A man who died from the coronavirus disease (COVID-19) is wrapped in a body bag at the United Memorial Medical Center’s coronavirus disease (COVID-19) intensive care unit in Houston, Texas, U.S., June 29, 2020.
Callaghan O’Hare | Reuters
The number of confirmed U.S. deaths due to the coronavirus is substantially lower than the true tally, according to a study published Wednesday in JAMA Internal Medicine.
Using National Center for Health Statistics data, researchers at Yale University compared the number of excess U.S. deaths from any causes with the reported number of weekly U.S. Covid-19 deaths from March 1 through May 30. The numbers were then compared with deaths from the same period in previous years.
Researchers found that the excess number of deaths over normal levels also exceeded those attributed to Covid-19, leading them to conclude that many of those fatalities were likely caused by the coronavirus but not confirmed. State reporting discrepancies and a sharp increase in U.S. deaths amid a pandemic suggest the number of Covid-19 fatalities is undercounted, they said.
“Our analyses suggest that the official tally of deaths due to Covid-19 represent a substantial undercount of the true burden,” Dan Weinberger, an epidemiologist at Yale School of Public Health and a lead author of the study, told CNBC. Weinberger said other factors could contribute to the increase in deaths, such as people avoiding emergency treatment for things like heart attacks. However, he doesn’t think that is the main driver.
The study was supported by the National Institute of Health.
The 781,000 total deaths in the United States in the three months through May 30 were about 122,300, or nearly 19% higher, than what would normally be expected, according to the researchers. Of the 122,300 excess deaths, 95,235 were attributed to Covid-19, they said. Most of the rest of the excess deaths, researchers said, were likely related to or directly caused by the coronavirus.
Covid-19 affects nearly every system in the body, including the circulatory system, leading to an uptick in heart attacks and strokes that physicians now believe were indirectly caused by the virus.
The number of excess deaths from any causes were 28% higher than the official tally of U.S. Covid-19 deaths during those months. The researchers noted the increase in excess deaths in many states trailed an increase in outpatient visits from people reporting an “influenza-like illness.”
The report comes as the coronavirus continues to rapidly spread across the United States. New cases in the U.S. grew by 5% or more in at least 40 states, based on a seven-day average, including Arizona, Texas, Florida and Oklahoma as of Monday, according to a CNBC analysis of data compiled by Johns Hopkins University. At least 127,425 have died in the United States, according to Hopkins data.
The researchers noted the gap between the reported coronavirus deaths and the excess deaths varied by states. For example, California reported 4,046 Covid-19 deaths and 6,800 excess deaths, leaving 41% of the excess deaths unattributed to Covid-19 they said.
Texas and Arizona had wider gaps, with roughly 55% and 53%, respectively, of excess deaths unattributed to Covid-19.
The researchers said some of the discrepancies could be related to the intensity and timing of increases in testing.
The record-long U.S. expansion ended in February, according to the academic panel that serves as the arbiter of America’s business cycles, putting an official date on the start of the coronavirus-induced recession.
“The committee has determined that a peak in monthly economic activity occurred in the U.S. economy in February 2020,” the National Bureau of Economic Research’s Business Cycle Dating Committee said in a web statement on Monday. “The unprecedented magnitude of the decline in employment and production, and its broad reach across the entire economy, warrants the designation of this episode as a recession, even if it turns out to be briefer than earlier contractions.”
Coronavirus ends longest-running U.S. economic expansion
The NBER said the past expansion lasted 128 months, the longest in the history of U.S. business cycles dating back to 1854. Its statement hinted that the downturn could be shorter than usual, with signs of recovery already evident, including an unexpected gain in jobs last month. If that continues, the recession could be dated to last only a few months.
Later Monday, the S&P 500 erased its 2020 loss as U.S. stocks rallied on optimism around the easing of lockdowns and reopening of the economy.
“It does seems like there has been an improvement in the economy since mid-April,” said James Stock, a Harvard University economist and committee member. “What happens going forward depends on policy, specifically epidemiological policy, and on the course of the virus.”
Stock said he’s worried that a “second wave” of infections could hurt any recovery and lengthen a downturn, which would have the result of turning short-term unemployment into long-term joblessness, with a wave of bankruptcies. Some economists worry the recovery won’t be robust, just as the 10-year expansion was muted following the financial crisis.
“Technically, the recession could be over, making it the deepest and shortest on record,” said Ryan Sweet, head of monetary policy research at Moody’s Analytics. “Even though growth has resumed, marking a technical end to the recession, for a large number of businesses and individuals, it’s going to feel like a recession for years to come.”
Many economists informally define a recession as two negative quarters of gross domestic product. The bureau doesn’t use that definition and instead looks for a significant decline in economic activity, typically lasting more than a few months. In the case of the latest downturn, the depth of the decline outweighed its brevity.
“The committee weighs the depth of the contraction, its duration, and whether economic activity declined broadly across the economy,” the NBER said. “The committee recognizes that the pandemic and the public health response have resulted in a downturn with different characteristics and dynamics than prior recessions.”
Committee members said the depth of the downturn — with a record drop in employment — made the call easier to make without a lengthy delay for deliberations. Typically, it’s taken the committee six to 18 months following a peak to declare a recession.
“All of our decisions involve a painstaking review of all the relevant data, including this one,” said Robert Hall, a Stanford University professor who leads the committee. “The decline in economic activity starting in March was huge.”
Harvard’s Stock said, “in this case, the peak was clear, from nearly all indicators.” The “profound depth” of the decline makes it clearly a recession “even if the duration is as short as two months — a theoretical possibility — although we might not know the actual trough for quite a while, there are so many special factors affecting the data.”
The committee commented on the possible brevity of the recession, not to conclude it’s over but to emphasize the NBER would be comfortable with the call even if the downturn is very short, said James Poterba, NBER president.
“The committee doesn’t have a crystal ball and the statement was not making any forecast,” he said.
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Published on 12-May-2020
Academy Award winner Russell Crowe stars in Unhinged, a timely psychological thriller that explores the fragile balance of a society pushed to the edge, taking something we’ve all experienced- road rage – to an unpredictable and terrifying conclusion. Rachel (Caren Pistorius) is running late to work when she has an altercation at a traffic light with a stranger (Crowe) whose life has left him feeling powerless and invisible.
Soon, Rachel finds herself and everyone she loves the target of a man who decides to make one last mark upon the world by teaching her a series of deadly lessons. What follows is a dangerous game of cat and mouse that proves you never know just how close you are to someone who is about to become unhinged.
Solstice Studios and Ingenious Media present a film by Derrick Borte, starring Russell Crowe, Caren Pistorius, Gabriel Bateman, Jimmi Simpson and Austin P. McKenzie.
Unhinged opens in theaters July 1, 2020.
NEW YORK — The number of potential coronavirus-related deaths in New York City has jumped to 5,293 — up from roughly 3,000 in mid-April — according to health department data published Monday by the U.S. Centers for Disease Control and Prevention.
Last month, the city expanded its death toll significantly by including probable coronavirus deaths — those that were likely due to the coronavirus but had not been confirmed for a variety of reasons. However, city officials warned there were 3,000 or so additional deaths that were related to the coronavirus but did not have a strong enough link to be classified as such.
Those may include people who suffered from the coronavirus but did not have it noted on their death certificate. In other cases, the primary cause may be something else, but exacerbated by a coronavirus infection. In particular, there has been a surge in cardiac arrests — and officials are probing whether many of the heart attacks were caused by the coronavirus.
According to health department data published by the CDC, those cases are now estimated at 5,293.
“During March 11–May 2, 2020, a total of 32,107 deaths were reported to DOHMH; of these deaths, 24,172 were found to be in excess of the seasonal expected baseline,” the CDC report reads. “Included in the 24,172 deaths were 13,831 laboratory-confirmed COVID-19–associated deaths and 5,048 probable COVID-19–associated deaths, leaving 5,293 excess deaths that were not identified as either laboratory-confirmed or probable COVID-19–associated deaths.”
By Monday the virus had killed 19,931 people in the city — a number that includes confirmed and probable cases, but not the 5,293 potentially related cases.
“This crisis has taken a devastating toll on our city and we are still working to fully measure the scale of what we’ve lost,” New York City health department spokesperson Patrick Gallahue said in a statement. “This is a critical part of both understanding the virus as well as the healing process that New Yorkers will go through.”
President Donald Trump and his supporters argue the death tolls are overblown because some authorities are including suspected, but not confirmed, coronavirus deaths in their initial totals. Health specialists say the approach is essential to ensure that the death toll is not significantly undercounted in the moment.
President Trump said coronavirus won’t be coming back in the fall, but Dr. Fauci believes otherwise, contradicting the president’s statements.
Sweden, unlike its Nordic neighbors Denmark and Norway – and virtually every other country in the western world – has resisted extensive lockdown restrictions to stem the coronavirus outbreak. Instead, it’s largely kept society, including schools and restaurants open, and relied on voluntary social-distancing measures that appeal to the public’s sense of self-restraint. Polls show the strategy is broadly supported by most Swedes.
Scientists in Sweden and abroad have accused the country of dangerously pursuing “herd immunity” – the idea that by building a broad base of recovered infections in society the disease will eventually stop spreading because a majority of people will not be susceptible. “Herd immunity” is usually achieved by vaccination and takes place when a large enough percentage of the population are immune.
Anders Tegnell, chief epidemiologist at Sweden’s Public Health Agency – the nation’s top infectious disease official and architect of Sweden’s coronavirus response –denied that “herd immunity” formed the central thrust of Sweden’s containment plan, in an interview with USA TODAY. Yet he also said the country may be starting to see the impact of “herd immunity.”
This is a lightly edited transcript of USA TODAY’s interview with Tegnell.
From six to 95 years old: These are survivors of coronavirus
Tegnell: We are doing two major investigations. We may have those results this week or a bit later in May. We know from modeling and some data we have already – these data are a little uncertain – that we probably had a transmission peak in Stockholm a couple of weeks ago, which means that we are probably hitting the peak of infections right about now. We think that up to 25% of people in Stockholm have been exposed to coronavirus and are possibly immune. A recent survey from one of our hospitals in Stockholm found that 27% of staff there are immune. We think that most of those are immune from transmission in society, not the workplace. We could reach herd immunity in Stockholm within a matter of weeks.
(Editor’s note: The World Health Organization has warned that individuals who have had COVID-19 are not necessarily immune, by the presence of antibodies, from getting the virus again. They might be, but the scientific work hasn’t reached the stage where that has been conclusively proved. Tegnell said that, at the population level, if antibodies can’t be viewed as an indication of immunity then this undermines the whole rationale for developing a vaccine. “If you can’t get population immunity how can we then think a vaccine will protect us?” he said.The precise percentage required for “herd immunity” changes based on the disease. Britain briefly entertained a “herd immunity” strategy before altering course amid a rapidly rising death toll. Britain’s chief scientific officer concluded that a figure of 60% might be needed for COVID-19. It could be months before a fuller picture emerges of who remains vulnerable to coronavirus.)
Tegnell: We are trying to keep transmission rates at a level that the Stockholm health system can sustain. So far that has worked out. The health system is stressed. They are working very hard. But they have delivered health care to everybody, including those without COVID-19. That is our goal. We are not calculating herd immunity in this. With various measures, we are just trying to keep the transmission rate as low as possible. The amount of cases has been stable for the last two-to-three weeks. We believe herd immunity will of course help us in the long run, and we are discussing that, but it’s not like we are actively trying to achieve it as has been made out (by the press and some scientists). If we wanted to achieve herd immunity we would have done nothing and let coronavirus run rampant through society. We are trying to keep the transmission rate as low as we can. We have taken reasonable measures without really hurting health care or schools. We are going for a sustainable strategy; something we can keep on doing for months. Coronavirus is not something that is just going to go away. Any country that believes it can keep it out (by closing borders, shuttering businesses, etc.) will most likely be proven wrong at some stage. We need to learn to live with this disease.
Tegnell: You’ll need to ask our economists. I know nothing about this. But at a glance it looks to me that Sweden’s economy is doing a lot better than others’. Our strategy has been successful because health care is still working. That’s the measure we look at.
(Editor’s note: Sweden’s COVID-19 strategy may ultimately result in a smaller – albeit historically deep – economic contraction than the rest of Europe is now facing, according to a recent Bloomberg article, citing an HSBC Global Research economist. Surveys show that about half of Swedes are working from home, use of public transport is down by about 50% and economic activity has slowed. But shops, restaurants and hair salons remain open. Still, Sweden’s Finance Minister Magdalena Andersson has warned that annual GDP could shrink by 10% and unemployment rise to 13.5%. Economic forecasts for the U.S. vary. Some economists believe GDP will suffer a double-digit decline in the second quarter. The Congressional Budget Office forecasts a whopping 28% annual decline for U.S. GDP, but this assumes four consecutive quarterly declines of 7%. Many economists predict the U.S. economy may rebound this summer. The March unemployment rate in the U.S. stood at 4.4%. White House economic adviser Kevin Hassett has forecast that the figure for April could soar to 16-17%.).
Tegnell: We don’t really know yet. What the crisis has shown is that we need to do some serious thinking about nursing homes because they have been so open to transmission (more than a third of Sweden’s COVID-19 fatalities have been reported in nursing homes) of the disease and we had such a hard time controlling it in that setting. However, this is only indirectly related to our strategy because the strategy was to protect those people and that part of it did not work out. This is perhaps not a surprise because there has always been a problem with running these homes safely in Sweden going back a long time. That’s something we are taking advice on now and that we intend to do better on.
(Editor’s note: Sweden has a population of 10 million people, about twice as large as its nearest Scandinavian neighbors. As of April 28, the country’s COVID-19 death toll reached 2,274, about five times higher than in Denmark and 11 times higher than in Norway, according to John Hopkins University’s coronavirus tracker.)
Tegnell: It’s not just me running this. It’s the entire agency and the government. We are all having continuous discussions about what we are doing and whether it’s the right thing. So far everyone is reasonably OK with it, with the exception of the high proportion of deaths in nursing homes. But it’s also accepted that this is to a great extent a separate problem. Crucially, the public is on our side. They are worried, about the economy, but not that the disease is spreading uncontrollably in Sweden. We have many reasons to think that we are doing the right thing. It’s true that our death toll is higher compared to Denmark and Norway, but we have a lot of other things going for us. If you compare us to other countries in Europe who have severe lockdowns we are doing at least as good as them and in many cases better. Every country is wondering whether they are doing the right thing. What’s happening now is that many countries are starting to come around to the Swedish way. They are opening schools, trying to find an exit strategy. It comes back to sustainability. We need to have measures in place that we can keep on doing over the longer term, not just for a few months or several weeks.
Tegnell: I don’t know it well enough but it still seems to me that the Americans let coronavirus go too far before any real strategy came into place. One of the real big problems in the beginning was the lack of testing. I’m also not really sure how well the U.S. health system can change as dramatically as we in Sweden have been able to, for example. We have almost double the intensive care capacity that we had a couple of weeks ago. Being centrally organized and steered (as part of a state-funded system) allows for greater flexibility in changing the health system. I’m not sure how well that can be done in the U.S. with all the private actors and insurance firms. It may make it more difficult to handle this kind of situation.
(Editor’s note: According to the most recent data available, published by the National Institutes of Health prior to the coronavirus outbreak, the U.S. had between 20-31 intensive care bed units per 100,000 people; Sweden had been between 6-9 per 100,000 people. After a slow start, U.S. testing has accelerated.)
NIH chief on COVID-19:Best response one people would find ‘too drastic’
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