COVID updates - leading causes of death, vaccines, etc.

I'm tracking a few interesting articles related to COVID-19 here...

First article I've seen correlating vaccine use to lower COVID-19 cases and deaths.
Vaccination tied to all-time low in long-term care COVID-19 deaths, cases—KFF
McKnight’s Senior Living, April 26, 2021, Hospice News Today summary
COVID-19 cases deaths among assisted living and nursing home residents and staff members have fallen dramatically since vaccines were introduced in December, with deaths declining by almost 89% and cases by nearly 92%, according to a Kaiser Family Foundation analysis. Eight states are reporting increases in long-term care cases, however, reflecting a potentially troubling trend of increasing community spread. The KFF analysis found that COVID-19 deaths in assisted living communities, nursing homes and other congregate care settings fell from 1.7 deaths per 100,000 state residents in December to just 0.2 deaths per 100,000 residents in April—an all-time low, according to the KFF analysis. ... More than 1.4 million residents and more than 1 million staff members in long-term care facilities are fully vaccinated. ... But eight states experienced an increase in coronavirus cases in long-term care facilities between March and April. The increase ranged from 6% in New Hampshire to a more than 150% jump in Connecticut and Michigan. Other states that saw an increase in long-term care facility cases from March to April were Idaho (9%), Louisiana (31%), New Jersey (36%), Ohio (78%) and Alabama (81%).

The Leading Causes of Death in the US for 2020
Ahmad FB and Anderson RN. The Leading Causes of Death in the US for 2020. JAMA Online, 3/31/21.

An interesting article detailing causes of death in the US for 2020, including COVID-19. Some of my calculations, based on the table below:

• Typically we see an increase of ~1% in the total number of deaths each year, but from 2019-2020 we see an increase of 17.7%.
• The new category of COVID-19 deaths appears in 2020 (345,323) as the 3rd highest cause of death in the country.
• Typically we see an increase of ~30,000 total deaths each year, but from 2019-2020 we see an increase of 503,976.
• Increased deaths in some diagnoses: heart disease, unintentional injuries, stroke, Alzheimer's, diabetes, influenza and pneumonia, and kidney disease.
• Decreased deaths in other diagnoses: cancer, chronic lower respiratory diseases, and suicide.

It will take time to understand mortality in the context of a pandemic - including concepts such as "excess mortality", dying "of COVID-19" vs "with COVID-19", and how COVID-19-related deaths impact how deaths by other diagnoses are reported.

Excess Deaths from COVID-19 and Other Causes in the US, 3/1/20-1/2/21.
Woolf SH, Chapman DA, Sabo RT. JAMA Network Online 4/2/21.

Discussion
The 22.9% increase in all-cause mortality reported here far exceeds annual increases observed in recent years (≤2.5%). The percentage of excess deaths among non-Hispanic Black individuals (16.9%) exceeded their share of the US population (12.5%), reflecting racial disparities in COVID-19 mortality. Excess deaths surged in the east in April, followed by extended summer and early winter surges concentrated in southern and western states, respectively. Many of these states weakly embraced, or discouraged, pandemic control measures and lifted restrictions earlier than other states.

Excess deaths not attributed to COVID-19 could reflect either immediate or delayed mortality from undocumented COVID-19 infection, or non–COVID-19 deaths secondary to the pandemic, such as from delayed care or behavioral health crises. Death rates from several non–COVID-19 diseases (eg, heart disease, Alzheimer disease) increased during surges. The model does not adjust directly for population aging, which could contribute to an overestimate of excess deaths. Other study limitations include reliance on provisional data, inaccurate death certificates, and modeling assumptions.

Reactogenicity Following Receipt of mRNA-Based COVID-19 Vaccines

Chapin-Bardales J, Gee J, Myers T. JAMA Insights 4/5/21.

Comparing side effects of the Pfizer and Moderna vaccines.