Excess deaths reveal the true spatial, temporal, and demographic impact of COVID-19 on mortality in Ecuador

Background: In early 2020, Ecuador reported one of the highest surges of per capita deaths across the globe. Methods: We collected a comprehensive dataset containing individual death records between 2015 and 2020 from the Ecuadorian National Institute of Statistics and Census and the Ecuadorian Ministry of Government. We computed the number of excess deaths across time, geographical locations and demographic groups using Poisson regression methods. Results: Between January 1st and September 23rd, 2020, the number of excess deaths in Ecuador is 36,402 (95% CI: 35,762-36,827) or 208 per 105 population, which is 171% of the expected deaths in that period in a typical year. Only 20% of the excess deaths are attributable to confirmed COVID-19 deaths. Strikingly, in provinces that were most affected by COVID-19, such as Guayas and Santa Elena, the all-cause deaths are more than double the expected number of deaths that would have occurred in a normal year. The extent of excess deaths in men is higher than in women, and the number of excess deaths increases with age. Indigenous populations had the highest level of excess deaths among all ethnic groups. Conclusions: Overall, the exceptionally high level of excess deaths in Ecuador highlights the enormous burden and heterogeneous impact of COVID-19 on mortality especially in older age groups and indigenous populations in Ecuador that was not fully revealed by COVID-19 death counts. Together with the limited testing in Ecuador, our results suggest that the majority of the excess deaths were likely to be undocumented COVID-19 deaths.

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Excess Mortality Associated With COVID-19 by Demographic Group: Evidence From Florida and Ohio

Public Health Reports ◽

10.1177/00333549211041550 ◽

2021 ◽

pp. 003335492110415

Author(s):

Troy Quast ◽

Ross Andel

Keyword(s):

Excess Mortality ◽

Prediction Interval ◽

National Level ◽

Age Groups ◽

Black Population ◽

Infection Rates ◽

Black Adults ◽

Demographic Groups ◽

Younger Age ◽

Excess Deaths

Objective COVID-19 mortality varies across demographic groups at the national level, but little is known about potential differences in COVID-19 mortality across states. The objective of this study was to estimate the number of all-cause excess deaths associated with COVID-19 in Florida and Ohio overall and by sex, age, and race. Methods We calculated the number of weekly and cumulative excess deaths among adults aged ≥20 from March 15 through December 5, 2020, in Florida and Ohio as the observed number of deaths less the expected number of deaths, adjusted for population, secular trends, and seasonality. We based our estimates on death certificate data from the previous 10 years. Results The results were based on ratios of observed-to-expected deaths. The ratios were 1.17 (95% prediction interval, 1.14-1.21) in Florida and 1.15 (95% prediction interval, 1.11-1.19) in Ohio. Although the largest number of excess deaths occurred in the oldest age groups, in both states the ratios of observed-to-expected deaths were highest among adults aged 20-49 (1.21; 95% prediction interval, 1.11-1.32). The ratio of observed-to-expected deaths for the Black population was especially elevated in Florida. Conclusions Although excess deaths were largely concentrated among older cohorts, the high ratios of observed-to-expected deaths among younger age groups indicate widespread effects of COVID-19. The high levels of observed-to-expected deaths among Black adults may reflect in part disparities in infection rates, preexisting conditions, and access to care. The finding of high excess deaths among Black adults deserves further attention.

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Excess deaths reveal unequal impact of COVID-19 in Ecuador

BMJ Global Health ◽

10.1136/bmjgh-2021-006446 ◽

2021 ◽

Vol 6 (9) ◽

pp. e006446

Author(s):

Leticia Cuéllar ◽

Irene Torres ◽

Ethan Romero-Severson ◽

Riya Mahesh ◽

Nathaniel Ortega ◽

...

Keyword(s):

Diagnostic Testing ◽

Age Groups ◽

Indigenous Women ◽

Indigenous Populations ◽

Significant Finding ◽

Age Group ◽

Excess Death ◽

Higher Ed ◽

All Cause Mortality ◽

Excess Deaths

Latin America has struggled to control the transmission of COVID-19. Comparison of excess death (ED) rates during the pandemic reveals that Ecuador is among the highest impacted countries. In this analysis, we update our previous findings with the most complete all-cause mortality records available for 2020, disaggregated by sex, age, ethnicity and geography. Our study shows that in 2020, Ecuador had a 64% ED rate (95% CI 63% to 65%) or 64% more deaths than expected. Men had a higher ED rate, 75% (95% CI 73% to 76%), than women’s 51% (95% CI 49% to 52%), and this pattern of higher EDs for men than women held for most age groups. The only exception was the 20–29 age group, where women had 19% more deaths, compared to 10% more deaths for men, but that difference is not statistically significant. The analysis provides striking evidence of the lack of COVID-19 diagnostic testing in Ecuador: the confirmed COVID-19 deaths in 2020 accounted for only 21% of total EDs. Our significant finding is that indigenous populations, who typically account for about 5% of the deaths, show almost four times the ED rate of the majority mestizo group. Indigenous women in each age group have higher ED rates than the general population and, in ages between 20 and 49 years, they have higher ED rates than indigenous men. Indigenous women in the age group 20–29 years had an ED rate of 141%, which is commensurate to the ED rate of indigenous women older than 40 years.

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A Study on Knowledge, Attitude, Awareness and Practice About HIV/AIDS among different age group of Karachi, Pakistan

Research in Pharmacy and Health Sciences ◽

10.32463/rphs.2017.v03i03.14 ◽

2017 ◽

Vol 3 (3) ◽

pp. 328-333

Author(s):

Safia Mehmood ◽

Sheema Zia ◽

Nida Aziz ◽

Omama Sajid

Keyword(s):

Hiv Transmission ◽

Age Groups ◽

World Population ◽

Major Barrier ◽

Initial Stage ◽

Awareness Programs ◽

And Gender ◽

Strongly Agree ◽

High Level ◽

Lack Of Knowledge

The AIDS is one of the most complicated health problems of the 21st century and it threatens the world population. AIDS spread at an alarming rate. This was a descriptive study to determine the knowledge, awareness, and practice about HIV among different age groups. The study carried out in Karachi, Pakistan during the period of January 2016-april 2016, in which 82 peoples are participated; 65 peoples having age in between 18-30, people’s lies in 31-40 years, while only 4 peoples having age above 40. From which 91% peoples thought HIV is dangerous virus and 51% peoples having misconception that it cause AIDS on initial stage and does not have any effect on CD4+. Majority of peoples aware about transmission of AIDS through intercourse, and during pregnancy. But the study show the high level of misbelieve also in mode of transmission that HIV transmit through sweat, saliva etc. Majority of the peoples have knowledge that HIV-1 is the most common type found worldwide. Also large number of peoples have knowledge that HIV weak immune system by destroying CD4+ and require long exposure to progress AIDS. Less than 15% of peoples strongly agree that AIDS is common in women. This misconception reflex the lack of knowledge and awareness in the HIV transmission and gender relation. Also majority of peoples thought that lack of knowledge is major barrier in the proper cure of disease. So increasing knowledge by awareness programs; sexual prevention; by starting national testing resources and curing poverty will cured AIDS in Pakistan. Newly drugs are introduced which can stop the progression of AIDS.

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Estimation of Excess Mortality and Years of Life Lost to COVID-19 in Norway and Sweden between March and November 2020

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18083913 ◽

2021 ◽

Vol 18 (8) ◽

pp. 3913

Author(s):

Martin Rypdal ◽

Kristoffer Rypdal ◽

Ola Løvsletten ◽

Sigrunn Holbek Sørbye ◽

Elinor Ytterstad ◽

...

Keyword(s):

Excess Mortality ◽

Age Groups ◽

Years Of Life Lost ◽

Regressive Model ◽

Epidemic Period ◽

All Cause Mortality ◽

Auto Regressive ◽

Expected Mortality ◽

Auto Regressive Model ◽

Excess Deaths

We estimate the weekly excess all-cause mortality in Norway and Sweden, the years of life lost (YLL) attributed to COVID-19 in Sweden, and the significance of mortality displacement. We computed the expected mortality by taking into account the declining trend and the seasonality in mortality in the two countries over the past 20 years. From the excess mortality in Sweden in 2019/20, we estimated the YLL attributed to COVID-19 using the life expectancy in different age groups. We adjusted this estimate for possible displacement using an auto-regressive model for the year-to-year variations in excess mortality. We found that excess all-cause mortality over the epidemic year, July 2019 to July 2020, was 517 (95%CI = (12, 1074)) in Norway and 4329 [3331, 5325] in Sweden. There were 255 COVID-19 related deaths reported in Norway, and 5741 in Sweden, that year. During the epidemic period of 11 March–11 November, there were 6247 reported COVID-19 deaths and 5517 (4701, 6330) excess deaths in Sweden. We estimated that the number of YLL attributed to COVID-19 in Sweden was 45,850 [13,915, 80,276] without adjusting for mortality displacement and 43,073 (12,160, 85,451) after adjusting for the displacement accounted for by the auto-regressive model. In conclusion, we find good agreement between officially recorded COVID-19 related deaths and all-cause excess deaths in both countries during the first epidemic wave and no significant mortality displacement that can explain those deaths.

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A proposal to enhance national capability to manage epidemics: The critical importance of expert statistical input including official statistics

Statistical Journal of the IAOS ◽

10.3233/sji-210808 ◽

2021 ◽

pp. 1-17

Author(s):

N.I. Fisher ◽

D.J. Trewin

Keyword(s):

Data Streams ◽

Age Groups ◽

Quantitative Information ◽

Economic Welfare ◽

Way Of Life ◽

Policy Makers ◽

The Social ◽

Novel Virus ◽

High Level ◽

Integration Analysis

Given the high level of global mobility, pandemics are likely to be more frequent, and with potentially devastating consequences for our way of life. With COVID-19, Australia is in relatively better shape than most other countries and is generally regarded as having managed the pandemic well. That said, we believe there is a critical need to start the process of learning from this pandemic to improve the quantitative information and related advice provided to policy makers. A dispassionate assessment of Australia’s health and economic response to the COVID-19 pandemic reveals some important inadequacies in the data, statistical analysis and interpretation used to guide Australia’s preparations and actions. For example, one key shortcoming has been the lack of data to obtain an early understanding of the extent of asymptomatic and mildly symptomatic cases or the differences across age groups, occupations or ethnic groups. Minimising the combined health, social and economic impacts of a novel virus depends critically on ongoing acquisition, integration, analysis, interpretation and presentation of a variety of data streams to inform the development, execution and monitoring of appropriate strategies. The article captures the essential quantitative components of such an approach for each of the four basic phases, from initial detection to post-pandemic. It also outlines the critical steps in each stage to enable policy makers to deal more efficiently and effectively with future such events, thus enhancing both the social and the economic welfare of its people. Although written in an Australian context, we believe most elements would apply to other countries as well.

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121 Behavioral Attention Relationships Vary Between Demographic Groups Across Sleep Loss and Recovery

SLEEP ◽

10.1093/sleep/zsab072.120 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A49-A50

Author(s):

Caroline Antler ◽

Erika Yamazaki ◽

Tess Brieva ◽

Courtney Casale ◽

Namni Goel

Keyword(s):

Sleep Deprivation ◽

Repeated Measures ◽

Age Groups ◽

Response Speed ◽

Sleep Loss ◽

Demographic Groups ◽

Time In Bed ◽

Median Split ◽

The Relationship ◽

High Bmi

Abstract Introduction The Psychomotor Vigilance Test (PVT) is a behavioral attention measure widely used to describe sleep loss deficits. Although there are reported differences in PVT performance for various demographic groups, no study has examined the relationship between measures on the 10-minute PVT (PVT10) and the 3-minute PVT (PVT3) within sex, age, and body mass index (BMI) groups throughout a highly controlled sleep deprivation study. Methods Forty-one healthy adults (mean±SD ages, 33.9±8.9y) participated in a 13-night experiment [2 baseline nights (10h-12h time in bed, TIB) followed by 5 sleep restriction (SR1-5) nights (4h TIB), 4 recovery nights (R1-R4; 12h TIB), and 36h total sleep deprivation (TSD)]. A neurobehavioral test battery, including the PVT10 and PVT3 was completed every 2h during wakefulness. Repeated measures correlation (rmcorr) compared PVT10 and PVT3 lapses (reaction time [RT] >355ms [PVT3] and >500ms [PVT10]) and response speed (1/RT) by examining correlations by day (e.g., baseline day 2) and time point (e.g., 1000h-2000h) within sex groups (18 females), within age groups defined by a median split (median=32, range=21-49y), and within BMI groups defined by a median split (median=25, range=17-31). Results PVT10 and PVT3 1/RT was significantly correlated at all study days and time points excluding at baseline for the younger group and at R2 for the higher BMI group. PVT10 and PVT3 lapses showed overall lower correlations across the study relative to 1/RT. Lapses were not significantly correlated at baseline for any group, for males across recovery (R1-R4), for the high BMI group at R2-R4, for the older group at R2-R3, or for the younger group at SR5 or R3. Conclusion Differentiating participants based on age, sex, or BMI revealed important variation in the relationship between PVT10 and PVT3 measures across the study. Surprisingly, lapses were not significantly correlated at baseline for any demographic group or across recovery for males or the high BMI or older group. Thus, PVT10 and PVT3 lapses may be less comparable in certain populations when well-rested. These findings add to a growing literature suggesting demographic factors may be important factors to consider when evaluating the effects of sleep loss. Support (if any) ONR Award N00014-11-1-0361;NIH UL1TR000003;NASA NNX14AN49G and 80NSSC20K0243; NIHR01DK117488

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Disparity and Dynamics of Social Distancing Behaviors in Japan: An Investigation of mobile phone mobility data (Preprint)

10.2196/preprints.31557 ◽

2021 ◽

Author(s):

Zeyu Lyu ◽

Hiroki Takikawa

Keyword(s):

Large Scale ◽

Age Groups ◽

Mitigation Strategies ◽

Social Distancing ◽

Demographic Groups ◽

Fine Grained ◽

Mobility Data ◽

The Social ◽

The Government ◽

Over Time

BACKGROUND The availability of large-scale and fine-grained aggregated mobility data has allowed researchers to observe the dynamic of social distancing behaviors at high spatial and temporal resolutions. Despite the increasing attentions paid to this research agenda, limited studies have focused on the demographic factors related to mobility and the dynamics of social distancing behaviors has not been fully investigated. OBJECTIVE This study aims to assist in the design and implementation of public health policies by exploring the social distancing behaviors among various demographic groups over time. METHODS We combined several data sources, including mobile tracking data and geographical statistics, to estimate visiting population of entertainment venues across demographic groups, which can be considered as the proxy of social distancing behaviors. Then, we employed time series analyze methods to investigate how voluntary and policy-induced social distancing behaviors shift over time across demographic groups. RESULTS Our findings demonstrate distinct patterns of social distancing behaviors and their dynamics across age groups. The population in the entertainment venues comprised mainly of individuals aged 20–40 years, while according to the dynamics of the mobility index and the policy-induced behavior, among the age groups, the extent of reduction of the frequency of visiting entertainment venues during the pandemic was generally the highest among younger individuals. Also, our results indicate the importance of implementing the social distancing policy promptly to limit the spread of the COVID-19 infection. However, it should be noticed that although the policy intervention during the second wave in Japan appeared to increase the awareness of the severity of the pandemic and concerns regarding COVID-19, its direct impact has been largely decreased could only last for a short time. CONCLUSIONS At the time we wrote this paper, in Japan, the number of daily confirmed cases was continuously increasing. Thus, this study provides a timely reference for decision makers about the current situation of policy-induced compliance behaviors. On the one hand, age-dependent disparity requires target mitigation strategies to increase the intention of elderly individuals to adopt mobility restriction behaviors. On the other hand, considering the decreasing impact of self-restriction recommendations, the government should employ policy interventions that limit the resurgence of cases, especially by imposing stronger, stricter social distancing interventions, as they are necessary to promote social distancing behaviors and mitigate the transmission of COVID-19. CLINICALTRIAL None

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Morphological traits of the development of the skin and wool cover in sheep of Prikatunsky meat and wool type

Glavnyj zootehnik (Head of Animal Breeding) ◽

10.33920/sel-03-2110-07 ◽

2021 ◽

pp. 60-68

Author(s):

I. I. Dmitrik ◽

G. V. Zavgorodnyaya ◽

M. I. Pavlova ◽

N. A. Podkorytov

Keyword(s):

Physical Properties ◽

Morphological Traits ◽

Age Groups ◽

Body Side ◽

Low Level ◽

Research Material ◽

High Level ◽

Significant Factors

A large number of works are devoted to the development of the skin and hair cover of sheep, depending on their breed affiliation, age, feeding conditions and housing. The authors point out that along with other conditions the quality of wool and wool clip is greatly influenced by the conditions of the feeding of animals. A high level of feeding increases the wool clip and improves the quality of the wool and vice versa a low level reduces, causes thinning and worsens other physical properties of the wool. As is known, one of the significant factors that determine the increase in wool clip is the size of the animal and, consequently, the total area of the skin. The purpose of the research was to investigate the morphological traits of the development of the skin and wool cover in sheep of Prikatunsky meat and wool type. The research material was wool samples from four topographic areas of the animal’s body (side/thigh/back/belly) and skin (side) of different sex and age groups, selected from the animals of the studied groups. In the course of research, the quality of wool and indicators of the histostructure of the skin of Prikatunsky meat and wool type of sheep have been investigated. In terms of thick-haired of wool, replacement rams and gimbers of Prikatunsky meat and wool type of sheep were superior by 4,82 pcs. per mm² or 19,0 % and 4,41 pcs. per mm² or 15,8 % of adult animals, respectively. Balance secondary follicles/primary follicles in young animals were higher by 10,3 and 17,3 % compared to breeding rams and ewes. The wool of the replacement young animals was thinner by 7,28 and 4,78 microns and they were more thick-haired. The obtained data will be used in the mating campaign when mating program rams in order to improve the sheep of Prikatunsky meat and wool type.

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Analysis and forecasts of Salmonella spp. antibiotic resistance in Dnipropetrovsk region (Ukraine)

Veterinary Medicine: inter-departmental subject scientific collection ◽

10.36016/vm-2019-105-3 ◽

2019 ◽

pp. 16-19

Author(s):

H. A. Martynenko

Keyword(s):

Antibiotic Resistance ◽

Age Groups ◽

Quantitative Information ◽

Graphical Form ◽

Salmonella Spp ◽

Gram Negative ◽

Trend Line ◽

E Coli ◽

Short Period ◽

High Level

The paper presents data of the research aimed at studying the species composition of major pathogens circulating in the region and the resistance to antibacterial drugs in pathogens of salmonella, one of the most common zoonoses. Within the period 2014–2018 the qualitative composition of microflora from biological and pathological materials from different groups of animals was studied in Dnipropetrovsk region. Own research results and the results of the regional veterinary statistical reporting were analyzed. Within the short period of five years, 237 cultures of Gram-negative bacteria were detected and studied. The dominant agent in the studied region was E. coli (56.7%) from the Enterobacteriaceae family. The second most frequent agent in the pathology was Salmonella spp. (10.5%). In total, 29 cultures of salmonella infection were isolated from six species of animals with a predominance of bird isolates. Thus, for different age groups of poultry the most common were S. Gallinarum-Pullorum (56%) and S. Enteritidis (32%). An antibiotic resistance increase in pathogenic salmonella was observed for β-lactam antibiotics (cefazolin, ceftriaxone), aminoglycosides (gentamicin, streptomycin, kanamycin), as well as for tetracycline and polymyxin. Taking into consideration the high level of resistance against norfloxacin in the region’s dominant pathogens of the Enterobacteriaceae family, we performed a forecast in MS Excel graphically and added a trend line. In the course of work it was proved that the Dnipropetrovsk region is a geographic zone with a stable high (86 ± 3.7%) allocation from different groups of animals of Gram-negative microorganisms. It was found that local dominant pathogens are representatives of the Enterobacteriaceae family (E. coli, Salmonella spp.). This data can be used as surrogate resistance markers. The epizootological patterns of animal salmonellosis are determined. It is shown the possibility of forecasting the distribution of antibiotic resistant strains in MS Excel in graphical form by adding a trend line, using quantitative information on the sensitivity of bacteria. Prospects for further research are the prevention and control of the emergence of resistance to antibiotics in veterinary medicine and agriculture in the region and in the country

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Pattern of resilient age-related measles immunity

Russian Journal of Infection and Immunity ◽

10.15789/2220-7619-por-1173 ◽

2020 ◽

Vol 10 (2) ◽

pp. 375-380

Author(s):

A. G. Sonis ◽

O. A. Gusyakova ◽

F. N. Gilmiyarova ◽

A. A. Ereshchenko ◽

N. K. Ignatova ◽

...

Keyword(s):

Measles Virus ◽

Age Groups ◽

Igg Antibody ◽

Infection Level ◽

Age Related ◽

Specific Igg ◽

Young Subjects ◽

High Level ◽

Medical University ◽

Igg Level

Epidemiological situation describing global measles spread is ambiguous. Along with countries succeeded in measles eradication, there are those wherein measles rate remains at quite high level. Because measles is a vaccine-preventable infection, it may then be eradicated solely by ensuring sufficient population coverage with preventive vaccination. The aim of our study was to assess level of measles immunity in medical workers at the Clinics of Samara State Medical University as well as the Samara State Medical University. There were enrolled 1503 subjects (aged 18–79 years), among which all individuals under 55 (77.58%) but not older counterparts provided with medical record on previous measles vaccination or measles infection. Level of serum measles virus-specific IgG antibodies was measured by using ELISA (VektoKor-IgG, JSC Vector-Best, Novosibirsk), with mean concentration ranging in general population within 1.02±0.02 IU/ ml. Positive results were observed in 72.52% of the examined individuals. Average vs. high measles virus-specific IgG level was detected in 52.90% (mean age — 41.4±0.5 years) and 19.62% (mean age — 54.2±0.72 years) of individuals, whereas at level below threshold — in 27.48% of subjects (mean age — 33.25±0.53 years). Thus, in 34.16% of the surveyed vaccinated individuals mostly presented by young subjects contained anti-measles virus-specific antibodies below protective level. Older age groups were shown to increase in average IgG amount with age. Interestingly, age-related measles immunity pattern was observed: percentage of subjects with high vs. low measles virus-specific IgG level increases and decreases, respectively. Taking into consideration a large percentage of subjects previously vaccinated against measles among carriers of low measles immunity, it may be concluded that measles virus-specific IgG antibody level must be monitored in young adulthood to decide of whether subsequent revaccination is necessary.

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