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Grim new analyzes shed light on how America is failing in pandemic




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A grim series of articles published today in the Journal of the American Medical Association show how the United States has failed to control the ongoing novel coronavirus pandemic as the country has a horrific death toll from its inability to lower its disgracefully high death rates.

It was already clear that the United States had more deaths from the coronavirus than any other country and has one of the highest per capita death rates in the world. But, according to an article in the series, the United States is also failing to reduce COVID-19 death rates, even as hardest-hit countries have managed to learn lessons from early spikes in the disease. and significantly reduce their rates.

For the analysis, researchers Alyssa Bilinski of Harvard and Ezekiel Emanuel of the University of Pennsylvania compared the changing death rates from COVID-19 from 18 high-income countries over three windows. The idea was to see how death rates changed as countries adopted different public health interventions, especially if they had seen outbreaks of early cases that had increased their overall death rates during the pandemic. Specifically, Bilinski and Emanuel looked at COVID-19 deaths per 100,000 people as of February 13, May 10, and June 7, with all three windows ending on September 19.

The United States was in the category of high death rates from the start, with 60 COVID-19 deaths per 100,000 since the pandemic began in February. This puts the United States on par with Italy (59), the United Kingdom (63), Spain (65) and Belgium (86). However, as the periods shifted later in the pandemic, these rates dropped significantly for countries except the United States. The death rate in Italy has fallen to 9 and 3 since May and June, respectively. The UK rate fell to 16 and then to 5. The Belgians fell to 12 then 4.

Ars Technica

But the death rate in the United States, meanwhile, has remained high at 37 since May and 27 since June. The only other country that comes close to rivaling the United States in its meager progress is Sweden, which recorded death rates of 57, 23.5 and 10 in all three windows.

After the first peak in early spring, U.S. death rates from COVID-19 and all causes remained higher than even in countries with high COVID-19 mortality, Bilinski and Emanuel conclude. This may be due to several factors, including weak public health infrastructure and a decentralized and inconsistent United States response to the pandemic.

Heavy toll

In another article in the JAMA series, researchers at Virginia Commonwealth University and Yale focused solely on the United States. They compared the expected number of deaths in the United States to the actual number between March and August, finding more than 225,000 additional deaths, a jump of 20%. And only 67% of those additional deaths were directly linked to COVID-19 on death certificates. The rest may have been misclassified or due to disruptions in healthcare during the pandemic or other issues related to the pandemic.

If the pandemic continues in the United States as it has, researchers estimate that there could be over 400,000 additional deaths in the United States for all of 2020. The significance of this estimate cannot be overrated, wrote Howard Bauchner, editor-in-chief of JAMA, and Phil Fontanarosa, editor-in-chief of JAMA, in an accompanying editorial. The toll explains what could be a decrease in some causes of death, such as traffic accidents, but increasing in others, such as myocardial infarction.

In yet another article, a team of psychiatrists points out that each additional death creates its own ray of devastation. Each death from COVID-19 leaves around 9 family members in mourning, write psychiatrists. This project affects approximately 2 million bereaved people in the United States, including 225,000 additional deaths to date. Thus, the effect of deaths from COVID-19 on mental health will be profound.

They go on to explain how this tandem bereavement epidemic will lead to spikes in prolonged grief disorders, substance abuse, and social disruption. And that toll does not include the mental distress of healthcare workers, who are witnessing firsthand the ravages of illness and death from COVID-19.

Devastation is imminent

In summary, a second wave of devastation is imminent, attributable to the consequences of COVID-19 on mental health, write the psychiatrists. The scale of this second wave is likely to overwhelm the already unraveled mental health system, resulting in access challenges, especially for the most vulnerable.

With the additional deaths, long-term health problems, the looming mental health crisis, and the loss of gross domestic product from the pandemic, Harvard economists David Cutler and Lawrence Summers estimate that the cumulative financial costs of the pandemic of COVID-19 will be $ 16 trillion.

Of course, health, death and economic consequences will not be felt the same way, write Lisa Cooper of Johns Hopkins University and David Williams of Harvard. The implications for the United States are sobering, they write, but run even deeper for communities of color.

The COVID-19 pandemic has further exacerbated health, social and economic disparities in communities of color, they add. The effects of 2020 will be felt for years to come.

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