FIGURE 1. Provisional* number of COVID-19–associated deaths† and other deaths and percentage of deaths associated with COVID-19, by week of death — National Vital Statistics System, United States, 2023
* National Vital Statistics System provisional data for 2023 are incomplete. Data from December 2023 are less complete because of reporting lags. These data exclude deaths that occurred in the United States among residents of U.S. territories and foreign countries.
† Deaths with confirmed or presumed COVID-19 as an underlying or contributing cause of death, with International Classification of Diseases, Tenth Revision code U07.1.
Excerpt:
Abstract
Final annual mortality data from the National Vital Statistics System for a given year are typically released 11 months after the end of the calendar year. Provisional data, which are based on preliminary death certificate data, provide an early estimate of deaths before the release of final data. In 2023, a provisional total of 3,090,582 deaths occurred in the United States. The age-adjusted death rate per 100,000 population was 884.2 among males and 632.8 among females; the overall rate, 750.4, was 6.1% lower than in 2022 (798.8). The overall rate decreased for all age groups. Overall age-adjusted death rates in 2023 were lowest among non-Hispanic multiracial (352.1) and highest among non-Hispanic Black or African American persons (924.3). The leading causes of death were heart disease, cancer, and unintentional injury. The number of deaths from COVID-19 (76,446) was 68.9% lower than in 2022 (245,614). Provisional death estimates provide an early signal about shifts in mortality trends. Timely and actionable data can guide public health policies and interventions for populations experiencing higher mortality.
Author(s): Farida B. Ahmad, MPH1; Jodi A. Cisewski, MPH1; Robert N. Anderson, PhD
Suggested citation for this article: Ahmad FB, Cisewski JA, Anderson RN. Mortality in the United States — Provisional Data, 2023. MMWR Morb Mortal Wkly Rep 2024;73:677–681. DOI: http://dx.doi.org/10.15585/mmwr.mm7331a1
Since the COVID-19 pandemic began, in early 2020, Globe Life has been one of the life insurers that’s been quickest to give analysts candid assessments of U.S. mortality.
Mortality is much lower than it was when pandemic-related mortality was peaking, and mortality trends are now helping, not, hurting, Globe Life’s earnings, Kalmbach said.
“Mortality has been fairly consistent over the last few quarters, which has been good,” he said.
He sees the mortality rate from accidents and other nonmedical causes improving.
….
“Heart disease and cancer, although improved, are still a little bit higher,” he said. “Another one that remains elevated as a cause of death is neurological disorders, which would be stroke and Alzheimer’s. We’re keeping an eye on that.”
There were 8,400 more deaths in Australia in 2023 than predicted had the pandemic not occurred – less than half of the almost 20,000 excess deaths estimated for 2022.
The new Research Paper from the Mortality Working Group explores how COVID-19 affected mortality in Australia from 2020 to 2023 and how Australia’s experience compares with the rest of the world.
In brief:
The steep decline in excess deaths in 2023 was primarily due to the number of people dying from COVID-19 falling to 4,600 in 2023 from 10,300 in 2022.
While Australia’s excess mortality rate had dropped substantially, it remains significantly higher than the 1-2% excess observed in years of high flu deaths prior to the pandemic.
When analysing the excess mortality of 40 countries from 2020 to 2023, Australia’s excess mortality over the four-year period (5%) was low by global standards (11%).
Author(s): Mortality Working Group. Members Karen Cutter, Ronald Lai, Jennifer Lang, Han Li, Richard Lyon, Matt Ralph, Amitoze Singh, Michael Seymour, Zhan Wang.
In the experiment, he says, what if we compare the control arm of the Pfizer study against an imaginary vaccine arm. And for the thought experiment assume the vaccine is useless. As the table above shows, both groups have identical numbers of covid cases— just what you would expect from a useless vaccine. A straight forward analysis shows no benefit (second to last row)
But in the ‘fictional vaccine observational study’ cases are excluded for 36 days. When this is done the useless vaccine, looks like it reduces infections by 48%!!
Doshi makes a very good point in his paper that the solution is to subtract the 36 day infection rate from the observational control arm. Sadly most investigations don’t do that.
This is one of several biases Doshi discusses, and it plagues the vaccine literature.
Importance Antivaccine sentiment is increasingly associated with conservative political positions. Republican-inclined states exhibit lower COVID-19 vaccination rates, but the association between political inclination and reported vaccine adverse events (AEs) is unexplored.
Objective To assess whether there is an association between state political inclination and the reporting rates of COVID-19 vaccine AEs.
Design, Setting, and Participants This cross-sectional study used the AE reports after COVID-19 vaccination from the Vaccine Adverse Event Reporting System (VAERS) database from 2020 to 2022, with reports after influenza vaccines from 2019 to 2022 used as a reference. These reports were examined against state-level percentage of Republican votes in the 2020 US presidential election.
Exposure State-level percentage of Republican votes in the 2020 US presidential election.
Main Outcomes and Measures Rates of any AE among COVID-19 vaccine recipients, rates of any severe AE among vaccine recipients, and the proportion of AEs reported as severe.
Results A total of 620 456 AE reports (mean [SD] age of vaccine recipients, 51.8 [17.6] years; 435 797 reports from women [70.2%]; a vaccine recipient could potentially file more than 1 report, so reports are not necessarily from unique individuals) for COVID-19 vaccination were identified from the VAERS database. Significant associations between state political inclination and state AE reporting were observed for all 3 outcomes: a 10% increase in Republican voting was associated with increased odds of AE reports (odds ratio [OR], 1.05; 95% CI, 1.05-1.05; P < .001), severe AE reports (OR, 1.25; 95% CI, 1.24-1.26; P < .001), and the proportion of AEs reported as severe (OR, 1.21; 95% CI, 1.20-1.22; P < .001). These associations were seen across all age strata in stratified analyses and were more pronounced among older subpopulations.
Conclusions and Relevance This cross-sectional study found that the more states were inclined to vote Republican, the more likely their vaccine recipients or their clinicians reported COVID-19 vaccine AEs. These results suggest that either the perception of vaccine AEs or the motivation to report them was associated with political inclination.
Now let’s turn to the paper. Here is what the authors find (weak correlation btw voting and vaccine injuries) , and here are the issues.
These data are ecological. It doesn’t prove that republicans themselves are more likely to report vaccine injuries. It would not be difficult to pair voting records with vaccine records at an individual patient level if the authors wished to do it right— another example of research laziness.
What if republicans actually DO have more vaccine injuries? The authors try to correct for the fact by adjusting for influenza adverse events.
Let me explain why this is a poor choice. The factors that predict whether someone has an adverse event to influenza vaccine may not be the same as those that predict adverse events from covid shots. It could be that there are actually more covid vaccine injuries in one group than another— even though both had equal rates of influenza injuries.
Another way to think of it is, there can be two groups of people and you can balance them by the rate with which they get headaches from drinking wine, but one group can be more likely to get headaches from reading without glasses because more people in that group wear glasses. In other words, states with more republicans might be states with specific co-morbidities that predict COVID vaccine adverse side effects but not influenza vaccine side effects. We already know that COVID vaccine injuries do affect different groups (young men, for e.g.).
Author(s): Vinay Prasad
Publication Date: 2 Apr 2024
Publication Site: Vinay Prasad’s Thoughts and Observations at substack
Brain fog is a colloquial term that describes a state of mental sluggishness or lack of clarity and haziness that makes it difficult to concentrate, remember things and think clearly.
Fast-forward four years and there is now abundant evidence that being infected with SARS-CoV-2 – the virus that causes COVID-19 – can affect brain health in many ways.
In addition to brain fog, COVID-19 can lead to an array of problems, including headaches, seizure disorders, strokes, sleep problems, and tingling and paralysis of the nerves, as well as several mental health disorders.
Making those timelines — 2020, 2021, 2022, 2023, 2024 — really brought home to me how long this pandemic has been going on; I lost track in the daily grind (though the daily grind is also my form of coping). And it’s a bit discouraging to see the most solidarity our society seems capable of fizzle out after 2020, followed by a struggle to return to business as usual, a struggle that failed by 2024, in that a once-essential part of touring — contact with the fans — has now gone missing.
We can, of course, moralize about what how these artists have gone about their business:
To be fair, though, when CDC Director Mandy Cohen is swanning about with no mask, modeling how to infect everybody she breathes on, what’s a poor celebrity to do? Restoring social norms that support non-pharmaceutical interventions will probably take a whole-of-society approach (which could happen when those Tiktokers start doing their research).
Here, however, are two small steps artists like Adele and Taylor Swift could do to improve the Covid pandemic situation.
First, big acts could really help out smaller acts by supporting organizations like this one: [Clean Air Club]
Second, sell N95s at your concerts and on your websites as branded merch. K-Pop powerhouse Twice already does this (though KN94s, not N95s):
And if, by some happy chance, some intern from either organization reads this post, please champion these ideas!
Oh, and champion clean air, too. Who could be against that? Miasma delenda est!
Uptake of the current COVID-19 vaccine is higher in non-profit facilities than in for-profit or government facilities (Figure 2). The percentage of nursing facility residents who received the updated vaccine is 46% in non-profit facilities compared with 35% in for-profit facilities and 43% in government facilities. Uptake of the fall 2022 vaccine was also highest in non-profit facilities and lowest in for-profit facilities. Rates of vaccine uptake for nursing facility staff were low in all types of facilities with minimal variation across facility types (data not shown).
COVID-19, caused by the SARS-CoV-2 virus, is a respiratory infectious disease. While most patients recover after treatment, there is growing evidence that COVID-19 may result in cognitive impairment. Recent studies reveal that some individuals experience cognitive deficits, such as diminished memory and attention, as well as sleep disturbances, suggesting that COVID-19 could have long-term effects on cognitive function. Research indicates that COVID-19 may contribute to cognitive decline by damaging crucial brain regions, including the hippocampus and anterior cingulate cortex. Additionally, studies have identified active neuroinflammation, mitochondrial dysfunction, and microglial activation in COVID-19 patients, implying that these factors may be potential mechanisms leading to cognitive impairment. Given these findings, the possibility of cognitive impairment following COVID-19 treatment warrants careful consideration. Large-scale follow-up studies are needed to investigate the impact of COVID-19 on cognitive function and offer evidence to support clinical treatment and rehabilitation practices. In-depth neuropathological and biological studies can elucidate precise mechanisms and provide a theoretical basis for prevention, treatment, and intervention research. Considering the risks of the long-term effects of COVID-19 and the possibility of reinfection, it is imperative to integrate basic and clinical research data to optimize the preservation of patients’ cognitive function and quality of life. This integration will also offer valuable insights for responding to similar public health events in the future. This perspective article synthesizes clinical and basic evidence of cognitive impairment following COVID-19, discussing potential mechanisms and outlining future research directions.
