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Why COVID death counts in America may be higher than officials say

Jacob Scott

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Brown Institute for Media Innovation and MuckRock’s Documenting COVID-19 project

Death rates among Native, Hispanic and Black Americans still outpace pre-pandemic figures, showing the hidden toll of COVID-19 on communities of color even as vaccines have become widely available, according to data released this week by the Centers for Disease Control and Prevention.

Consider the impact to Hispanic residents: In the first 10 months of 2021, before the typically deadly winter months, the death rate for Hispanic Americans was 17% higher than it was in all of 2019. That follows 2020, when the death rate was 40% higher than 2019.

It’s particularly bad in places like Albuquerque, New Mexico; Miami-Dade County, Florida; Jersey City, New Jersey; and New York City. All have had higher death rates for Hispanics during the pandemic than the national rate.

The new data, which provide cause of death information down to the county level for 2020 and January through October of this year, have more detail, more recently, on deaths during the pandemic than ever before. 

Information included – such as where someone died, what other causes of death were on the death certificate or whether a body was autopsied – can point to communities where COVID-19 deaths have been undercounted. 

Public health experts say the true death toll of the pandemic in the U.S. is upwards of 20% higher than the official tally. That’s based on research showing that deaths attributed to COVID-19 do not account for all of the increased deaths in 2020 and 2021 when compared to prior years. Researchers call the number of deaths above a typical year “excess deaths.”

That means the number of Americans who have died from the virus could be closer to 1 million, not the roughly 793,000 deaths officially recorded as of Wednesday.

But it’s been hard for researchers to figure out exactly how many COVID-19 deaths are going uncounted and why. 

“We’ve almost certainly undercounted,” Dr. Bob Anderson, chief of mortality statistics for the CDC, said. “But if we want to really improve the data, we need to know a little more. We need to know where we’re missing cases.” 

Deadly discrimination:America’s history of racism was a preexisting condition for COVID-19

On Monday, the CDC released new data and a public tool that will bring researchers closer to understanding that.

The data could answer questions about what types of non-COVID deaths increased during the pandemic and which COVID-19 deaths have been misclassified as something else, such as a death from heart disease, stroke or a respiratory illness, said Andrew Stokes, an assistant professor of demography and sociology at Boston University’s Department of Global Health.

“In a public health emergency, real-time surveillance is critical,” Stokes said. “This data will be routinely updated with a two-to-four-week lag, and it also allows us to drill down to the county level and see how things are evolving locally. That is unprecedented compared to where we were at just a year ago.” 

COVID’s unequal impact on people of color

Hispanics had the highest increase in death rates from 2019 to 2020 of any single demographic group tracked by the CDC. Native Americans, Alaska Natives and Black Americans weren’t far behind. The death rate for Native Americans and Alaska Natives rose by 37% from 2019 to 2020. For Black Americans, it rose by 29%.

The new CDC data shows the 2021 death rates for those groups are on track to exceed pre-pandemic levels.

For Native Americans and Alaska Natives, the death rate so far in 2021 is 11% higher than it was in all of 2019. The 2021 death rate among Black Americans is on track to remain above 2019.

In 2020, the death rate among white Americans was 14% higher than in 2019. For the first 10 months of 2021, it’s 9% lower than 2019, suggesting that deaths for the full year will be closer to pre-pandemic levels. 

Daniel Dawes, executive director of the Satcher Health Leadership Institute at the Morehouse School of Medicine in Atlanta, said the 2021 figures for communities of color are “really troubling,” though the disparities are not surprising.

Worked to death:Latino farmworkers have long been denied basic rights. COVID-19 showed how deadly racism could be.

The figures reflect the unequal impact of the coronavirus on communities of color. Hispanics, African Americans and other people of color have long struggled with access to health care and insurance to deal with health conditions such as asthma and diabetes.

COVID-19 vaccination rates for people of color have lagged white Americans. Recent data suggests the gap is narrowing, but it hasn’t been eliminated. 

Data sheds light on deaths at home

Of the 3.4 million Americans who died in 2020, roughly a third died in their home, mirroring national trends prior to the pandemic. However, deaths at home increased from 2019 to 2020 more than in-patient deaths, especially in the early months of the pandemic. 

While COVID-19 was the leading cause of death for those who died in a medical facility, the virus ranks considerably lower for those who died at home. The leading cause of death at home, lung cancer, was 13% higher than in previous years, and the second, coronary heart disease, was 20% higher. 

Deaths at home increased in states with larger rural populations, including Maine, New Hampshire, Vermont and Iowa.

“Almost all of the excess home deaths are occurring for other causes,” Stokes said. 

“Whatever the story explaining the difference between excess and COVID deaths is, it’s in these home deaths, and we need to get to the bottom of them,” he said. “These were people who were afraid to go to the hospital, who were afraid to lose contact with loved ones, who heard the shelter-in-place policies and thought they wouldn’t be able to get care, or who, if ICU beds were full, didn’t have access.”

Tool allows researchers to investigate deaths in communities

By looking at groupings of underlying causes of death – such as deaths from heart attacks in Hinds and Rankin counties, two counties in the Jackson, Mississippi, area – we can see how the pandemic changed why and how Americans die. 

In Hinds County, deaths from acute myocardial infarction, or heart attacks, increased 54% from 2019 to 2020. In neighboring Rankin County they doubled. In both places, the majority of those deaths happened at home.

The increase in heart attack deaths at home suggests that those people avoided treatment for other conditions or were in fact sick with COVID-19. 

While deaths from heart attacks are common outside a hospital, the stark increase during the pandemic points to existing problems worsened by the pandemic. Mississippi ranks lowest in the country on a number of health indicators, and it has one of the country’s highest rates of diabetes and heart disease. 

“The combination of fear and misinformation around COVID meant people who may have contracted the disease were afraid to go in, or they didn’t have access to health care, so they couldn’t afford it,” said Dr. Paul Burns, a social epidemiologist and assistant professor of population health at the University of Mississippi Medical Center.

There are sizable gaps in the data as local and state medical examiners and coroners wrap up their death reporting for the year. 

Due to a lag in death certificate reporting, more than 110,000 deaths in 2021 haven’t been assigned a cause of death yet. Another 74,000 deaths in 2021 are attributed to an “ill-defined” cause – nearly double the annual average before the pandemic. That’s likely due to overwhelmed medical examiners and coroners who have’t finished investigating those deaths.

The impact of undercounted COVID-19 deaths is twofold, experts say. It can lead to complacency and undermine preventative measures like masking. And a low count of COVID-19 deaths might result in fewer state and federal resources into a given county or region.

“That’s why accurate reporting of COVID deaths is important,” said Enbal Shacham, a professor of public health at Saint Louis University and a leading expert on community health and health behavior. “It should define the public health infrastructure in your community.”

Help Documenting COVID-19 investigate

The Documenting COVID-19 project wants to help reporters, researchers and the public access and interpret this data. So they’re cleaning and posting county- and state-level data from the CDC, a Department of Justice survey released earlier this month covering some 2,000 medical examiner and coroner’s offices, and “excess death” modeling from Boston University and other academic teams. 

We will publish our findings as part of yearslong investigation into the undercounting of certain causes of death, to be published jointly with the USA TODAY Network. We’re also inviting those who have dealt with death certificates to reach out to us, and share information and stories about what they’ve seen across the country.

Contributing: Nada Hassanein, USA TODAY

The Documenting COVID-19 project, supported by Columbia University’s Brown Institute for Media Innovation and MuckRock, collects and shares government documents related to the COVID-19 pandemic and works on investigative journalism projects with partner newsrooms.

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‘Moon Knight’ Took Marvel in a Different Orbit, but It Didn’t Rise to the Occasion

Jacob Scott

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Before anyone writes that off as an anomaly, “Eternals” tackled a similar introduction of a dense mythology on the bigger screen, with equally mixed results. It’s a reminder that while film-goers have had more than a decade to get to know characters like Iron Man, Captain America and Thor, introducing some of these lesser-known heroes can pose a more formidable challenge beyond catering to the most ardent fans.
For Marvel, there are warning signs in that, since “Moon Knight” will be followed by several series based on second-tier characters, although the next two on the horizon, “Ms. Marvel” (which is due in June) and “She-Hulk,” at least have the benefit of sharing franchises and name recognition with existing Avengers.
Ultimately, “Moon Knight’s” murky storytelling appeared to squander its principal assets, which included the cool look of the character — a costume that was too seldom used — and the presence of Isaac, who possesses additional genre credentials via the “Star Wars” sequels.

Taking its time in peeling back the layers of the character’s complicated backstory, “Moon Knight” took a weird plunge into the Egyptian mythology behind it, in ways that became increasingly confounding and surreal.

By the time the protagonist’s two halves, Steven Grant and Marc Spector, wound up in a psychiatric hospital talking to an anthropomorphic hippo in the penultimate chapter, the question wasn’t so much being able to keep up with the story as whether bothering to do so was worth the effort.

The sixth and final episode brought the plot to a messy close, seeking to stop the goddess Ammit from proceeding to “purify the souls of Cairo, and then the world.” In the customary credit sequence, the producers capped that off by introducing a third personality, Jake Lockley, also rooted in the comics. While that seemingly spelled the end for the show’s villain (Ethan Hawke), the finish — giving the god Khonshu the protégé he sought — paved the way for further adventures should Marvel so choose.

That last twist might be cause for celebration in narrower confines of the Marvel fan universe, but “Moon Knight” too often felt like it was one long Easter-egg sequence, conspicuously preaching to that choir.

Granted, Marvel has made clear that Disney+ offers the chance to explore different kinds of stories, but “Moon Knight” feels at best like a quirky showcase for Isaac and at worst a failed experiment in terms of execution and tone.

That doesn’t mean this “Moon” won’t somehow rise again, if the closely held streaming data justifies it. But the promise that surrounded this property has faded, providing further evidence that even Marvel isn’t immune from setbacks as it moves into its next phase.

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Start-up Pony.ai says it’s the first self-driving company to get a taxi license in China

Jacob Scott

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Autonomous driving start-up Pony.ai can collect fares for robotaxi rides in parts of two major Chinese cities as of Sunday.

Pony.ai handout

BEIJING — Self-driving start-up Pony.ai announced Sunday it received a taxi license, the first of its kind in China.

The license allows Pony.ai to operate 100 self-driving cars as traditional taxis in the Nansha district of the southern city of Guangzhou, the company said.

The Chinese start-up, which is backed by Toyota, received approval from Beijing city late last year to charge fees to operate a commercial robotaxi business in a suburban district of the city. It is not the same as a taxi licence.

Baidu’s Apollo Go also received approval in the same Beijing district last year.

Pony.ai was valued at $8.5 billion in early March. The company said its Nansha taxi license required 24 months of autonomous driving testing in China and/or other countries, and no involvement in any active liability traffic accidents, among other factors.

The start-up said it plans to launch commercial robotaxi businesses in two other large Chinese cities next year. The company is already testing self-driving cars in those cities and in California. 

Robotaxis in China currently have a human driver present for safety.

— CNBC’s Arjun Kharpal contributed to this report.

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How to watch Timberwolves vs. Grizzlies: TV channel, NBA live stream info, start time

Jacob Scott

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Who’s Playing

Memphis @ Minnesota

Current Records: Memphis 2-1; Minnesota 1-2

What to Know

The Memphis Grizzlies’ road trip will continue as they head to Target Center at 10 p.m. ET this past Saturday to face off against the Minnesota Timberwolves. Memphis will be strutting in after a win while Minnesota will be stumbling in from a loss.

The Grizzlies are hoping for another victory. They beat the Timberwolves 104-95 this past Thursday. The victory came about thanks to a strong surge after the first quarter to overcome a 39-21 deficit. Memphis’ success was spearheaded by the efforts of power forward Brandon Clarke, who had 20 points in addition to eight rebounds, and shooting guard Desmond Bane, who shot 7-for-15 from beyond the arc and finished with 26 points and six boards.

Barring any buzzer beaters, Memphis is expected to win a tight contest. They might be worth taking a chance on against the spread as they are currently on a two-game streak of ATS wins.

Memphis’ win brought them up to 2-1 while the Timberwolves’ defeat pulled them down to a reciprocal 1-2. A couple offensive stats to keep in the back of your head while watching: The Grizzlies come into the game boasting the second most points per game in the league at 115.6. But Minnesota is even better: they rank first in the league when it comes to points per game, with 115.9 on average. Tune in for what’s sure to be a high-scoring contest.

How To Watch

When: Saturday at 10 p.m. ET Where: Target Center — Minneapolis, Minnesota TV: ESPN Online streaming: fuboTV (Try for free. Regional restrictions may apply.) Follow: CBS Sports App Ticket Cost: $76.96

Odds

The Grizzlies are a slight 2.5-point favorite against the Timberwolves, according to the latest NBA odds.

The oddsmakers had a good feel for the line for this one, as the game opened with the Grizzlies as a 3-point favorite.

Over/Under: -110

See NBA picks for every single game, including this one, from SportsLine’s advanced computer model. Get picks now.

Series History

Memphis have won 19 out of their last 28 games against Minnesota.

Apr 21, 2022 – Memphis 104 vs. Minnesota 95 Apr 19, 2022 – Memphis 124 vs. Minnesota 96 Apr 16, 2022 – Minnesota 130 vs. Memphis 117 Feb 24, 2022 – Minnesota 119 vs. Memphis 114 Jan 13, 2022 – Memphis 116 vs. Minnesota 108 Nov 20, 2021 – Minnesota 138 vs. Memphis 95 Nov 08, 2021 – Memphis 125 vs. Minnesota 118 May 05, 2021 – Memphis 139 vs. Minnesota 135 Apr 02, 2021 – Memphis 120 vs. Minnesota 108 Jan 13, 2021 – Memphis 118 vs. Minnesota 107 Jan 07, 2020 – Memphis 119 vs. Minnesota 112 Dec 01, 2019 – Memphis 115 vs. Minnesota 107 Nov 06, 2019 – Memphis 137 vs. Minnesota 121 Mar 23, 2019 – Minnesota 112 vs. Memphis 99 Feb 05, 2019 – Memphis 108 vs. Minnesota 106 Jan 30, 2019 – Minnesota 99 vs. Memphis 97 Nov 18, 2018 – Memphis 100 vs. Minnesota 87 Apr 09, 2018 – Minnesota 113 vs. Memphis 94 Mar 26, 2018 – Memphis 101 vs. Minnesota 93 Dec 04, 2017 – Memphis 95 vs. Minnesota 92 Feb 04, 2017 – Memphis 107 vs. Minnesota 99 Nov 19, 2016 – Memphis 93 vs. Minnesota 71 Nov 01, 2016 – Minnesota 116 vs. Memphis 80 Oct 26, 2016 – Memphis 102 vs. Minnesota 98 Mar 16, 2016 – Minnesota 114 vs. Memphis 108 Feb 19, 2016 – Memphis 109 vs. Minnesota 104 Jan 23, 2016 – Minnesota 106 vs. Memphis 101 Nov 15, 2015 – Memphis 114 vs. Minnesota 106

Injury Report for Minnesota

No Injury Information

Injury Report for Memphis

Dillon Brooks: Game-Time Decision (Foot) Santi Aldama: Out (Knee) Killian Tillie: Out (Knee)

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