Tag: death rate

Gender of COVID-19 cases and deaths in Maryland

After my previous posts about age of COVID-19 cases and deaths in Maryland, it was logical that I write about the gender of these cases and deaths. Rest assured: this time, it will be much shorter 😉

Indeed, in a nutshell, in Maryland (like in the rest of the world), women are more impacted than men by the disease. But men are dying of the disease a little bit more than women.

Note: this post was updated on July 15, 2020, to fix an error in my code!

Now for the details …

In terms of positive COVID-19 tests / cases, the difference between men and women started early in April, with the number of positive tests or cases in women increasing faster than men over time. Today (July 15, 2020), Maryland counted a cumulative 39k positive cases for women and a cumulative 35.9k positive cases for men. The number of new cases in men and women in Maryland follows (of course) the trend in new cases, with peaks in May, a decrease until now and a fear for new increase of cases now (see bottom graph, below).

Even if we take into account the number of cases relative to the population of each gender, because there is approximately the same number of men and women in Maryland (2.9 mio men, 3.1 mio women, from the MD department of Planning), women always saw more cases than men (even if by just a little bit). Today, here is the data (also see graph below):

Cumulative COVID-19 cases / 100,000 pop.	Female	Male
July 15, 2020	1,230.8	1,211.3

In terms of deaths, we see the opposite trend: since the beginning of data reporting, there were always more men who died of COVID-19 than women. On a daily basis, it’s less clear (and since I’m not smoothing nor averaging anything, it’s a bit jagged) but the overall result remains the same.

Even when we consider deaths relative to the respective populations, men die in larger numbers to their population (than women) and this is consistently the case since the beginning of data availability (see also chart below):

Cumulative deaths per 100,000 pop.	Female	Male
July 15, 2020	49.6	54.8

These observations were already widely shared, for the general (i.e. non-MD) population, in the media. There could several factors to explain that more women are tested positive than men: men could be less enclined to be tested than women, women could be more concerned about their health than men (seeking more testing resulting in discovering more positive cases), … And there are two main hypotheses to explain that more men are dying of COVID-19 than women: women tend to have a stronger immune system than men, there are also “gender-based lifestyle choices” (e.g. more men are smoking than women, and smoking is, directly or indirectly, affecting the predisposition to complications due to COVID-19), … So, contrary to the perceived lack of manliness some men express about the mask, men should have even more reason to wear a mask, just to protect them (and others) from dying.

To be continued …

As usual, you’ll find other graphs on my page about COVID-19 in Maryland (and figures above are updated with new data as they appear) and the data, code and figures are on Github (including these ones).

P.S. This post was amended a after its publication, thanks to a remark by W Jauquet on Twitter: the calculation for the relative number of cases and deaths was wrong. The code and text above were corrected to reflect that.

Age of COVID-19 deaths in Maryland

After my previous post on the age of COVID-19 cases in Maryland, it was logical that I write about the age of COVID-19 deaths in Maryland. So far, media and State Departments of Health all agreed that the older someone is, the more risk this person has to die from coronavirus.

So far, this is unfortunately also true in Maryland. In the graph below, we clearly see that people 50-59 years old have more than 250 deaths, people 60-69 have more than 500 deaths, people 70-79 have more than 750 deaths and people 80+ have nearly … 1,5000 deaths! The graph at the bottom also clearly shows that people in age categories 60 and above provide most of the new daily deaths due to COVID-19 (even if we came back down from a peak at about 40 deaths in 80+ at the end of April).

The simpler section at the latest date for which death data by age is available (i.e. today, July 9th, 2020) also shows this curve highly skewed towards older age groups (at the bottom, compare that to cumulative cases, on top):

The two graphs below confirm that people in old age are at much higher risk of death due to COVID-19. On top, if we report the deaths in each age group by the population they actually are in Maryland, we also see that deaths in 80+ disproportionaly affect this age group, reaching a COVID-19-specific mortality rate of 629 per 100,000 pop.!!! The table under the graph gives all the data points.

And when we look at it to see the relative importance of each age groups compared to the total number of cases, we see again that people aged 80+ have 46% of all deaths, followed by people 70-79 (25%) and people 60-69 (16%).

Age group (years old)	COVID-19-specific mortality rate (per 100,000 pop.)
0-9	0
10-19	0.1
20-29	2.2
30-39	4.9
40-49	13.1
50-59	28.8
60-69	70.8
70-79	180.1
80+	629.8

COVID-19-specific mortality rate, by age group, in Maryland, on July 9th, 2020

As opposed to cases by age, we don’t see here any shift in most affected age group: the older some is, the more risk of dying from COVID-19 exists (and part of the problem is the close living conditions in nursing homes). There aren’t 1,000 solutions to protect them: wear a mask and practice physical distancing, especially when there is a risk to meet elderly people and transmit the disease to them!

To be continued …

COVID-19 inequalities in Maryland

The recent Black Live Matters protests made me think a lot – as a white man, as a husband and dad, as a biologist by training, as a health economist by day, as someone interested in COVID-19 data where I live by night … as a human, in summary. I don’t have grandiose pieces of advice or any deep thoughts, not for here (but if you call me, we can talk ;-)). Here, let’s continue our exploration of COVID-19 data in Maryland.

There are only 2 metrics that the MDH dashboard provides, around races: confirmed cases and deaths (and probable deaths but as this is not precise and small, let’s put this aside for the moment).

Today (June 12, 2020), communities worst hit (in crude numbers) are African Americans and Hispanics in terms of cases (17,345=28% and 16,293=27%) and African Americans and Whites in terms of confirmed deaths (1,133=41% and 1,164=42%). This is represented in the figure below. Note also the high number of “race not available” in the cases chart (this could mean a worst impact for some communities as some would fear negative consequences of disclosing their race).

But this means little if we don’t know how many Marylanders are in each categories. Numbers varies and I couldn’t find the following data from the Census or the CDC directly (the 2 sources I would consider the most reliable on this): number of people categorized in 1 and only 1 race at a time (which is an approximation of reality but allows for easier calculations below). I found the following data from SuburbanStats: in Maryland there are approximately

1.7 million African Americans (~27%),
318 thousands Asians (~5%),
479 thousands Hispanics (~7%),
3.3 million Whites (~53%) and
410 thousands of “others”.

Given this, we can see a different picture …

In this figure, on top, we see the evolution of crude case numbers since April (up to June 11). We also see the rapid rise of cases in Hispanics since they were separated from the “Others” (April 14). But at the bottom, I show the evolution of cases relative to the population. And here we can clearly see that, very early on, Hispanics accumulated cases in larger proportion compared to their less than half million population. Yesterday (June 11, 2020), there were 3,461 Hispanic COVID-19 cases per 100,000 population (compare that to 350 in Whites).

In the following figure, on top, we see the evolution of confirmed deaths since April (also up to June 11). Here, both African Americans and Whites are close and widely distancing the other communities. But at the bottom, the evolution of deaths relative to the population is shown. And here we can clearly see that African Americans (especially) and Hispanics are the worst hit communities compared to their general population. Yesterday (June 11, 2020), there were 66 African American deaths per 100,000 population and 58 Hispanic deaths per 100,000 population (compare that to 34 in Whites).

The table below summarizes cases and deaths relative to population on June 11, 2020, in Maryland:

Community	Cumulative COVID-19 (cases / 100,000 pop.)	COVID-19-specific death rate (deaths / 100,000 pop.)	Share of the general population
African Americans	1,020	66	27%
Asians	368	32	5%
Hispanics	3,461	58	7%
White	350	34	53%

Community-related cases and deaths in Maryland on June 11, 2020

So even in Maryland, a US state ranked 6th best state overall and #8 for healthcare in 2019, disparities exist. Hispanics are the worst hit in COVID-19 cases (27% of cases and > 3,000 cases per 100,000) in cases while they represent only 7% of the population. And African Americans are the worst hit in COVID-19 confirmed deaths (41% of deaths and > 60 deaths per 100,000) while representing only 27% of the population. The CDC has an interesting summary of main causes of these disparities but also what people and organizations can do about it; a good read to start doing something about these inequalities.

To be continued …

As usual, you’ll find other graphs on my page about COVID-19 in Maryland (and figures above are updated with new data as they appear) and the data, code and figures are on Github.

Post Scriptum – but still important … Methodologically, there are a few caveats for all this. First, the concept of race is linked with so many other parameters that COVID-19 is probably exacerbating these other issues (with an indirect effect on people of color) rather than targeting a specific population (the virus itself does not choose who it will infect). Also, there is no explanation on how race information is collected: with a question on the test form (with all the reporting bias it contains), by linking the names or social security number to a previously recorded race identity, …? This is another source of potential bias. Third, we have here the 2 extreme metrics: cases and deaths. There is no information on hospitalizations, despite requests to the MD Department of Health or the Governor’s staff (no hospitalizations info for counties neither btw). I suspect here that race collection in hospitals is not performed (because unethical?) and/or there would be HIPAA issues if this data would be transmitted from hospitals to the state, for instance.

Weekly seasonality in COVID-19 deaths reported in Maryland

On its dashboard, the Maryland Department of Health is reporting confirmed deaths due to COVID-19 in two ways: by date of report and by date of death (updated as amendments to the death record are received). The definition of confirmed death is:

A death is classified as confirmed if the person had a laboratory-confirmed positive COVID-19 test result.

What I was intrigued is that reporting seems to follow a pattern influenced by the day of the week (see figure below). The top chart (cumulative) is just an addition. A plateau would be welcome: it would indicate death rate is slowing down. Today, the COVID-19 death rate is 41 / 100,000 population. The bottom chart shows the number of deaths due to COVID-19 reported each day: the black line represents the number of deaths each day they were reported; the grey line represents the number of deaths each day they occurred.

Evolution of coronavirus confirmed deaths in Maryland, as of June 3, 2020

One could see that in both lines, there are two kind of patterns. The first in an overall trend upwards until beginning of May, followed by a decrease since then. The second trend has a big peak being followed by a decrease with 2 smaller peaks and a big dip – then an up, decrease with 2 peaks and a big dip – etc.. As data was reported, we saw intuitively that the big dip came on Sundays, the big peak on Tuesdays and the rest of the week was a decrease towards Sunday.

And this is confirmed by the analysis of seasonality for confirmed death by reported date:

Here, the top chart is just the data we observed before. Below, the trend shows that, indeed, there was an increase up to end of April and we then see a slow decline. The third graph (“seasonal”) shows the pattern I mentioned earlier. This confirms the lowest reporting on Sundays and the highest reporting on Tuesdays. The bottom chart (“irregular”) shows that, even if there is a pattern, there are a lot of irregularities added to the seasonality.

The same patterns can be observed for the deaths by date of death (when they occurred; see chart below). This shows we are currently also in a decreasing number of deaths, each day (fortunately!). The pattern here is that the number of deaths increase from the lowest on Saturday to the peak on Friday (with an intermediary peak on Wednesday). Again, note the important number of irregularities (at the bottom).

In my opinion, this regular patterns come from the reporting system. I don’t see why COVID-19 patients would die more towards the end of the week and less during the weekend. But please tell me if you have more information about this (in the comments below or by email)!

To be continued …

As usual, you’ll find other graphs on my page about COVID-19 in Maryland and the data, code and figures are on Github.

P.S. I’m not counting probable deaths. The MD Department of Health reports this variable but, as it is dependent of a confirmation, it is highly fluctuating and not necessarily representative of deaths due to COVID-19. If confirmed, these probable deaths are accounted in the confirmed deaths (counted here).

MD counties COVID-19-specific death rate

Since a few weeks, I report the raw number of COVID-19 deaths in Maryland counties. If this gives an idea of the cumulative number of deaths – which is interesting – it doesn’t reflect the fact that some counties have more inhabitants than others. That’s why I plotted below the number of COVID-19 deaths adjusted for the population (i.e. the COVID-19-specific death rate):

Today (May 16, 2020), in terms of absolute number of deaths, Montgomery, Prince Georges and Baltimore County are the top 3 counties (this is the same for cases but not in the same order). In terms of confirmed deaths per 100,000 population, the top 3 counties are Kent, Prince Georges and Montgomery.

Rank on May 16, 2020	Absolute # of COVID-19 deaths	COVID-19 deaths per 100,000 population
1	Montgomery (423)	Kent (66.9)
2	Prince Georges (399)	Prince Georges (43.5)
3	Baltimore County (223)	Montgomery (40.2)
4	Baltimore City (192)	Carroll (39.0)
5	Anne Arundel (133)	Charles (35.8)

Overall in Maryland so far, 1,842 deaths were reported – for a total population of 6,141,808. This gives a COVID-19-specific death rate of 29.9 per 100,000 pop. For comparison, the CDC reported a flu-specific death rate of 2 per 100,000 pop. (for the whole US, 2017) and 863.8 deaths per 100,000 pop. for all-cause deaths.

Source of Maryland County population: projections from the Maryland Department of Planning.
As usual, you’ll find other graphs on my page about COVID-19 in Maryland and the data, code and figures are on Github.

Edited a few minutes after publication to add a paragraph with the comparison with Maryland and flu; adapted the y-axis label following Michael Brown‘s comment on Twitter (thanks!); and specified the flu-specific death rate from CDC following Melissa Schweisguth‘s comment on Twitter (thanks too!).