Background: During the first year of the COVID-19 pandemic, workers in essential sectors had higher rates of SARS-CoV-2 infection and COVID-19 mortality than those in non-essential sectors. It is unknown whether disparities in pandemic-related mortality across occupational sectors have continued to occur during the periods of SARS-CoV-2 variants and vaccine availability.
Methods: In this longitudinal cohort study, we obtained data from the California Department of Public Health on all deaths occurring in the state of California, USA, from Jan 1, 2016, to Dec 31, 2021. We restricted our analysis to residents of California who were aged 18-65 years at time of death and died of natural causes. We classified the occupational sector into nine essential sectors; non-essential; or unemployed or without an occupation provided on the death certificate. We calculated the number of COVID-19 deaths in total and per capita that occurred in each occupational sector. Separately, using autoregressive integrated moving average models, we estimated total, per-capita, and relative excess natural-cause mortality by week between March 1, 2020, and Nov 30, 2021, stratifying by occupational sector. We additionally stratified analyses of occupational risk into counties with high versus low vaccine uptake, categorising high-uptake regions as counties where at least 50% of the population were fully vaccinated according to US guidelines by Aug 1, 2021.
Findings: From March 1, 2020, to Nov 30, 2021, 24 799 COVID-19 deaths were reported in residents of California aged 18-65 years and an estimated 28 751 (95% prediction interval 27 853-29 653) excess deaths. People working in essential sectors were associated with higher COVID-19 deaths and excess deaths than were those working in non-essential sectors, with the highest per-capita COVID-19 mortality in the agriculture (131·8 per 100 000 people), transportation or logistics (107·1 per 100 000), manufacturing (103·3 per 100 000), facilities (101·1 per 100 000), and emergency (87·8 per 100 000) sectors. Disparities were wider during periods of increased infections, including during the Nov 29, 2020, to Feb 27, 2021, surge in infections, which was driven by the delta variant (B.1.617.2) and occurred during vaccine uptake. During the June 27 to Nov 27, 2021 surge, emergency workers had higher COVID-19 mortality (113·7 per 100 000) than workers from any other sector. Workers in essential sectors had the highest COVID-19 mortality in counties with low vaccination uptake, a difference that was more pronounced during the period of the delta infection surge during Nov 29, 2020, to Feb 27, 2021.
Interpretation: Workers in essential sectors have continued to bear the brunt of high COVID-19 and excess mortality throughout the pandemic, particularly in the agriculture, emergency, manufacturing, facilities, and transportation or logistics sectors. This high death toll has continued during periods of vaccine availability and the delta surge. In an ongoing pandemic without widespread vaccine coverage and with anticipated threats of new variants, the USA must actively adopt policies to more adequately protect workers in essential sectors.
Funding: US National Institute on Aging, Swiss National Science Foundation, and US National Institute on Drug Abuse.
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http://dx.doi.org/10.1016/S2468-2667(22)00191-8 | DOI Listing |
Eur J Med Res
December 2024
Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK.
Background: Dexamethasone 6 mg in patients with severe COVID-19 has been shown to decrease mortality and morbidity. The effects of higher doses of corticosteroid, that would further increase anti-inflammatory effects, are uncertain. The objective of our study was to assess the effect of 20 mg dexamethasone vs.
View Article and Find Full Text PDFBMC Med
December 2024
Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology & Population Health, London, School of Hygiene and Tropical Medicine, London, UK.
Background: Direct oral anticoagulants (DOACs) have been reported to be associated with a higher risk of mortality compared with an older alternative, warfarin using primary care data in the United Kingdom (UK). However, other studies observed contradictory findings. We therefore aimed to investigate the association between mortality and warfarin, compared with DOACs.
View Article and Find Full Text PDFNurs Open
December 2024
School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.
Aim: To discuss the need to expand advanced practice nurse education in Sub-Saharan Africa as a strategic response to the impact of the COVID-19 pandemic.
Design: Discursive paper.
Method: Searching international literature in PubMed, CINAHL and Google Scholar databases, we explored the impact of COVID-19 in Sub-Saharan Africa and the advanced practice nurse role and education in the pandemic response.
Virol Sin
December 2024
Department of Laboratory Medicine, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, China; School of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan 430065, China. Electronic address:
Acute respiratory tract infections (ARTIs) are among the leading causes of morbidity and mortality in children worldwide. Human adenovirus (HAdV) infections are estimated to account for at least 5% of pediatric ARTIs. The circulated genotypes of HAdV and the correlation between genotype and clinical manifestations in Wuhan, China, before and after the complete relaxation of nonpharmaceutical interventions against severe acute respiratory syndrome coronavirus 2, remain unknown.
View Article and Find Full Text PDFCurr Probl Cardiol
December 2024
Department of Medicine, Creighton University School of Medicine, 7710 Mercy Road, Suite 301, Omaha, Nebraska, United States of America 68124.
Introduction: Heart failure (HF) represents a significant contributor to morbidity and mortality. Heart failure mortality trends among the middle aged have not been fully characterized into the years of the COVID-19 pandemic. Our objective was to analyze the trends in mortality related to heart failure across various demographic and geographic categories-including gender, race, and census region-spanning from 1999 to 2022, with particular attention paid to the effect of the COVID-19 pandemic on HF mortality.
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