![]() Errors are therefore likely and raw data may not be reliable or representative. However, the effects of COVID-19 on mortality trends may be mitigated in 2021 given better detection and treatment options as well as increasing natural and vaccine-related immunity.Īhmad and Anderson's Viewpoint and the associated comments from distinguished readers revives an important discussion of a substantial body of research over the past 4 decades that has repeatedly established conventional death certification as imprecise and often erroneous, replete with multi-level threats to validity that every clinician can readily acknowledge.ĭiagnostic accuracy in medicine continues to improve but the majority of those who die are not in a framework of intensive current investigation historical data and agonal clinical examination is often all the information available to the certifier. 7 The effects of the pandemic are likely to continue through 2021 as well because COVID-19 has already caused more than 100 000 deaths this year. ![]() Early estimates of life expectancy at birth, based on provisional data for January to June 2020, show historic declines not seen since World War II (1942-1943). Provisional, national mortality data show that the COVID-19 pandemic substantially affected mortality in 2020. Final mortality data will help determine the effect of the pandemic on concurrent trends in drug overdose deaths. Increases in unintentional injury deaths in 2020 were largely driven by drug overdose deaths. 6 Increases in other leading causes, especially heart disease, Alzheimer disease, and diabetes, may also reflect disruptions in health care that hampered early detection and disease management. These increases may indicate, to some extent, underreporting of COVID-19, ie, limited testing in the beginning of the pandemic may have resulted in underestimation of COVID-19 mortality. However, increases were also noted for several other leading causes of death. Most of the increase in deaths from 2019 to 2020 was directly attributed to COVID-19. During the COVID-19 pandemic, changes in leading causes provide insight into the direct and indirect effects of the pandemic on mortality burden. Trends in mortality for leading causes of death are important indicators of shifting patterns in mortality. Understanding Mortality in the Context of a Pandemic Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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