scholarly journals Population-level COVID-19 mortality risk for non-elderly individuals overall and for non-elderly individuals without underlying diseases in pandemic epicenters

2020 ◽  
Author(s):  
John P.A. Ioannidis ◽  
Cathrine Axfors ◽  
Despina G. Contopoulos-Ioannidis
Keyword(s):  
New York ◽  
New York City ◽  
Absolute Risk ◽  
Population Level ◽  
European Countries ◽  
Elderly Individuals ◽  
Death Risk ◽  
The Absolute ◽  
The Uk ◽  
Underlying Diseases

AbstractOBJECTIVETo provide estimates of the relative risk of COVID-19 death in people <65 years old versus older individuals in the general population, the absolute risk of COVID-19 death at the population level during the first epidemic wave, and the proportion of COVID-19 deaths in non-elderly people without underlying diseases in epicenters of the pandemic.ELIGIBLE DATACountries and US states with at least 800 COVID-19 deaths as of April 24, 2020 and with information on the number of deaths in people with age <65. Data were available for 11 European countries (Belgium, France, Germany, Ireland, Italy, Netherlands, Portugal, Spain, Sweden, Switzerland, UK), Canada, and 12 US states (California, Connecticut, Florida, Georgia, Illinois, Indiana, Louisiana, Maryland, Massachusetts, Michigan, New Jersey and New York) We also examined available data on COVID-19 deaths in people with age <65 and no underlying diseases.MAIN OUTCOME MEASURESProportion of COVID-19 deaths in people <65 years old; relative risk of COVID-19 death in people <65 versus ≥65 years old; absolute risk of COVID-19 death in people <65 and in those ≥80 years old in the general population as of May 1, 2020; absolute COVID-19 death risk expressed as equivalent of death risk from driving a motor vehicle.RESULTSIndividuals with age <65 account for 4.8-9.3% of all COVID-19 deaths in 10 European countries and Canada, 13.0% in the UK, and 7.8-23.9% in the US locations. People <65 years old had 36- to 84-fold lower risk of COVID-19 death than those ≥65 years old in 10 European countries and Canada and 14- to 56-fold lower risk in UK and US locations. The absolute risk of COVID-19 death as of May 1, 2020 for people <65 years old ranged from 6 (Canada) to 249 per million (New York City). The absolute risk of COVID-19 death for people ≥80 years old ranged from 0.3 (Florida) to 10.6 per thousand (New York). The COVID-19 death risk in people <65 years old during the period of fatalities from the epidemic was equivalent to the death risk from driving between 13 and 101 miles per day for 11 countries and 6 states, and was higher (equivalent to the death risk from driving 143-668 miles per day) for 6 other states and the UK. People <65 years old without underlying predisposing conditions accounted for only 0.7-2.6% of all COVID-19 deaths (data available from France, Italy, Netherlands, Sweden, Georgia, and New York City).CONCLUSIONSPeople <65 years old have very small risks of COVID-19 death even in pandemic epicenters and deaths for people <65 years without underlying predisposing conditions are remarkably uncommon. Strategies focusing specifically on protecting high-risk elderly individuals should be considered in managing the pandemic.

scholarly journals SARS-CoV-2 infection in London, England: changes to community point prevalence around lockdown time, March–May 2020

2020 ◽  
pp. jech-2020-214730 ◽  
Author(s):  
Michael Edelstein ◽  
Chinelo Obi ◽  
Meera Chand ◽  
Susan Hopkins ◽  
Kevin Brown ◽  
...  
Keyword(s):  
Population Level ◽  
Small Sample ◽  
Point Prevalence ◽  
European Countries ◽  
Limited Information ◽  
The Uk ◽  
The Impact

BackgroundThe UK has been one of the European countries most affected by COVID-19 pandemic. The UK implemented a lockdown in March 2020, when testing policy at the time was focusing on hospitalised cases. Limited information is therefore available on the impact of the lockdown on point prevalence in the community. We assessed COVID-19 point prevalence in London between early April and early May 2020, which approximately reflect infection around the time of the lockdown and 3–5 weeks into lockdown.MethodsWe tested 1064 participants of a community surveillance cohort for acute COVID-19 infection using PCR in London in April and May 2020 and described positivity as well as characteristics and symptoms of the participants.ResultsPoint prevalence decreased from 2.2% (95% CI 1.4 to 3.5) in early April to 0.2% (95% CI 0.03 to 1.6) in early May. 22% of those who tested positive in April were asymptomatic. Extrapolation from reports of confirmed cases suggest that 5–7.6% of total infections were confirmed by testing during this period.ConclusionCOVID-19 point prevalence in the community sharply decreased after lockdown was implemented. This study is based on a small sample and regular seroprevalence studies are needed to better characterise population-level immunity.

scholarly journals Overcoming Reporting Delays Is Critical to Timely Epidemic Monitoring: The Case of COVID-19 in New York City

2020 ◽  
Author(s):  
Jeffrey E Harris
Keyword(s):  
New York ◽  
New York City ◽  
Statistical Method ◽  
York City ◽  
Population Level ◽  
Disease Spread ◽  
Individual Level ◽  
Specimen Processing ◽  
Reporting Delays ◽  
The Individual

During a fast-moving epidemic, timely monitoring of case counts and other key indicators of disease spread is critical to an effective public policy response. We describe a nonparametric statistical method - originally applied to the reporting of AIDS cases in the 1980s - to estimate the distribution of reporting delays of confirmed COVID-19 cases in New York City. During June 21 - August 1, 2020, the estimated mean delay in reporting was 5 days, with 15 percent of cases reported after 10 or more days. Relying upon the estimated reporting-delay distribution, we project COVID-19 incidence during the most recent three weeks as if each case had instead been reported on the same day that the underlying diagnostic test had been performed. The statistical method described here overcomes the problem of reporting delays only at the population level. The method does not eliminate reporting delays at the individual level. That will require improvements in diagnostic technology, test availability, and specimen processing.

scholarly journals A tool for translating polygenic scores onto the absolute scale using summary statistics

2022 ◽  
Author(s):  
Oliver Pain ◽  
Alexandra C. Gillett ◽  
Jehannine C. Austin ◽  
Lasse Folkersen ◽  
Cathryn M. Lewis
Keyword(s):  
Genome Wide Association Study ◽  
Absolute Risk ◽  
Summary Statistics ◽  
Clinical Implementation ◽  
Polygenic Score ◽  
Absolute Scale ◽  
Polygenic Scores ◽  
The Absolute ◽  
The Uk ◽  
Normally Distributed

AbstractThere is growing interest in the clinical application of polygenic scores as their predictive utility increases for a range of health-related phenotypes. However, providing polygenic score predictions on the absolute scale is an important step for their safe interpretation. We have developed a method to convert polygenic scores to the absolute scale for binary and normally distributed phenotypes. This method uses summary statistics, requiring only the area-under-the-ROC curve (AUC) or variance explained (R2) by the polygenic score, and the prevalence of binary phenotypes, or mean and standard deviation of normally distributed phenotypes. Polygenic scores are converted using normal distribution theory. We also evaluate methods for estimating polygenic score AUC/R2 from genome-wide association study (GWAS) summary statistics alone. We validate the absolute risk conversion and AUC/R2 estimation using data for eight binary and three continuous phenotypes in the UK Biobank sample. When the AUC/R2 of the polygenic score is known, the observed and estimated absolute values were highly concordant. Estimates of AUC/R2 from the lassosum pseudovalidation method were most similar to the observed AUC/R2 values, though estimated values deviated substantially from the observed for autoimmune disorders. This study enables accurate interpretation of polygenic scores using only summary statistics, providing a useful tool for educational and clinical purposes. Furthermore, we have created interactive webtools implementing the conversion to the absolute (https://opain.github.io/GenoPred/PRS_to_Abs_tool.html). Several further barriers must be addressed before clinical implementation of polygenic scores, such as ensuring target individuals are well represented by the GWAS sample.

scholarly journals Highlighting the ratio of sodium to potassium in population-level dietary assessments: cross-sectional data from New York City, USA

2014 ◽  
Vol 17 (11) ◽  
pp. 2484-2488 ◽  
Author(s):  
Stella S Yi ◽  
Christine J Curtis ◽  
Sonia Y Angell ◽  
Cheryl AM Anderson ◽  
Molly Jung ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Population Level ◽  
Population Based ◽  
Dual Frame ◽  
Cross Sectional ◽  
Mean Values ◽  
Representative Study ◽  
Random Digit Dial

AbstractObjectiveTo contrast mean values of Na:K with Na and K mean intakes by demographic factors, and to calculate the prevalence of New York City (NYC) adults meeting the WHO guideline for optimal Na:K (<1 mmol/mmol, i.e. <0·59 mg/mg) using 24 h urinary values.DesignData were from the 2010 Community Health Survey Heart Follow-Up Study, a population-based, representative study including data from 24 h urine collections.SettingParticipants were interviewed using a dual-frame sample design consisting of random-digit dial telephone exchanges that cover NYC. Data were weighted to be representative of NYC adults as a whole.SubjectsThe final sample of 1656 adults provided 24 h urine collections and self-reported health data.ResultsMean Na:K in NYC adults was 1·7 mg/mg. Elevated Na:K was observed in young, minority, low-education and high-poverty adults. Only 5·2 % of NYC adults had Na:K in the optimal range.ConclusionsNa intake is high and K intake is low in NYC adults, leading to high Na:K. Na:K is a useful marker and its inclusion for nutrition surveillance in populations, in addition to Na and K intakes, is indicated.

scholarly journals On white-collar boxing and social class

2019 ◽  
Vol 67 (6) ◽  
pp. 1400-1416 ◽  
Author(s):  
Edward J. Wright
Keyword(s):  
New York ◽  
New York City ◽  
Social Class ◽  
White Collar ◽  
Sociological Research ◽  
The Social ◽  
The Uk ◽  
A Site ◽  
Post Industrial ◽  
Late Modern

This article is based on the first sociological research of white-collar boxing in the UK. Grounded in an ethnography of a boxing gym in the Midlands, the article argues that the term ‘white-collar boxing’ in this context is immediately misleading, and entails the term being used in a way with which sociologists are unaccustomed. Whereas white-collar boxing originated in the context of post-industrial New York City as a pastime only for the extremely wealthy, the situation in the UK is different. Participants actively reject this understanding of white-collar boxing. The term white-collar boxing does not signify the social class of participants, but refers to their novice status. Given that boxing is an example through which Bourdieu’s theory of distinction is discussed, and that white-collar boxing is a distinctly late-modern version of the sport containing an erroneous class signifier, this version of the sport is a site through which such discussions of consumption can be furthered. Whilst consumed by actors in various class positions, a logic of distinction is present in white-collar boxing, which becomes recognisable through analysis of the ‘plurality of consumption experiences’. This is proffered as a concept which can aid in the analysis of consumption beyond white-collar boxing.

scholarly journals GPs’ understanding of the benefits and harms of treatments for long-term conditions: an online survey

BJGP Open ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. bjgpopen20X101016 ◽  
Author(s):  
Julian Stephen Treadwell ◽  
Geoff Wong ◽  
Coral Milburn-Curtis ◽  
Benjamin Feakins ◽  
Trisha Greenhalgh
Keyword(s):  
Decision Making ◽  
Online Survey ◽  
Treatment Effects ◽  
Clinical Decision Making ◽  
Absolute Risk ◽  
Clinical Decision ◽  
Long Term Conditions ◽  
The Absolute ◽  
The Uk

BackgroundGPs prescribe multiple long-term treatments to their patients. For shared clinical decision-making, understanding of the absolute benefits and harms of individual treatments is needed. International evidence shows that doctors’ knowledge of treatment effects is poor but, to the authors knowledge, this has not been researched among GPs in the UK.AimTo measure the level and range of the quantitative understanding of the benefits and harms of treatments for common long-term conditions (LTCs) among GPs.Design & settingAn online cross-sectional survey was distributed to GPs in the UK.MethodParticipants were asked to estimate the percentage absolute risk reduction or increase conferred by 13 interventions across 10 LTCs on 17 important outcomes. Responses were collated and presented in a novel graphic format to allow detailed visualisation of the findings. Descriptive statistical analysis was performed.ResultsA total of 443 responders were included in the analysis. Most demonstrated poor (and in some cases very poor) knowledge of the absolute benefits and harms of treatments. Overall, an average of 10.9% of responses were correct allowing for ±1% margin in absolute risk estimates and 23.3% allowing a ±3% margin. Eighty-seven point seven per cent of responses overestimated and 8.9% of responses underestimated treatment effects. There was no tendency to differentially overestimate benefits and underestimate harms. Sixty-four point eight per cent of GPs self-reported ‘low’ to ‘very low’ confidence in their knowledge.ConclusionGPs’ knowledge of the absolute benefits and harms of treatments is poor, with inaccuracies of a magnitude likely to meaningfully affect clinical decision-making and impede conversations with patients regarding treatment choices.

scholarly journals A Surveillance-Based Hepatitis C Care Cascade, New York City, 2017

2018 ◽  
Vol 133 (4) ◽  
pp. 497-501 ◽  
Author(s):  
Miranda S. Moore ◽  
Angelica Bocour ◽  
Fabienne Laraque ◽  
Ann Winters
Keyword(s):  
New York ◽  
New York City ◽  
Hepatitis C ◽  
York City ◽  
Population Level ◽  
Health Department ◽  
Department Of Health ◽  
Care Cascade ◽  
Laboratory Surveillance ◽  
Direct Acting

Objectives: The care cascade, a method for tracking population-level progression from diagnosis to cure, is an important tool in addressing and monitoring the hepatitis C virus (HCV) epidemic. However, little agreement exists on appropriate care cascade steps or how best to measure them. The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) sought to construct a care cascade by using laboratory surveillance data with clinically relevant categories that can be readily updated over time. Methods: We identified all NYC residents ever reported to the DOHMH surveillance registry with HCV through June 30, 2017 (n = 175 896). To account for outmigration, death, or treatment before negative RNA results became reportable to the health department, we limited the population to people with any test reported since July 1, 2014. Of these residents, we identified the proportion with a reported positive RNA test and estimated the proportion treated and cured since July 2014 by using DOHMH-developed surveillance-based algorithms. Results: Of 78 886 NYC residents ever receiving a diagnosis of HCV and tested since July 1, 2014, a total of 70 397 (89.2%) had ever been reported as RNA positive through June 30, 2017; 36 875 (46.7%) had initiated treatment since July 1, 2014, and 23 766 (30.1%) appeared cured during the same period. Conclusion: A substantial gap exists between confirming HCV infection and initiating treatment, even in the era of direct-acting antivirals. Using this cascade, we will monitor progress in improved treatment and cure of HCV in NYC.

scholarly journals Trends in Thoracic Impedance and Arrhythmia Burden Among Patients with Implanted Cardiac Defibrillators During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Yuan Lu ◽  
Karthik Murugiah ◽  
Paul W Jones ◽  
César Caraballo ◽  
Shiwani Mahajan ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Remote Monitoring ◽  
York City ◽  
Cardiovascular Health ◽  
Saint Paul ◽  
Population Level ◽  
Thoracic Impedance ◽  
Cardiac Status ◽  
True Population

ABSTRACTHospitalizations for acute cardiac conditions have markedly declined during the coronavirus disease 2019 (COVID-19) pandemic, yet the cause of this decline is not clear. Using remote monitoring data of 4,029 patients with implantable cardiac defibrillators (ICDs) living in New York City and Minneapolis/Saint Paul, we assessed changes in markers of cardiac status among these patients and compared thoracic impedance and arrhythmia burden in 2019 and 2020 from January through August. We found no change in several key disease decompensation markers among patients with implanted ICD devices during the first phase of COVID-19 pandemic, suggesting that the decrease in cardiovascular hospitalizations in this period is not reflective of a true population-level improvement in cardiovascular health.

Introduction to Part 2

2020 ◽  
pp. 143-146
Author(s):  
Jordan D. Rosenblum
Keyword(s):  
New York ◽  
Twentieth Century ◽  
New York City ◽  
York City ◽  
European Countries ◽  
Jewish Communities ◽  
Jewish Immigrants

There is no singular culinary category of “Jewish food.” As discussed in the introduction to this volume, different Jewish communities in different times and places developed culinary preferences and styles, but these do not coalesce into a universal culinary category. In general, Jewish communities adopted local cuisines and tweaked them to accord with kosher laws. However, there are exceptions. For example, in New York City in the twentieth century, Jewish immigrants from various European countries swapped recipes and developed the menu of the “Jewish deli.”...

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