顶级期刊最新发布: 新冠肺炎已经成为美国主要死亡原因！
热门报告： 全球精准医学领域十大热门行研报告盘点
2019-2025年中国独立医学实验室行业市场供需预测及投资战略研究报告
2020全球新冠检测市场报告：全球新冠检测市场高达4000亿！
众所周知，新英格兰医学杂志（NEJM）、柳叶刀（Lancet）、美国医学会杂志（JAMA）、英国医学期刊（BMJ）被称作是“四大顶级医学期刊”。近日，JAMA发文指出新冠肺炎已成为2020年美国人口主要死亡原因。
COVID-19 as the Leading Cause of Death in the United States
Steven H. Woolf, Derek A. Chapman, Jong Hyung Lee
JAMA. Published online December 17, 2020. doi:10.1001/jama.2020.24865
The current exponential increase in coronavirus disease 2019 (COVID-19) is reaching a calamitous scale in the United States, potentially overwhelming the health care system and causing substantial loss of life. The news media dutifully report each day’s increase in new cases and deaths, but putting these numbers in perspective may be difficult. The daily US mortality rate for COVID-19 deaths is equivalent to the September 11, 2001, attacks, which claimed 2988 lives,1 occurring every 1.5 days, or 15 Airbus 320 jetliners,2 each carrying 150 passengers, crashing every day.
当前，美国2019年的冠状病毒疾病（COVID-19）呈指数级增长，已达到灾难性规模，可能使医疗保健系统不堪重负，并造成大量生命损失。新闻媒体尽职尽责地报道每天新发病例和死亡人数的增加，但要想清楚这些数字可能会很困难。美国每天因COVID-19死亡而造成的死亡率相当于2001年9月11日袭击事件，或相当于20架载有150名乘客空中客车320班机，每天坠毁。
A helpful approach to put the effects of the pandemic in context is to compare COVID-19–related mortality rates with the leading causes of death that, under ordinary circumstances, would pose the greatest threat to different age groups.3 The conditions listed in the Table include the 3 leading causes of death in each of the 10 age groups from infancy to old age. Using data from the Centers for Disease Control and Prevention, the Table shows mortality rates for these conditions during the period of March through October 20184 (the most recent year for which detailed cause-of-death data are available) with COVID-19 mortality rates during March through October 2020.5
结合大流行的影响，一种有用的方法是将COVID-19相关的死亡率与其它主要的死亡原因进行比较，这些死亡原因在通常情况下会对不同年龄组构成最大威胁。下表列出了从婴儿期到老年期的10个年龄组中的3个主要死亡原因。该表采用的是疾病控制和预防中心的数据，数据显示了3月至2018年10月（可获得详细死因数据的最近一年）期间这些疾病的死亡率以及COVID-19死亡率从2020年三月到十月。
The Table shows that by October 2020 COVID-19 had become the third leading cause of death for persons aged 45 through 84 years and the second leading cause of death for those aged 85 years or older. Adults 45 years or older were more likely to die from COVID-19 during those months than from chronic lower respiratory disease, transport accidents (eg, motor vehicle fatalities), drug overdoses, suicide, or homicide. In contrast, for individuals younger than age 45 years, other causes of death, such as drug overdoses, suicide, transport accidents, cancer, and homicide exceeded those from COVID-19.
图表显示，到2020年10月，COVID-19已成为45至84岁年龄段的第三大死亡原因，也是85岁以上年龄段的第二大死亡原因。与那些因慢性下呼吸道疾病，交通事故（例如，汽车死亡），药物过量，自杀或凶杀案造成的死亡相比，在那几个月内，年龄在45岁以上的成年人死于COVID-19的可能性更高。相反，对于45岁以下的个人，其他死因，例如药物过量，自杀，交通事故，癌症和凶杀，均超过了COVID-19。
Especially for older adults, the threat from COVID-19 may be even greater, for 3 reasons. First, the Tablepresents the aggregate 8-month mortality rate for COVID-19, not the current mortality rate, which has been increasing rapidly. Between November 1, 2020, and December 13, 2020, the 7-day moving average for daily COVID-19 deaths tripled, from 826 to 2430 deaths per day, and if this trend is unabated will soon surpass the daily rate observed at the height of the spring surge (2856 deaths per day on April 21, 2020).6As occurred in the spring, COVID-19 has become the leading cause of death in the United States (daily mortality rates for heart disease and cancer, which for decades have been the 2 leading causes of death, are approximately 1700 and 1600 deaths per day, respectively4). With COVID-19 mortality rates now exceeding these thresholds, this infectious disease has become deadlier than heart disease and cancer, and its lethality may increase further as transmission increases with holiday travel and gatherings and with the intensified indoor exposure that winter brings.
特别是对于老年人，出于3个原因，COVID-19的威胁可能更大。首先，该表列出了COVID-19的8个月总死亡率，而不是目前的死亡率，后者一直在迅速增加。在2020年11月1日至2020年12月13日之间，每日COVID-19死亡人数的7天移动平均值从每天826例死亡增加到2430例，增加了两倍。在春季发生时，COVID-19已成为美国主要的死亡原因（超过心脏病和癌症的每日死亡率，数十年来一直是美国死亡原因的前两位，每天分别有大约1700和1600人死亡）。随着COVID-19死亡率现在超过这些阈值，这种传染病已经变得比心脏病和癌症更致命，随着假日旅行和聚会的传播以及冬季室内暴露的加剧，其致死性可能进一步增加。
Second, the reported number of COVID-19 deaths underestimates the excess deaths produced by the pandemic. Due to reporting delays and miscoding of COVID-19 deaths and an increase in non–COVID-19 deaths caused by disruptions produced by the pandemic, excess deaths are estimated to be 20% higher than publicly reported COVID-19 death counts.7 Third, COVID-19 is unlike other causes of death in the Table because it is communicable; individuals who die from homicide or cancer do not transmit the risk of morbidity or mortality to those nearby. Every COVID-19 death signals the possibility of more deaths among close contacts.
其次，见诸报告的COVID-19死亡人数远低于大流行期间实际造成死亡人数。由于上报延迟，漏报以及COVID-19导致的间接死亡案例的增加，因此超额死亡估计比公开报告的COVID-19死亡计数高20％。第三， COVID-19与表中的其他死亡原因不同，因为它可以传染；死于凶杀或癌症的人不会将发病或死亡的风险传递给附近的人。每次COVID-19死亡都表明密切接触者有更多死亡的可能性。
The failure of the public and its leaders to take adequate steps to prevent viral transmission has made the nation more vulnerable, allowing COVID-19 to become the leading cause of death in the United States, particularly among those aged 35 years or older. Much of this escalation was preventable, as is true for many deaths to come. The prospect of a vaccine offers hope for 2021, but that solution will not come soon enough to avoid catastrophic increases in COVID-19–related hospitalizations and deaths. The need for the entire population to take the disease seriously—notably to wear masks and maintain social distance—could not be more urgent.
公众及其领导人未能采取适当措施阻止病毒传播，这使该国变得更加脆弱，使COVID-19成为美国的主要死亡原因，特别是在35岁以上的人群中。这种升级在很大程度上是可以预防的。疫苗的前景为2021年带来了希望，但该解决方案将不会很快到来重磅！新冠疫苗被国际顶刊主编质疑，真实有效率仅19~29%！，为避免与COVID-19相关的住院和死亡人数的灾难性增加。迫切需要全体人民认真对待这种疾病，尤其是戴着口罩和保持社会距离。