Total deaths recorded during the pandemic far exceed those attributed to COVID-19, new data show
States that reopened sooner, such as Texas, Arizona and Florida,
experienced summer surges, report says

Date:
October 12, 2020
Source:
Virginia Commonwealth University
Summary:
For every two deaths attributed to COVID-19 in the U.S., a third
American dies as a result of the pandemic, according to new
data. The study shows that deaths between March 1 and Aug. 1
increased 20 percent compared to previous years -- maybe not
surprising in a pandemic. But deaths attributed to COVID-19 only
accounted for 67 percent of those deaths.



FULL STORY ==========================================================================
For every two deaths attributed to COVID-19 in the U.S., a third American
dies as a result of the pandemic, according to new data publishing
Oct. 12 in the Journal of the American Medical Association.


==========================================================================
The study, led by researchers at Virginia Commonwealth University,
shows that deaths between March 1 and Aug. 1 increased 20% compared
to previous years - - maybe not surprising in a pandemic. But deaths
attributed to COVID-19 only accounted for 67% of those deaths.

"Contrary to skeptics who claim that COVID-19 deaths are fake or that
the numbers are much smaller than we hear on the news, our research
and many other studies on the same subject show quite the opposite,"
said lead author Steven Woolf, M.D., director emeritus of VCU's Center
on Society and Health.

The study also contains suggestive evidence that state policies on
reopening early in April and May may have fueled the surges experienced
in June and July.

"The high death counts in Sun Belt states show us the grave consequences
of how some states responded to the pandemic and sound the alarm not
to repeat this mistake going forward," said Woolf, a professor in the Department of Family Medicine and Population Health at the VCU School
of Medicine.

Total death counts in the U.S. are remarkably consistent from year to
year, as the study notes. The study authors pulled data from the Centers
for Disease Control and Prevention for 2014 to 2020, using regression
models to predict expected deaths for 2020.



==========================================================================
The gap between reported COVID-19 deaths and all unexpected deaths can
be partially explained by delays in reporting COVID-19 deaths, miscoding
or other data limitations, Woolf said. But the pandemic's other ripple
effects could explain more.

"Some people who never had the virus may have died because of disruptions caused by the pandemic," said Woolf, VCU's C. Kenneth and Dianne Wright Distinguished Chair in Population Health and Health Equity. "These include people with acute emergencies, chronic diseases like diabetes that were
not properly care for, or emotional crises that led to overdoses or
suicides." For example, the study specifically showed that the entire
nation experienced significant increases in deaths from dementia and
heart disease. Woolf said deaths from Alzheimer's disease and dementia increased not only in March and April, when the pandemic began, but
again in June and July when the COVID-19 surge in the Sun Belt occurred.

This study, with data from March to Aug. 1, builds on a previously
published JAMA article by the same authors from VCU and Yale University
that focused on data from March to May 1. And it brings in new data
about the timing of when states lifted restrictions on social distancing.

States like New York and New Jersey, which were hit hard early, were
able to bend the curve and bring death rates down in less than 10
weeks. Meanwhile, states such as Texas, Florida and Arizona that escaped
the pandemic at first but reopened early showed a protracted summer surge
that lasted 16-17 weeks - - and was still underway when the study ended.



==========================================================================
"We can't prove causally that the early reopening of those states led
to the summer surges. But it seems quite likely," said Woolf. "And most
models predict our country will have more excess deaths if states don't
take more assertive approaches in dealing with community spread. The enforcement of mask mandates and social distancing is really important
if we are to avoid these surges and major loss of life." Woolf paints
a grim picture, warning that long-term data may show a broader impact
of the pandemic on mortality rates. Cancer patients who have had their chemotherapy disrupted, women who have had their mammograms delayed -
- preventable, early deaths may increase in the coming years, he said.

"And death is only one measure of health," Woolf said. "Many people
who survive this pandemic will live with lifelong chronic disease complications. Imagine someone who developed the warning signs of a stroke
but was scared to call 9-1- 1 for fear of getting the virus. That person
may end up with a stroke that leaves them with permanent neurological
deficits for the rest of their life." Diabetes complications
that aren't being managed properly could lead to kidney failure and
dialysis. And behavioral health issues, like emotional trauma, are going untreated. Woolf worries most about the lasting effects on children -
- long-term, generational outcomes.

"This isn't a pandemic involving a single virus," said Peter Buckley,
M.D., dean of the VCU School of Medicine. "This is a public health
crisis with broad and lasting ripple effects. VCU researchers have
been diligent in their investigations into both treatment of COVID-19
and in understanding the long- term repercussions of the pandemic,
so that fellow doctors, policymakers and community members can fight
these battles on multiple fronts." Co-authors on Woolf's paper include:
Derek Chapman, Ph.D., Latoya Hill, DaShaunda Taylor and Roy Sabo, Ph.D.,
of VCU; and Daniel Weinberger, Ph.D., of Yale University.

The study complements another VCU researcher's recent data showing an
alarming surge in opioid overdoses at VCU Medical Center during the
pandemic. Taylor Ochalek, Ph.D., a postdoctoral research fellow at
the Wright Center, found a 123% increase in nonfatal overdoses between
March and June this year, as compared to last, in a study also published
in JAMA.

Woolf notes that the CDC has released provisional overdose deaths under
a broad label called "external causes," which also includes car crashes
and homicides, making research like Ochalek's all the more important.

"Car crashes decreased because fewer people were driving during the
lockdowns," Woolf said. "We worry that the broad umbrella category of
'external causes' may hide an increase in deaths from overdoses, because
the opioid epidemic didn't go away." The CDC, Woolf added, has rushed
out provisional mortality data this year because of the pandemic. More reliable, granular detail will come out later and allow researchers to
unpack the detailed contributors to excess deaths and secondary health
impacts of the pandemic.

Researchers across multiple disciplines at VCU are studying the secondary health impacts of the pandemic -- from substance use disorders and
intimate partner violence to diminished access to regular medical care --
all of which could contribute to loss of life, according to Woolf's study.


========================================================================== Story Source: Materials provided by
Virginia_Commonwealth_University. Original written by Jackie
Kruszewski. Note: Content may be edited for style and length.


========================================================================== Journal References:
1. Steven H. Woolf, Derek A. Chapman, Roy T. Sabo, Daniel
M. Weinberger,
Latoya Hill, DaShaunda D. H. Taylor. Excess Deaths From COVID-19
and Other Causes, March-July 2020. JAMA, Oct. 12, 2020; DOI:
10.1001/ jama.2020.19545
2. Steven H. Woolf, Derek A. Chapman, Roy T. Sabo, Daniel
M. Weinberger,
Latoya Hill. Excess Deaths From COVID-19 and Other
Causes, March-April 2020. JAMA, 2020; 324 (5): 510 DOI:
10.1001/jama.2020.11787
3. Taylor A. Ochalek, Kirk L. Cumpston, Brandon K. Wills, Tamas
S. Gal, F.

Gerard Moeller. Nonfatal Opioid Overdoses at an Urban Emergency
Department During the COVID-19 Pandemic. JAMA, 2020; DOI: 10.1001/
jama.2020.17477 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/10/201012115953.htm

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