Heart Disease Deaths Spiked During COVID

Nov. 29, 2022 – Deaths from heart disease and stroke among adults living in the United States have been on the decline since 2010. But the COVID-19 pandemic reversed that downward trend in 2020, new research shows. 

It was as if COVID had wiped out 5 years of progress, pushing rates back to levels seen in 2015, the researchers say.

Non-Hispanic Black people and those who were younger than 75 were affected more than others, with the pandemic reversing 10 years of progress in those groups. 

Rebecca C. Woodruff, PhD, presented these study findings at the American Heart Association 2022 Scientific Sessions.

The rate of death from heart disease had been falling for decades in the United States due to better detection of risk factors, such as high blood pressure, and better treatments, such as statins for cholesterol, she said.

The decrease in deaths from heart disease from 1900 to 1999 “has been recognized as a top public health achievement of the twentieth  century,” said Woodruff, who is an epidemiologist for the CDC.

The reversal of this positive trend shows that it is important that people “work with a health care provider to prevent and manage existing heart disease, even in challenging conditions like the COVID-19 pandemic,” she said. 

Woodruff advised that “everyone can improve and maintain their cardiovascular health and reduce the risk of cardiovascular disease by following the American Heart Association’s Life’s Essential 8 – eating better, being more active, quitting tobacco, getting healthy sleep, managing weight, controlling cholesterol, managing blood sugar, and managing blood pressure.” 

“COVID-19 vaccines can help everyone, especially those with underlying heart disease or other health conditions, and protect people from severe COVID-19,” she stressed.

Andrew J. Einstein, MD, PhD, from Columbia University Irving Medical Center in New York City, who was not involved with this research, says the results show “very disturbing changes” to the decline in deaths from heart disease over the past decade. 

The study findings underscore that “as a society, we need to take efforts to ensure that all people are engaged in the health care system, with one aim being improving heart health outcomes, which worsened significantly in 2020,” he says. 

“If you don’t actively see a primary care provider, it’s important to find one with whom you can have a good relationship and can discuss with you heart-healthy living; check your blood pressure, sugar, and cholesterol; ask you about symptoms and examine you to detect disease early; and refer you for more specialized heart care as needed,” he says. 

Some Study Findings

The researchers analyzed data from the CDC’s WONDER database.

They identified adults ages 35 and older with heart disease as cause of death.

They found that the number of people who died from heart disease in every 100,000 people (heart disease death rate) dropped each year from 2010 to 2019, but it increased in 2020, the first year of the pandemic.

This increase was seen in the total population, in men, in women, in all age groups, and in all race and Hispanic ethnicity groups.

In the total population, the heart disease death rate dropped by 9.8% from 2010 to 2019. But this rate increased by 4.1% in 2020, going back to the rate it had been in 2015.

Among non-Hispanic Black people, the heart disease death rate fell by 10.4% from 2010 to 2019, but it increased by 11.2% in 2020, going back to the rate it had been in 2010.

Similarly, among adults ages 35 to 54 and those ages 55 to 74, the rates of heart disease deaths decreased from 2010 to 2019 and increased in 2020 to rates higher than they had been in 2010.

In 2020, about 7 years of progress in declining heart death rates was lost among men and 3 years of progress was lost among women, the researchers said. 

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Is It Flu, RSV or COVID? Experts Fear the ‘Tripledemic’


Oct. 25, 2022 – Just when we thought this holiday season, finally, would be the back-to-normal one, some infectious disease experts are warning that a so-called tripledemic – influenza, COVID-19, and RSV – may be in the forecast.

The warning isn’t without basis. 

  • The flu season has gotten an early start. As of Oct. 21, early increases in seasonal flu activity have been reported in most of the country, the CDC says, with the southeast and south-central areas having the highest activity levels. 
  • Children’s hospitals and emergency departments are seeing a surge in children with RSV.
  • COVID-19 cases are trending down, according to the CDC, but epidemiologists – scientists who study disease outbreaks – always have their eyes on emerging variants. 

Predicting exactly when cases will peak is difficult, says Justin Lessler, PhD, a professor of epidemiology at the University of North Carolina at Chapel Hill. Lessler is on the coordinating team for the COVID-19 Scenario Modeling Hub, which aims to predict the course COVID-19, and the Flu Scenario Modeling Hub, which does the same for influenza.

For COVID-19, some models are predicting some spikes before Christmas, he says, and others see a new wave in 2023. For the flu, the model is predicting an earlier-than-usual start, as the CDC has reported.  

While flu activity is relatively low, the CDC says, the season is off to an early start. For the week ending Oct. 21, 1,674 patients were hospitalized for flu, higher than in the summer months but fewer than the 2,675 hospitalizations for the week of May 15, 2022. 

As of Oct. 20, COVID-19 cases have declined 12% over the last 2 weeks, nationwide. But hospitalizations are up 10% in much of the Northeast, The New York Times reports, and the improvement in cases and deaths has been slowing down. 

As of Oct. 15, 15% of RSV tests reported nationwide were positive, compared with about 11% at that time in 2021, the CDC says. The surveillance collects information from 75 counties in 12 states. 

Experts point out that the viruses — all three are respiratory viruses —  are simply playing catchup. 

“They spread the same way and along with lots of other viruses, and you tend to see an increase in them during the cold months,” says Timothy Brewer, MD, professor of medicine and epidemiology at UCLA.

The increase in all three viruses “is almost predictable at this point in the pandemic,” says Dean Blumberg, MD, a professor and chief of pediatric infectious diseases at the University of California Davis Health. “All the respiratory viruses are out of whack.” 

Last year, RSV cases were up, too, and began to appear very early, he says, in the summer instead of in the cooler months. Flu also appeared early in 2021, as it has this year. 

That contrasts with the flu season of 2020-2021, when COVID precautions were nearly universal, and cases were down. At UC Davis, “we didn’t have one pediatric admission due to influenza in the 2020-2021 [flu] season,” Blumberg says. 

The number of pediatric flu deaths usually range from 37 to 199 per year, according to CDC records. But in the 2020-2021 season, the CDC recorded one pediatric flu death in the U.S.

Both children and adults have had less contact with others the past 2 seasons, Blumberg says, “and they don’t get the immunity they got with those infections [previously]. That’s why we are seeing out-of-season, early season [viruses].” 

Eventually, he says, the cases of flu and RSV will return to previous levels. “It could be as soon as next year,” Blumberg says. And COVID-19, hopefully, will become like influenza, he says.

“RSV has always come around in the fall and winter,” says Elizabeth Murray, DO, a pediatric emergency medicine doctor at the University of Rochester Medical Center and a spokesperson for the American Academy of Pediatrics. This year, children are back in school and for the most part not masking, she says. “It’s a perfect storm for all the germs to spread now. They’ve just been waiting for their opportunity to come back.” 

Self-Care vs. Not

RSV can pose a risk for anyone, but most at risk are children under age 5, especially infants under age 1, and adults over age 65.  There is no vaccine for it. Symptoms include a runny nose, decreased appetite, coughing, sneezing, fever, and wheezing. But in young infants, there may only be decreased activity, crankiness, and breathing issues, the CDC says.

Keep an eye on the breathing if RSV is suspected, Murray tells parents. If your child can’t breathe easily, is unable to lie down comfortably, can’t speak clearly, or is sucking in the chest muscles to breathe, get medical help. Most kids with RSV can stay home and recover, she says, but often will need to be checked by a medical professional.

She advises against getting an oximeter to measure oxygen levels for home use. “They are often not accurate,” she says. If in doubt about how serious your child’s symptoms are, “don’t wait it out,” she says, and don’t hesitate to call 911.

Symptoms of flu, COVID, and RSV can overlap.  But each can involve breathing problems, which can be an emergency. 

“It’s important to seek medical attention for any concerning symptoms, but especially severe shortness of breath or difficulty breathing, as these could signal the need for supplemental oxygen or other emergency interventions,” says Mandy De Vries, a respiratory therapist and director of education at the American Association for Respiratory Care. Inhalation treatment or mechanical ventilation may be needed for severe respiratory issues.

Precautions

To avoid the tripledemic – or any single infection – Timothy Brewer, MD, a professor of medicine and epidemiology at UCLA, suggests some familiar measures: “Stay home if you’re feeling sick. Make sure you are up to date on your vaccinations. Wear a mask indoors.”



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