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Commentary
Spike In Atlanta Georgia Deaths Raises Pandemic Concerns
Recombinomics
Commentary 19:12
March 30, 2010
Surgeon General Dr. Regina Benjamin and Dr. Anne Schuchat, director of the Centers for Disease Control and Prevention's (CDC's) National Center for Immunization and Respiratory Diseases, told reporters on a conference call that they are particularly concerned about the "worrisome trend" in Georgia, where "more than 40" people were hospitalized in the past week for lab-confirmed flu.
The above comments describe yesterday’s CDC press conference on H1N1 hospitalizations in Georgia. Although the take home message to vaccinate was clear, the details surrounding the H1N1 increases in hospitalizations and deaths remains cloudy.
The increases in region 4 have been clear for many weeks. The percent positive cases rose to double digits in February and have been at that level throughout February and March. States in region 4 reported increases in hospitalizations and deaths, but the biggest jump came from Georgia which reported 80 new hospitalizations between March 3-9. This jump was 1 shy of the record weekly total from last fall and suggested a third wave was beginning. The GA department of health then put out a March 24 press release noting the jump in hospitalizations and deaths and the need for vaccinations. They cited 1012 H1N1 hospitalizations and 72 deaths. At that time the tables showed 940 hospitalizations and 58 deaths, so the difference of 72 hospitalizations was in line with the prior week’s jump, but the deaths were 14 higher.
The updated tables did match the press release on hospitalizations and the two week total of 152 was a record for reported H1N1in GA. However, the same table that had 1012 hospitalizations only had 60 deaths, leaving open the gap of 12 deaths between the press release and the updated table. Similarly, other tables which provided weekly age breakdowns of hospitalized and deaths had been showing the greatest numbers in the 25-49 age group, but these tables were running at about 40 cases per week, instead of the 75 cited in the latest two updates in the larger table and confirmed in the March 24 press release.
The CDC press release did little to clear up the confusion on the numbers. The press release focused on hospitalizations and did not mention an increase in deaths. However, testing remains abysmal, so many infected patients are not tested, or are tested with the rapid test, which in some cases has a sensitivity of 10%.
Another approach to monitoring deaths is through P&I reports from 122 cities in the US. Atlanta shows a dramatic jump in deaths. A year ago the rate for weeks 8-11 was 3.3%, but this year the rate was 9.2%, which would represent 31 excessive deaths. The jump for the past two weeks was even more dramatic. In 2009 the rate was 1.8%, but it 2010 it rose to 11.2%. Thus, in 2009 there were 6 P&I deaths for weeks 10 and 11, while in 2010 there were 28.
It is unclear if this spike in deaths in the P&I report for Atlanta was linked to the hastily called press release, but these numbers are clearly cause for concern.
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