COVID-19 news from Annals of Internal Medicine

December 14, 2020

Below please find a summary and link(s) of new coronavirus-related content published today in Annals of Internal Medicine. The summary below is not intended to substitute for the full article as a source of information. A collection of coronavirus-related content is free to the public at http://go.annals.org/coronavirus.

1. Accounting for recent population aging is critical for estimating non-COVID-19 excess deaths in the U.S.

Estimates of excess mortality during the coronavirus disease 2019 (COVID-19) pandemic provide an important metric for quantifying deaths due to COVID-19 as well as those indirectly caused by COVID- 19. To evaluate the excess deaths in 2020 without consideration of changes to the underlying population structure can result in overestimated excess deaths. The growth of the U.S. population, particularly in older age groups, means a higher expected number of deaths in 2020 from all causes, even in the absence of COVID-19.

Researchers from the National Cancer Institute used data from the CDC National Center for Health Statistics and the U.S. Census Bureau to estimate excess mortality in the period March through August 2020. By accounting for the recent aging of the population, they found the number of excess non-COVID-19 deaths was 44,600, which is 65 percent fewer than estimated without considering population aging. The number of COVID-19 deaths during this period did not change with adjustment for population structure. According to the study authors, these excess death estimates may help guide clinical and public health interventions to prevent future unnecessary deaths by highlighting excess deaths by cause and age. They note that the tremendous loss of life directly or indirectly due to COVID-19 over such a short period should not be understated. Deaths are currently increasing with more than 17,000 COVID-19 deaths in the U.S. last week. Continued efforts to reduce COVID-19 infections and deaths remain an urgent priority.

Read the full text:https://www.acpjournals.org/doi/10.7326/M20-7385.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. The lead corresponding, Meredith S. Shiels, PhD, MHS, can be reached through the NCI Press Office at ncipressofficers@mail.nih.gov.

2. During pandemic, researchers may need guidance on informed consent exceptions

A foundational requirement of ethical research is that persons provide informed consent. Yet, informed consent exceptions can be made when research poses no more than minimal risk to participants or would be impracticable to do without a waiver or alteration. The coronavirus disease 2019 (COVID-19) pandemic creates a challenge for these exceptions.

The authors from the University of Pennsylvania Perelman School of Medicine cite the example of a smoking-cessation trial. Before the pandemic, their institutional review board (IRB) had approved a trial comparing smoking cessation interventions among older, underserved adults. The study was approved using opt-out consent, a type of consent alteration. But because participants are required to submit samples in person or via a mobile laboratory, submitting samples may be higher than before the pandemic. To determine whether opt-out consent remains appropriate, the IRB must determine whether the study remains minimal risk. Examples such as this one make it important for IRBs to revisit informed consent exemptions during the pandemic.

Read the full text: https://www.acpjournals.org/doi/10.7326/M20-6993.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. The lead corresponding, Emily A. Largent, JD, PhD, RN, can be reached through Melissa Moody at Melissa.Moody@Pennmedicine.upenn.edu.
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American College of Physicians

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