Pre-existing coronavirus pandemic

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Adam Rogers

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A large new accounting of human fitness on Earth, which collects and deduces statistics on a lot of diseases and injuries in 204 countries, has more commonly intelligent news: people are fitter and stay fitter for longer. The bad news is that it’s not true if those other people are poor, of color, they live in the United States and there’s a pandemic.

Then they each other.

The ongoing paintings of thousands of foreign researchers, the allocation of Global Disease Burden was discovered at the University of Washington, which are many of the paintings of the Institute of Metrics and Health Assessment, which would possibly be seen due to its hyperpesimism but very motivating models of the coronavirus pandemic prior to this year. With GBD, this modeling experiment fills gaps in countries that not all collect the same knowledge, but in general, paintings are discovered in all kinds of epidemiological knowledge and fitness of governments and health care organizations, and compiles who are affected through what disease, age and sex, representing 286 causes of death , 369 ailments and injuries and 87 threat points in 204 countries and territories, with figures dating back to 1990. The Lancet The Bill and Melinda Gates Foundation is the main source of funding.

In a way, the Global Disease Burden report is an explosion of the past, a look at the fitness of a now-defunct planet: before times and the worst of Before Times. Chronic diseases undermine the benefits of fashion medicine and public aptitude. But 10 months after the start of a pandemic, the GBD report is a map of the vulnerabilities that Covid-19 would exploit. It is also a laser pointer that appears on the way to a brighter chronology.

In general, things that kill other people to the fullest are not communicable diseases like Covid-19. High blood pressure is the leading cause of death worldwide; the timing is smoking-related illness. In fact, everything in the maximum sensitive 10 is the same challenge of the entire population that demands that systemic replacement be corrected. It is air pollution; nutritional deficiencies leading to diabetes, obesity and central disease; and alcohol abuse. Infant and maternal mortality is still infiltrating the world’s maximum of 10 people.

Smoking has declined over the past decade, while “metabolic risks” (obesity, blood sugar, hypertension, blood cholesterol) have moved in the opposite direction. Together, those other 4 people were guilty of 26. 9 million deaths in 2019 and nearly 20% of what the GBD report describes as loss of fitness worldwide. This is a loss of life, but also a loss of years of end-of-life fitness, a statistic captured through mortality-adjusted life years, or AVAD. This number has increased by up to 50% since 1990.

Of course, as GBD authors point out, those effects vary geographically. Nutritional and tobacco effects are worse in Asia, Europe and Latin America. His Oceania group suffers the most from malnutrition and air pollution; in sub-Saharan Africa, malnutrition and lack of access to white water and sanitation are the worst. “This shows a global crisis of chronic diseases,” says Ali Mokdad, a professor of fitness science at IHME and one of the authors of GBD. “and, frankly, a failure of our public fitness formula to address those expanding, preventable threat points that make our population sick, kill many of us, and cause many fitness emergencies. “

But the literally attractive breakdown is on economic lines: low-income countries are doing a bigger task of cutting IADS than middle- and high-income countries like the United States, and the burden of disease in the United States disproportionately weighs on the deficient and “In america, when you compare us to the rest of our peers , countries that are very rich, looking like us, we are wrong,” says Mokdad. “Very poor. “

After 50 years of decline in cardiovascular disease in the United States, those numbers are increasing. Maternal and under-five mortality, in line with low-income countries, is 6. 5, consistent with 1000 live births in the United States. It’s 4. 9 in other rich countries, countries,In Australia, like the United States, a new country with a giant Aboriginal population and a majority of English speakers, is 3. 6. Healthy life expectancy, the number of years in which others live without disabilities, is approaching 86 in Japan; in the United States, it’s 65. 5 (people in the United States live long enough, until the late 1970s, but their lives have been less fun in recent years).

All of these figures date back to 2019, before the pandemic. As Lancet’s editors point out in an adjunct editorial, these statistics also show how Covid-19 has reshaped the United States in a country with one of the highest infection and mortality rates in the world. . These metabolic disorders have preferential effects on the deficient and other people of color. The deficient and other people of color are also, due to their precarious economic scenario in the United States, less likely to be able to paint from home and more likely to be “essential painters”, more exposed to the Covid-19. “They are other people of color. They have more chronic diseases. They retract medical care, they don’t have insurance, they don’t have cash and they don’t have access,” Mokdad says. They’re more exposed. They have more threat factors. And they’re more likely to die. ” The diseases and disorders they probably have are also the precise comorities that make Covid-19 more serious or fatal. These are literally and metaphorically the nation’s pre-existing situations.

This is a very tight type of screwdriver, because it didn’t have to be this way. This does not happen in societies with well-constructed social safety nets and skills. “If you have fewer assets, less income, less wealth, less housing, you’re a user of color, you’re less likely to be able to paint from home,” says Sandro Galea, epidemiologist and dean of the Boston University School of the Public. Health. “So there is a gap, a disparity in the threat of getting Covid. It is a reflected image of a higher exposure. “

These same people are also more likely to suffer from chronic diseases that highlight the global burden of disease, due to poverty, lack of universal fitness care, lack of access to higher quality food and ‘a public system of unfunded fitness, through some calculations, to the $4. 5 billion song before Covid-19 , even a twinkle in the eyes of a bat. “His death threat if he doesn’t have an underlying comorability is less than 0. 1 percent,” Galea says. “People of less socioeconomic prestige and other people of color were most at risk. Somehow, it’s that simple. “

To paraphrase a famous book, it’s a big trap. The virus that causes Covid-19 would have been fatal. But fewer people living in poverty, except others with diseases that turned out to be harmful comorities and a greater health care formula aimed at prevention rather than miracle cures would have meant that the same fatal virus would have killed fewer people. “Why did Covid become the challenge he was asking for in the first place?”Ask Galea. ” First, we have traditionally invested little in the public fitness formulas needed to stay in shape. And secondly, we have invested little in the social and economic situations that create a world in form. “

And the catch becomes more catchy. Earlier this week, in an article in the Journal of the American Medical Association, two Harvard economists estimated that all deaths and ailments due to Covid-19 so far, and those likely to happen before mid-2021, are combined with losses in The Economy, Intellectual Anguish, and Loss of Production will be reduced to the staggering $16 trillion. This represents approximately 90% of the U. S. annual gross domestic product. “For a circle of relatives of four, the estimated loss would be close to $200,000,” economists write. “About part of this amount is the loss of source of income due to the Covid-19-induced recession; the rest relates to the economic effects of a shorter, less healthy life. “

Even this burden is unfairly shared. ” At the end of the economy, we are doing more harm to deficient people and others of color, economically, than keeping it open,” says Alan Krupnick, economist and senior member of Resources for the Future. “But you can’t open up the economy until other people have a moderate hope of being safe when they move to restaurants or bars, or move to work. The disease will have to be cured first for the economy to flourish. of the revenue effect and creates a feedback loop. Trying to cope with the effects of the pandemic after it has already engulfed the economy exacerbates the economic effects on the maximum vulnerable . . . which means that financially, they have to put themselves to greater risk . . . making their comorities potentially more dangerous.

Some researchers have described Covid-19 as not a pandemic, but as a “syndemic,” a synergistic epidemic of similar overlapping problems, each aggravating the others. It is bad. But on the bright side (-ish), syndemics offer more targets of opportunity. Expensive drugs and fast-track vaccine trials are the kind of shots you’ll only bet on if you (or your government) haven’t highlighted the boring paintings of public aptitude of the entire population. The report on the global burden of disease quietly suggests that it is not too late. For Covid-19 in particular, it would be a post about wearing masks, how to implement large-scale innovations in ventilation formulas, and helping other people stay home. House. All painted in Singapore, Taiwan, South Korea, and even Wuhan. You can paint here. But the GBD numbers show how to build a formula that can solve all sorts of other problems, adding infectious surprises like SARS-CoV-2. And that same formula will make you a happier and fitter world, a world strong enough to one day get rid of SARS-CoV-3 as well.

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