for several years. The hospital has been run by management companies which have extracted fees but failed to come up with plans that developed sufficient funding to keep an obstetric wing open (it closed in 2018 after losing $1M a year) or to stock emergency drugs like rattlesnake antitoxin or Activase for strokes and heart attacks.
The town of Guymon has a population 11,000– it is the county seat of Texas County– and its largest employer is a pork-processing plant that employs 2,700 people. The plant is run by Seaboard Foods Corporation and has been there at least 25 years. The town is isolated, to say the least; the nearest other hospital is 40 miles away. There is nothing around Guymon except empty prairie and a few circular irrigated fields. Liberal, Kansas is the nearest town of any size, with 20,000 people.
The issue with Guymon is that Seaboard Foods in February 2020 planned to spend $100 million on the pork-processing plant there, including $20 on real property and $80 on capital improvements. They agreed to pay $1 million in 2018 to settle a civil suit by the federal government for hiring “undocumented” foreign workers (the plant is staffed by people from multiple foreign countries.)
Yet they couldn’t spend anything to help the hospital. This is important because there was a COVID-19 outbreak at the plant this spring. As of May 21, there were 641 positive tests, almost a quarter of the employees. In the county (which has only twice as many people altogether as live in the town) there were 820 cases and four deaths reported. Supposedly no-one at the plant died. The father of one worker, who was 56 and had been recovering from coronary bypass surgery, did die– despite never leaving the house except to walk the dog while wearing a mask.
The hospital was unable to treat the people who died because they couldn’t accommodate them with their antiquated ventilation system and physical plant. The hospital laid off half of its almost 200-person staff due to the financial problems over the past few years. Patients who needed hospitalization for the virus were often transferred by ambulance to larger hospitals a hundred miles away. With $1.3 million in emergency funds from the US Army Corps of Engineers, the hospital was able to convert the closed maternity wing to a COVID ward– but not until June.
Parenthetically, there has been scientific speculation that the low temperatures (4 degrees Celsius) at which meat processing plants work are ideal for transmission of coronavirus because the virus survives longer outside the body at low temperature and high humidity. This is one reason (of many) why there are such huge outbreaks of COVID-19 at these plants.
Why didn’t Seaboard Foods put some money into the hospital? Because they had to make a profit on pork processing for human consumption. By the way, the county went for he-who-must-not-be-named in a big way in 2016, partly because most of the people who work at the plant can’t vote. It seems to me that the company should be fined at least $1.3 million to recoup the emergency funds the feds spent on the hospital. At least.
The problem here is something that conservatives are really good at: socializing costs and privatizing profits. This is why Walmart can pay minimum wage, and then its employees have to get Medicaid and food stamps to survive. This is not right. Poor people shop at Walmart, and the federal government subsidizes the cost. Meanwhile, the family that owns Walmart is one of the richest families in the world. This is not right.
photo by Einfach-Eve courtesy of pixabay.com
After World War Two, the United States was the strongest country. China was just finishing up a bloody civil war that left the entire country in ruins. Europe had been bombed back into the Stone Age. The Soviet Union (Russia) had lost millions of soldiers and civilians to the war against the Nazis. Japan had been hit with two atomic bombs, after firebombs had killed hundreds of thousands in cities.
Now, after almost four years of destruction by he-who-must-not-be-named, the US has withdrawn from its involvement with the rest of the world. After over 70 years of rebuilding, the world is totally different, but until four years ago, the US was still the country with the most involvement in other countries. We gave the most support for democracy and human rights. Today, we have given up our role in the world and are in danger of ceding our power to China.
This is a very dangerous thing, because the Chinese government has no interest in democracy or human rights. The government is a product of its leaders, who from the beginning of the Chinese Revolution have been interested only in amassing power, first to overthrow the warlords, then to rebuild the country. They have always looked on democratic government as a weakness. They have never been interested in protecting freedom of expression or allowing cultures to continue their indigenous growth. Their leader, Mao, had a similar personality to our current leader, and he set the tone for the current Chinese government.
The US has long been an aspirant to democracy and to the rights of all humans. All the injustices and oppression that have taken place in the US have been opposed by the arc of its aspirational self-governance. Just when the equality of peoples has been nearly approached, it is in danger of being snatched away by the disinterest and active sabotage of our current leaders.
Drawing away from leadership towards equal representation in other countries, the administration in this country has turned towards re-oppressing its own peoples. Corruption and malfeasance in our government has not only encouraged state violence against our own people, but allowed tyrannical leaders in other countries to oppress their own people without fear of disapproval from our leaders. We must fight to return our country to a path towards equality and freedom for everyone by ending the current leadership and electing new leaders. We need leaders who respect everyone’s rights in this country and fight for the rights of peoples in other countries.
photo by Juraj Varga courtesy of pixabay.com
This report in the New York Times July 8 details a persistent shortage of personal protective equipment like N95 masks, gloves, and gowns that is preventing medical offices and dentists from seeing patients during the pandemic. Hospitals are able to obtain protective gear to cover most of their needs, but smaller groups are still struggling to obtain essential equipment. From the article:
Neurologists, cardiologists and cancer specialists around the country have been unable to reopen their offices in recent weeks, leaving many patients without care, according to the American Medical Association and other doctor groups.
Lubbock Kids Dental of Lubbock, Texas, which serves low-income children, has been unable to obtain masks and gloves for dental surgery and has a list of over 50 children with abscesses waiting for care. Treatment with antibiotics has not relieved the need for surgical drainage, and these patients are at risk of developing septicemia if the bacteria enter the bloodstream.
Other outpatient clinics also cannot obtain sufficient masks to re-open. Many hospitals are forcing their staff to re-use N95 masks, and some staff dealing with coronavirus patients can’t get the N95 masks at all. The article describes numerous cases of re-use and shortages.
The US is dependent on foreign manufacturers for most of its protective equipment; domestic companies are unable to make sufficient supplies to meet demand. The federal government could help by invoking the Defense Production Act, but it has done nothing to encourage or mandate supply improvements. Small amounts of PPE are being distributed by the Federal Emergency Management Administration (FEMA), but nowhere near enough to meet demand.
The shortage is felt most at the level of individual medical and dental practitioners, who cannot band together to order PPE supplies. The federal government is still doing nothing to help, and spokesmen like the Vice President are lying about the situation. From the article:
In a coronavirus briefing on Wednesday, Vice President Mike Pence downplayed the shortages, but said the government was preparing to issue new guidance on the preservation and reuse of protective gear. “P.P.E., we hear, remains very strong,” he said.
With the pandemic worsening every day in the South and West, this situation is critical and unconscionable, especially in a supposedly affluent country. The resulting suffering and deaths are entirely the responsibility of our leaders, especially he-who-must-not-be-named.
Electron micrograph of SARS-COV-2 virions in vitro
CNN reports that the US had 60,000 new cases on Tuesday, according to Johns Hopkins University. Other daily tracking reports are smaller. For example, worldometer says that there were 55,442 new cases yesterday. Ourworldindata reports 57,473.
The White House is openly pressuring both elementary/secondary and college-level schools to open for in-person classes this fall. They stated that the CDC’s guidelines were too expensive and convoluted to follow. All administration spokesmen are claiming that everything is under control. Even Dr. Birx claims that she has seen “encouraging signs” in Texas, Arizona, and Florida. Dr. Fauci has contradicted this happy talk, but he has been prevented from giving interviews to most media. I won’t repeat the other lies coming from the administration.
The White House has formally notified the World Health Organization (WHO) that it plans to withdraw from membership, effective in a year from now. There has no word on whether the US will pay the dues that it currently owes, although the US contributed the largest individual share of WHO’s budget last year. There have already been changes that have reduced the US participation in WHO. China will probably take the opportunity to increase its involvement in, and control over WHO because of the US withdrawal.
Miami-Dade County reported that 28% of its antigen tests are coming back positive. 42 Florida hospitals have completely full intensive care units (ICU) and a field hospital with 450 beds has been established at the Miami Convention Center. Miami-Dade and Broward County schools may not open this fall if conditions continue to deteriorate, despite the Florida state-wide “order” to re-open. The caveats included with the re-opening order make it possible for local officials to overrule the plans to open.
According to CNN, “In the past 13 days, Florida’s Miami-Dade County has seen a 70% increase in the number of Covid-19 patients being hospitalized. The number of intensive care unit beds being used has risen to 84% and the use of ventilators is at 116%, according to the latest data released by Miami-Dade County government.””
New Jersey, New York, and Connecticut have ordered travelers from at least 19 other states to self-quarantine for two weeks if they enter the state. Canada has seen a marked improvement in their daily case counts, and Prime Minister Trudeau decided not to travel to the White House for ceremonies marking the start of the new US-Canada-Mexico trade agreement.
Brazil continues to record increases in their daily case counts, with at least 45,000 new cases yesterday. Over 1,668,000 cases have been reported in that country. Their head, Jair Bolsonaro, reported that he has had a positive test, with symptoms, after refusing to wear a mask and exposing himself repeatedly. Brazil’s reaction to the virus has been chaotic and most of the population is unable to isolate because of poverty. All of South America is suffering greatly from the pandemic.
For additional minute-to-minute coronavirus updates, see the CNN website.
EM of sars-cov-2 budding from apoptotic (dying) cells–NIAID
This report in Brain Neurology Journal on July 8 gives details of 40 patients with acute neurological syndromes related to COVID-19. The first group is those with stroke, patients with large blood clots in major arteries leading to the brain; most have made only minimal recoveries. Another group had acute encephalomyelitis– some responded to corticosteroids and made partial recoveries. A third had acute encephalopathies with delirium or psychosis but no findings on MRI scans– most of these recovered. A fourth group had peripheral nerve disorders, some similar to Guillain-Barre Syndrome, with paralysis. A fifth group had difficult-to-categorize problems.
From the abstract: “SARS-CoV-2 infection is associated with a wide spectrum of neurological syndromes affecting the whole neuraxis, including the cerebral vasculature…”
This is an abstruse academic paper with many details for neurologists and other involved disciplines. The point of the paper for amateurs is that COVID-19 often affects the brain and nerves as well as the lungs. There are many cases, even in relatively mild illnesses, in which cough and fever are not the only problems. Patients who have mental symptoms or nerve problems should not feel that they are imagining things.
Many patients with apparently mild illness find that their reflexes are off, they have weakness, or they have clumsiness, even difficulty walking. There are also frequent reports of hallucinations, often worse at night. These symptoms are due to an as-yet unexplained effect of the virus on brain and nerves– not a direct infection, apparently, but an immune response.
Another issue is that many of these symptoms appear after the acute illness or persist long after one would expect to have recovered. The vast majority of illnesses have occurred in the last three months, and many of those affected have still not fully recovered. It remains to be seen how long these symptoms will last, or even if some of them may be permanent. We have a great deal to learn about this virus.
photo courtesy of qimono (Arek Socha) via pixabay.com
A retrospective study of over 300,000 elderly veterans (almost all men) showed a 25% reduction in mortality rates over seven years in a study reported in the Journal of the American Medical Association. This study is believable because it included a very large cohort of men observed over a long period of time. Here are the results:
Results Of 326 981 eligible veterans (mean [SD] age, 81.1 [4.1] years; 97% men; 91% white), 57 178 (17.5%) newly initiated statins during the study period. During a mean follow-up of 6.8 (SD, 3.9) years, a total 206 902 deaths occurred including 53 296 cardiovascular deaths, with 78.7 and 98.2 total deaths/1000 person-years among statin users and nonusers, respectively (weighted incidence rate difference [IRD]/1000 person-years, –19.5 [95% CI, –20.4 to –18.5]). There were 22.6 and 25.7 cardiovascular deaths per 1000 person-years among statin users and nonusers, respectively (weighted IRD/1000 person-years, –3.1 [95 CI, –3.6 to –2.6]). For the composite ASCVD outcome there were 123 379 events, with 66.3 and 70.4 events/1000 person-years among statin users and nonusers, respectively (weighted IRD/1000 person-years, –4.1 [95% CI, –5.1 to –3.0]). After propensity score overlap weighting was applied, the hazard ratio was 0.75 (95% CI, 0.74-0.76) for all-cause mortality, 0.80 (95% CI, 0.78-0.81) for cardiovascular mortality, and 0.92 (95% CI, 0.91-0.94) for a composite of ASCVD events when comparing statin users with nonusers.
(bolding applied to emphasize key points)
This study suggests that elderly men, regardless of their cholesterol levels, benefit from taking statins to improve their life expectancy. Two-thirds of the men, who were around 80 years old at the start of the study, died over the 6.8 years that it ran. 17.5% of the men started taking statins during the study, and of these men, there was an all-cause death hazard ratio of 0.75– meaning that men were 25% less likely to die if they took a statin drug.
The statins most widely used are atorvastatin (Lipitor), rosuvastatin (Crestor), and simvastatin (Zocor), among many others. The results of this study are no surprise and confirm the wide acceptance of these drugs among doctors.
The only limitations of the study are that it only includes men, mainly white men, and doesn’t address costs. Despite this, women should probably take statins as well after menopause, when their risk of cardiovascular disease rises to nearly the same level as men. The costs are now quite reasonable for these drugs, and Medicare pays the entire bill.
Non-white men, especially those with African-American or Caribbean-American heritage, should take statins as well, because their risks are higher than those of white men. Black men should also carefully control their blood pressure, partly because discrimination has been shown to raise one’s blood pressure (sorry, I don’t have the citation, but it’s out there.) High blood pressure also dramatically increases one’s risk of stroke, and the incidence of stroke is much higher in Black men.
Conrad Theodore Seitz 