COVID-19 Pandemic (Coronavirus)
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San Francisco Bay Area’s COVID death rate was among the lowest in the nation. Here’s why
A climber wears a protective mask while working out at Planet Granite climbing gym in San Francisco in 2021.
(Jeff Chiu / Associated Press)
BY RONG-GONG LIN II,
LUKE MONEY, SEAN GREENE
NOV. 27, 2023 3 AM PT
The San Francisco Bay Area fared better during the COVID-19 pandemic than many other largely populated areas, with a cumulative COVID-19 death rate among the lowest of the nation’s most populous counties, according to a Los Angeles Times analysis.
Of the nation’s 88 counties with a population greater than 750,000 people, San Francisco and neighboring Santa Clara, Alameda, Contra Costa and San Mateo counties had COVID death rates among the lowest in the country.
The nine-county region of the Bay Area reported 10,093 COVID-19 deaths through March, as tallied by Johns Hopkins University before it ended its comprehensive count. That translates to a cumulative rate of 130 deaths for every 100,000 residents. That’s 37% of Los Angeles County’s death rate of 354 deaths per 100,000 residents (the 27th-highest cumulative rate) and one-quarter of New York City’s cumulative rate of 540 deaths for every 100,000 residents.
Each of New York City’s five boroughs is technically its own county. If New York City were considered to be a single county, it would have the worst COVID-19 death rate among the nation’s counties with more than 750,000 residents.
Other highly populated counties with death rates comparable to the Bay Area’s include Honolulu County in Hawaii and Wake County in North Carolina, which is home to Raleigh, the state capital.
Even when the COVID death rates are adjusted for differences in the age distribution of the population, San Francisco and Santa Clara County — Northern California’s most populous county — still had a relatively low rate compared with the country’s two largest metropolitan areas.
A Times analysis, calculated from data released by local health officials and adjusted for age, shows San Francisco had one-third the death rate of L.A. County and roughly one-fourth that of New York City’s. Santa Clara County had an age-adjusted death rate about 40% of L.A. County’s and roughly 30% of New York City’s.
Some experts caution against comparing jurisdictions, given the wide differences in the structures of metropolitan areas. New York City was arguably quite vulnerable because of its population density — the number of people living per square mile — and possibly the way people’s lives are structured there, which may have allowed the coronavirus to spread unchecked before stay-at-home orders went into effect.
In addition, the colder weather in New York City could’ve contributed to the rapid spread of the virus in indoor public settings.
Los Angeles County had its own vulnerabilities, with more overcrowded homes than any other large U.S. county, a Times analysis published last year found. Many people could not work from home and became infected in crowded workplace settings such as factories.
By contrast, the Bay Area probably had some advantages, including the ability of many to work from home. The region’s poverty rate is also lower than L.A.’s: The San Jose-Sunnyvale-Santa Clara metro area has 7.3% of residents living below the poverty line, and the San Francisco-Oakland-Berkeley metro area has 9.2% living below the poverty line. In Los Angeles County, 13.9% live below the poverty line, and in New York City, 18.3% do.
Scientists can compare jurisdictions in other ways, including assessing the differences in “all-cause excess mortality” — the number of deaths from all causes that are above what would be expected if there weren’t a pandemic. This would include COVID-19 deaths plus those not directly caused by COVID, such as chronic health problems that worsened during the pandemic.
In a report published in the journal Public Health Reports, officials with the San Francisco Department of Public Health, along with co-authors from UC San Francisco and UC Berkeley, calculated the excess all-cause mortality rate in San Francisco in 2020, as well as statewide.
They found that San Francisco’s excess mortality rate was half the state’s total. In 2020, there was an 8% increase in deaths from all causes in San Francisco compared with the prior year. By contrast, across all of California, there was a 16% increase.
In that report, the authors touted policies issued early in the pandemic they say helped lower COVID’s impact on San Francisco, including the nation’s first regional stay-at-home order, an action epidemiologists said that, because it was implemented early, probably helped dramatically slow transmission of the coronavirus.
They also noted the region’s long-lasting mask mandate, which was in place for nearly two years, save for a brief gap before the Delta variant emerged in California in summer 2021.
Importantly, Bay Area residents seemed to be largely agreeable with the health orders. Adherence to mask use, for instance, appeared to be quite high compared with other parts of the state and country.
Vaccination rates were also high in the region. By the end of the national pandemic emergency on May 10, 96% of seniors in the Bay Area had completed their primary vaccination series, compared with 89% of Los Angeles County seniors and 91% of New York City seniors.
With each iteration of new booster shots, the Bay Area widened its relative lead among seniors. With the first round of boosters, given in late 2021, 86% of Bay Area seniors got one, compared with 75% in L.A. County and 60% in New York City.
And for the first updated booster shot, made available in September 2022, 63% of the Bay Area’s seniors got one, compared with 46% of seniors in L.A. County and 32% in New York City.
https://www.cidrap.umn.edu/covid-19/study-shows-infants-exposed-covid-utero-risk-developmental-delay
Study shows infants exposed to COVID in utero at risk for developmental delay
News briefDecember 6, 2023
Stephanie Soucheray, MA
Topics
COVID-19
Joshua Rappeneker / Flickr cc[/LEFT]
A new study based on a cohort of Brazilian infants shows those who were exposed to SARS-CoV-2 infections in the uterus may be at an increased risk for developmental delays in the first year of life. The study appeared yesterday in the International Journal of Infectious Diseases.
Women in northern Brazil were assessed from April 2020 to July 2021. Researchers compared outcomes among a case group of 69 children who were exposed to lab-confirmed COVID-19 in utero compared to 68 children who served as controls, and had no known exposure to COVID-19 in utero.
"All mothers were unvaccinated at the time of cohort inclusion, and maternal demographics were similar in the two groups," the authors wrote.
At 12 months, 20.3% of COVID-exposed children and 5.9% of the controls received a diagnosis of neurodevelopmental delay (risk ratio, 3.44; 95% confidence interval, 1.19 to 9.95).
For the exposed group, the prevalence of neurodevelopment impairment using the Ages & Stages Questionnaire (ASQ-3) was 35.7% at 4 months, 7.0% at 6 months, and 32.1% at 12 months.
Delays seen at 4, 12 months
"Over 50% of the SARS-CoV-2 exposed infants presented ASQ-3 scores below the expected cutoff, with about half classified with neurodevelopmental delay, mainly at 4 and 12 months,” the authors wrote.Previous studies conducted in the United States and elsewhere have shown a risk of delays in infants exposed to COVID-19 infections in utero, but this is the first study to look at the phenomenon in northern Brazil.
In follow-up of exposed infants, the researchers found 10% had an abnormal result on cranial ultrasonography, mainly mild ventriculomegaly, a swelling in the brain caused by cerebrospinal fluid buildup.
"That has been described with other congenital infections, like cytomegalovirus and Zika virus," they wrote. "Although the findings were mostly mild, there was an association between the diagnosis of abnormalities and the risk of developmental delay."[/SIZE]
Nearly half of COVID survivors in Africa have lingering symptoms, data reveal
News briefDecember 6, 2023
Mary Van Beusekom, MS
Topics
COVID-19
Wavebreakmedia / iStock
A systematic review and meta-analysis estimates a nearly 50% long-COVID rate months after infection in Africa, with psychiatric conditions the most common manifestations.
Published today in Scientific Reports, the February 2023 literature search and analysis involved 25 observational, English language long-COVID studies with 29,213 infected African patients.
Nearly half (48%) of the studies were from Egypt, the average patient age was 42 years (range, 7 to 73 years), 59.3% were females, and the median follow-up was 3 months.
"In low-income countries, the estimates of its [long COVID's] incidence vary greatly due to a significant number of hidden infections (i.e., asymptomatic or undisclosed) and difficulties in accessing testing," the study authors wrote.
A fourth of patients reported poor quality of life
The team, led by researchers from the University of Bari in Italy, found a long-COVID rate of 48.6%, with a predominance of psychiatric conditions, especially post-traumatic stress disorder (25.8%).The most common neurologic symptom was cognitive impairment (15%), and shortness of breath was the most common respiratory symptom (18.3%), followed by cough (10.7%). Other notable symptoms were loss of appetite (12.7%), weight loss (10.4%), fatigue (35.4%), and muscle pain (15.5%). A quarter (25.4%) of patients reported poor quality of life.
The high incidence of fatigue is particularly worrisome because of its debilitating nature. "This is concerning because, in Africa, it has the potential to lead to important impairment in productivity and further loss of economic agency," the researchers wrote.
Likewise, the mental illness burden in long-COVID patients poses a challenge on a continent with few mental health resources: "These findings highlight the pressing need for immediate policy implementation and reallocation of resources to address this severely underestimated public health issue."
Risk factors for long COVID included older age and hospitalization during infection.
"The study recommends identifying at-risk people and defining treatment strategies and recommendations for African long-COVID patients," the authors concluded, noting that high-quality studies are urgently needed.
Analysis shows racial disparities in COVID ICU admissions in California
News briefDecember 5, 2023
Stephanie Soucheray, MA
Topics
COVID-19
A new retrospective analysis of the California State Inpatient Database during 2020 shows Hispanic residents were disproportionately affected by the pandemic, with both the highest mortality rates and intensive care unit (ICU) admissions throughout the state.
The study, published in Scientific Reports, and adds to the growing body of literature showing significant racial disparities during the COVID-19 pandemic in the United States.
All hospitalizations for adults ages 18 and older were included in the final analysis. Among a total of 87,934 COVID-19 hospitalizations, Hispanics accounted for 56.5% of patients, followed by White (27.3%), Asian, Pacific Islander, Native American (9.9%), and Black (6.3%) residents of California.
When compared with White counterparts, Hispanic patients had a higher mortality risk, with a hazard ratio (HR) of 0.91 (95% confidence interval [CI], 0.87 to 0.96).
Hispanics most affected in California
Both Hispanic and Black patients had significantly greater odds of ICU admission compared to Whites (odds ratio [OR], 1.70; 95% CI, 1.67 to 1.74 for Hispanics and OR, 1.70; 95% CI, 1.64 to 1.78 for Blacks).Compared with other races and ethnicities, hospitalized Hispanics were also significantly younger, with 43.9% in the age group 45 to 64 years, while among Whites (46.5%) and Asian, Pacific Islander, Native Americans (40.0%), most hospitalized patients were in the age group 65 to 84 years.
The authors of the study said the proportion of comorbidities, such as diabetes mellitus, obesity, and liver disease, were highest among Hispanics.
"In this study of COVID-19 hospitalizations in California, the risk of all-cause in-hospital mortality was significantly higher among Hispanics and associated with older age, male sex, and comorbidities," the authors concluded.[/SIZE]
Small study finds brain alterations after COVID Omicron infection
Mary Van Beusekom, MSDecember 4, 2023
COVID-19
Researchers in China report thinning of the gray matter and other changes in certain parts of the brain in 61 men after COVID-19 Omicron infection.
For the study, published late last week in JAMA Network Open, the researchers evaluated 61 men before and after infection with the SARS-CoV-2 Omicron variant in January 2023. The men had been part of a larger cohort who had undergone magnetic resonance imaging (MRI) and neuropsychiatric screenings before infection in August and September 2022. Average age was 43 years.
The researchers collected MRI and neuropsychiatric data after COVID-19 infection and tracked clinical symptoms for 3 months. The average interval from infection and MRI scans was 22 days. Twenty-nine participants received at least one dose of COVID-19 vaccine, 17 received three, and 15 didn't report their vaccination status.
Links to anxiety, word fluency
After infection, Beck Anxiety Inventory scores were significantly higher (median, 4.50 to 4.00), while depressive distress scores were significantly lower (median, 18.00 to 16.00). The most common symptoms after infection were fever, headache, fatigue, muscle pain, cough, and shortness of breath.Of 17 participants who completed 3-month follow-up, fever (64.7% vs 11.8%), muscle pain (58.8% vs 17.6%), and cough (70.6% vs 23.5%) had improved significantly since infection.
In certain regions of the brain, gray-matter thickness had thinned, and the ratio of right hippocampus volume to total intracranial volume was significantly reduced after infection. Gray-matter thinness was negatively correlated with anxiety scores, and the ratio of the right hippocampus to total intracranial volume was positively correlated with Word Fluency Test scores.
"In this cohort study of male patients infected with the Omicron variant, the duration of symptoms in multiple systems after infection was short," the study authors wrote. "Changes in gray matter thickness and subcortical nuclear volume injury were observed in the post-Omicron period."
The results, they said, shine a light on the emotional and cognitive mechanisms of Omicron infection, show its link to nervous system alterations, and confirm that imaging can enable early detection and treatment of neurologic complications.[/SIZE]
People hold up a banner while listening to a news conference outside the San Quentin state prison in San Quentin, California, in July 2020. Photograph: Eric Risberg/AP
US prisons
US prison deaths soared by 77% during height of Covid-19 crisis, study finds
Analysis of in-custody deaths show mortality rates were more than three times the increase in general population in 2020
Edward Helmore
Sun 3 Dec 2023 17.01 EST
A study of US prison deaths at the height of the Covid-19 crisis in 2020 has found that mortality rates soared by 77% relative to 2019, or more than three times the increase in the general population.
The study, published by Science Advances last week, is the most comprehensive analysis of in-custody deaths since 2020. The report found that “Covid-19 was the primary driver for increases in mortality due to natural causes; some states also experienced substantial increases due to unnatural causes.”
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The report was compiled using data from record requests and some publicly available data, when necessary, from 49 state and federal departments of corrections.
Its lead author, Naomi Sugie, an associate professor of criminology, law and society at the University of California at Irvine, told Courthouse News that the actual toll of Covid-19 in the prison system had been little understood.
“We staffed a hotline and started this archival project hearing what people were going through in California prisons,” Sugie told the outlet. “And the conditions that people were describing were so dire and upsetting and really just violations of their health and, some may argue, human rights.”
Sugie began studying the effect of Covid-19 in California prisons after they imposed containment lockdowns in 2020. The PrisonPandemic project found that the institutions reduced facility communication and transparency down to zero with some facilities not recording causes of death that year at all.
The authors write that there has been no publicly available information about mortality in US prisons since 2019 despite the Death in Custody Reporting Act passed in 2000 and reauthorized in 2014 that requires the collection of information regarding the death of any person who is under arrest, en route to be incarcerated, incarcerated at a municipal or county jail, state prison, or other local or state correctional facility.
The 2022 Bureau of Justice statistics found that roughly 2,500 prisoners died of Covid-related causes between March 2020 and February 2021, but the number did not include a rise in mortality rates of natural deaths or unnatural deaths.
“These steep increases suggest systemic failures that simultaneously increased risk of illness and limited access to medical care,” the authors of the study wrote.
The study also found that pandemic-related lockdowns and restrictions on movement, including isolation, visitor prohibitions and solitary confinement in place of medical isolation, designed to mitigate infection had “increased stress, mental health challenges, and violence exacerbating the risk of deaths due to unnatural causes, such as drug overdoses, suicide, and violence”.
Sugie told the outlet that “for all of those deaths that are related to the pandemic, for various ways, we don’t know about them because they’re not officially coded as Covid-related”. Just like in the general population, she added, a lot of states did not test systemically, “so even if someone died of Covid, their death may not have been recorded as Covid-related”.
Elim Garak
Veteran
Something crazy is definitely going on. I just got over this shyt but I'm wondering if I need to start taking more precautions again.
louisvandross
the lesbian converter
What you mean took out? Out of work or out of life?
valet
The official Chaplain of the Coli
Out of work