COVID-19 Scan for Oct 25, 2022

News brief

Highest-density US metro areas had higher COVID-19 death rate in 2020

Age-adjusted US COVID-19 death rates in 2020 were 30% higher in large, central metropolitan areas than in medium-sized cities, finds a new Centers for Disease Control and Prevention (CDC) analysis.

The researchers examined COVID-19 death rates in six different types of areas—large central metropolitan, large fringe metropolitan, medium metropolitan, small metropolitan, and micropolitan rural and nonmetropolitan rural—by sex and age-group.

COVID-19 death rates were highest in large, central metropolitan areas, at 97.7 per 100,000 people, 30% higher than the 75.0-per-100,000 death rate in medium metropolitan areas, where death rates were the lowest. Death rates were 90.6 and 86.5 in noncore and micropolitan rural areas, respectively, and 78.2 and 75.0 in small metropolitan and large fringe metropolitan areas, respectively.

Rates differed by sex, with the greatest proportion of males dying in the most urban areas (129.3 per 100,000), while females' highest rates were in the most urban and most rural areas (72.8 and 73.8, respectively). In all areas, COVID-19 death rates were at least 50% higher among males than females, with the largest gap in large, central metropolitan areas (78% higher).

Among people 65 years and older, male COVID-19 death rates were highest in the most urban areas, while those for females were highest in both the most urban and most rural areas. In the younger age-group, the highest death rate was among males in the most urban areas (41.5 per 100,000), followed by noncore and micropolitan rural (33.7 and 29.8, respectively) and large fringe metropolitan areas (27.7). Among younger females, those in noncore rural areas had the highest death rate (24.2), while those in large fringe metropolitan areas had the lowest (13.6).

"These results show how a more detailed measure of urbanicity can result in a more precise analysis of COVID-19 death rates than is possible with the typical urban-rural dichotomy," the authors wrote.
Oct 25 CDC data brief

Physical activity may boost effectiveness of COVID-19 vaccines

A new study ties increased physical activity to greater effectiveness of COVID-19 vaccines, with higher activity levels associated with greater protection. The study was published yesterday in the British Journal of Sports Medicine.

The study was based on the electronic health records and wearable fitness-tracking devices of thousands of vaccinated and unvaccinated healthcare workers in South Africa, including those with low (under 60 minutes per week), medium (at least 60 to 149 minutes per week), and high (more than 150 minutes per week) levels of physical activity.

COVID-19 swab test results were analyzed for 53,771 participants with low levels of physical activity, 62,721 with medium levels, and 79,952 with high levels. Test results were for the time between Feb 16 and Oct 30, 2021.

Vaccine effectiveness against a COVID-19-related hospital admission among vaccinated individuals within the low-activity group was 60.0% (95% [confidence interval] CI, 39.0 to 73.8), 72.1% (95% CI, 55.2 to 82.6) for the moderate-activity group, and 85.8% (95% CI, 74.1 to 92.2) for the high-activity group.

"The reasons for the increased effect of vaccination in active individuals still have to be elucidated but may be a combination of enhanced antibody levels, improved T cell immunosurveillance and psychosocial factors," the authors write. "Public health messaging should encourage physical activity as a simple, cost-effective way of enhancing vaccine effectiveness to mitigate the risk of severe COVID-19 illness requiring hospital admission."

The authors said previous research has shown similar immune-boosting effects of exercise among influenza vaccine recipients.
Oct 24 Br J Sports Med study

News Scan for Oct 25, 2022

News brief

RSV infections, hospitalizations soaring across US

The United States is seeing unseasonably high levels of respiratory syncytial virus (RSV) cases among children, causing overflowing admissions at pediatric hospitals in several parts of the country.

According to National Public Radio, children's hospitals in the Washington, DC, area, including Children's National Hospital, Inova Fairfax, and Johns Hopkins in Baltimore, are at or near capacity. And doctors at a Fort Worth, Texas, hospital say they are seeing more than 300 cases per day.

Most doctors believe that after 2 years of distance learning, shuttered daycares, and mask wearing in public, many children have not been exposed to common childhood respiratory illnesses and have an "immune debt" that is leaving them at a disadvantage this cold and flu season, according to US News & World Report. Pre-pandemic, almost all US children typically contracted RSV before age 2.

According to the Centers for Disease Control and Prevention (CDC), RSV annually causes 2.1 million outpatient hospital visits and 58,000 hospitalizations for US children 5 and under.

"Prior to 2020, seasonal patterns for RSV in the United States were very consistent. However, the patterns of circulation for RSV and other common respiratory viruses have been disrupted since the start of the COVID-19 pandemic early in 2020," the CDC said. "Beginning in the southern region of the United States, RSV circulation began to rise in the spring months of 2021. It is too soon to predict when the previous seasonal patterns will return."
Oct 24 National Public Radio story
Oct 25 US News & World Report story
CDC RSV information page

Ebola sickens 5 more in Uganda as outbreak grows to 95 confirmed cases

Uganda's health ministry on Twitter today reported 5 more lab-confirmed Ebola cases, raising the outbreak total to 95.

The ministry didn't detail the locations of the latest cases, but the Uganda Monitor said today that infections in the greater Kampala area have risen to 15 over the past 48 hours. Earlier this week, the country's health minister detailed 9 recently confirmed cases from the Kampala, all of them contacts of a patient from outside the city who recently died from his infection in a Kampala hospital.

On a news show, Samuel Oledo, MD, the president of the Uganda Medical Association, said strict measures including a lockdown should be considered for Kampala to curb the spread of the virus, according to the Monitor.

No new deaths in lab-confirmed patients were reported, keeping the total at 28. Currently, 33 people are receiving medical care, and 1,830 contacts have been identified for follow-up. Earlier in the outbreak before the first lab-confirmed cases were identified, officials reported 20 suspected cases, all of them fatal.

The outbreak involves the less common Sudan Ebola strain. There are no approved vaccines or treatments for the strain, but health officials are planning vaccine trials in the outbreak area for as many as three vaccines targeting Sudan Ebola that are in the development stages.
Oct 25 Uganda health ministry tweet
Oct 25 Monitor story