High deaths in middle age

I want to go on and give you some other really quite disconcerting news now now this is from this journal article here access mortality in England postco 19 pandemic implications for a sec for secondary prevention and as you'll see this is published in the lanet regional health Europe now of course the lanet is a name that commands respect or it did but when a lot lot of people see it's in the lanet that's kind of a bit of a slam dunk really um and a few years ago that's what I believed is it still the case not for me to tell you what to think I'll just give you some information so here's the article here excess mortality in England postco 19 pandemic lit Regional Health Europe that is the link check it out for yourself this is all there now I did check on the Lancet uh site for this paper uh for the uh Lancet Regional Health Europe and I was a little bit concerned because I did find this um £4,000 fee is the article publishing charge for Open Access so if you want to publish in this journal and you want it to be open access which is good it means everyone can access it then that's fine just stomp up £4,000 so people that want their work to be read widely Open Access so anyone can get it £4,000 and the journal will facilitate that now this is not uncommon sadly at the moment that there is this fee for open open uh Open Access publishing pity but my question is if you pay £44,000 you're probably going to get more people reading your article that's uh quite a lot of money really unless you're funded externally or by an institution anyway I'll leave that with you that just that's just by The Bu now this is from the article um many countries including the UK have continued to experience an apparent excess uh excess of deaths um long after the Peaks associated with the covid-19 pandemic in 2020 and 2021 right so yes we are experiencing excess deaths around the world as we have tried to raise the alarm several times many times numbers of excess deaths estimated in this period are considerable we agree completely um UK office for National statistics on has calculated that there were 7.2% or 44255 more deaths registered in the UK in 2022 so that's on data fair enough now there are legitimate differences in the way that data is collected of course we did look uh last week at the oecd data for the UK which shows that for the same period is actually 52,000 so about another 8,000 higher 9.26% higher um not saying there's anything strange there that's ons numbers we have been alerted by people like Professor Norman Fenton into deficits or problems with the ons data but it is in the same range it's a concerning number whatever now this article goes on um the this this persisted into 2023 with uh 8 88.6% or 28,000 more deaths registered in the first 6 months of the year so 28,000 24 people more dying than we would expect first six months of the year as per this article uh base on based primarily on on uh data but so so that that's fine the these small differences aren't really surprising in the way that data is collected and we have this difficulty of course comparing country with country there are there are differences anyway oec data for that period Well the oec data for the first 44 weeks of 2023 was actually 49,000 deaths uh 389 deaths 99.44% so in the first 44 weeks of um according to the oecd first 44 weeks of 2023 99.44% excess deaths compared to 9.26% excess deaths in 2022 so we see that in 2022 and 2023 we've got in the order of 9% excess deaths for the data that we have now let's hope this plummets for the last part of 2023 but I'm afraid I'm not hopeful that's going to be the case anyway carrying on reading from this article from the Lancet the causes of multiple excess deaths are likely to be multiple and could include Direct effects of covid-19 infection yes um but we know know that that's not very many at all now um the majority of these deaths are not covid related we now know that certainly in the current time period now acute pressure on the NHS Services resulted in poor outcomes from episodes of acute illness acute pressures on the NHS being blamed here wait for it and disruption to chronic disease detection and management so chronic disease detection and management being blamed further analysis by by cause and age and sex group may help quantify the relative contributions of these causes and um no other causes that I could see were given there's the paragraph there now the question in my mind is could there be any other causes operating here other other than acute pressures on the NHS and chronic uh disease detection and management is that it is there any other possibilities has anything else changed prior to the data when the oec data was collected for example 15 2015 to 2019 is anything else changed anything else that we could think of that's changed well yeah acute pressures on the NHS detection and management of of disease but but is repeated in multiple countries around the world this is an international phenomena as we looked at in in the last video and I was a bit surprised that they didn't come up with any other possibilities anyway we'll go on office for health improvements and disparities now this is data from the 3rd of June 2022 to the 30th of June 2023 so that's what about 13mon or period so 13 months of data here now um when we have looked at this before this is largely from the office for health improvements and disparities but it is as reported it is as reported in this in this journal article read it for yourself um now excess deaths for all causes were relatively greatest for 50 to 64 year olds uh 15% higher than expected so 50 to 64 years now this is not really the age group the average age of death from Co of course is is way higher than that this is not a CO related age group really that's dying and yet they are dying 15% higher than expected 11% for 25 to 49 year olds now these are relatively young adults 11% higher and also um as far as I could gather from the way the article was written 11% higher for younger than 25 so what we see is young adults aged what um well younger than 25 18 to 25 25 to 49 dying 11% more than we would expect slightly older adults 50 to 64 dying 15% higher than we would expect and of course these young adults are not dying primarily of covid not at all about 9% higher for over 65s right now several causes in the 30-month period cardiovascular disease up by 12% heart failure up by 20% es schic heart disease not enough blood supply to The myocardium up by 15% liver disease up by 19% acute respiratory infections up by 14% diabetes up by 133% now I believe that the what is it the the office for uh Health improvements and disparities I don't know in detail how they collect their data but I've no reason to to doubt that this is is anything but completely accurate so if we take for example po esmic heart disease primarily caused by disease of the coronary arteries they're like a crown coronary around about the heart supplying The myocardium the pumping muscle of the heart with blood and they must have a patent Lumen if they get clogged up if they become inflamed they can get clogged up with atheroma atherosclerosis the disease process of atherosclerosis that can lead to reduced blood supply es schea that can lead to thrombus formation uh an acute coronary syndrome myocardial infarction fair enough 15% more of that but we have to what we have to look at is the proximal and the distal cause of disease this is what's not being done so any disease there a proximal cause or any death there's a proximal cause so yes this person died of es schic heart disease that's the immediate cause of death but what led to the es schic heart disease what are the distal causes is the question that really needs to be focused on again heart failure up by 20% yes heart failure is when The myocardium is not Contracting sufficiently to generate sufficient cardiac output to meet the metabolic demands of the body often accompanied by Venus congestion and edema we know what heart failure is so that's the immediate cause of death but what caused the heart failure what caused the heart failure have we got a national curiosity deficit disorder we should be asking these questions I'm afraid it gets worse for the slightly older age group for middle-aged adults 50 to 64 cardiovascular disease 33% higher than expected es schic heart disease 44% higher than expected but what the heck is causing the esic heart disease what is the distor causes cerebrovascular disease up by 40% heart failure up by 39% acute respiratory infection 43% High diabetes 33% 35% High so this these older adults are dying at really well all all adults are dying at a much higher rate adults age 50 to 64 dying particularly a higher rate my question is we need to look at the proximal causes yes this is the cause of death the distal causes what led up in the case of the coronary ARS that we looked at for example what led to the infl inflammation what led to the potentially accelerated rate of the development of atherosclerosis where's the pathology on this now okay this article can't list the whole thing but um that's the question I would like to to have addressed uh the pattern is now one of persistent excess deaths which are most prominent in relative terms in middle-aged and younger adults um this is an unfolding tragedy in my view young fit adults are dying at accelerated rates proximal causes identified distal causes not identified and I'm not I'm not going at this particular article I me I'm talking generally uh you really don't read much about what is causing the immediate cause of of death the pattern is now one of uh persisting excess tests which are most prominent Yeahs right timely and granular analysis I needed to describe such Trends so as to inform uh prevention and disease management efforts so timely okay yeah we need to do a longtitudinal sort of study on this needs to be done now granular I guess I guess what they mean there is looking at the nitty-gritty of it looking at things like uh age sex smoking status what medication someone's had over the past few years any variable you can think of I don't know whether they've had particular injections or not all these things should be analyzed so they're right granular analysis and uh the article does conclude I'll just show you it here the article concludes with uh dis uh dis uh Declaration of interest uh now remember the causes were put down as uh acute and chronic disease um Lely due to NHS problems but this is this is I'm not going to bother in names uh but this is direct from the article this is a lead auth I think lead author and corresponding author okay does various things um oh and reports personal fees from Novo Nordisk big Danish I think pharmaceutical company and uh fizer doesn't say how much money comes from there to the author but uh that interest is declared I've given you the information as accurately as I can make of it what you will how how long are these excess deaths going to go on for 2022 2023 still 9% or more in the UK and around the world if you're watching this video you're as frustrated as I am so I'll leave it there thank you for watching

Channel: Dr. John Campbell

Views: 927,635

Keywords: physiology, nursing, NCLEX, health, disease, biology, medicine, nurse education, medical education, pathophysiology, campbell, human biology, human body

Id: htRavAZ6jVE

Length: 14min 40sec (880 seconds)

Published: Thu Jan 04 2024