Joseph Friedman and Samir Akre are with the University of California, Los Angeles (UCLA) Medical Informatics PhD Program, Los Angeles, CA. J. Friedman is also with the Center for Social Medicine and Humanities, and the Medical Scientist Training Program at UCLA.
Am J Public Health. 2021 Jul;111(7):1284-1291. doi: 10.2105/AJPH.2021.306256. Epub 2021 Apr 15.
To determine the magnitude of increases in monthly drug-related overdose mortality during the COVID-19 pandemic in the United States. We leveraged provisional records from the Centers for Disease Control and Prevention provided as rolling 12-month sums, which are helpful for smoothing, yet may mask pandemic-related spikes in overdose mortality. We cross-referenced these rolling aggregates with previous monthly data to estimate monthly drug-related overdose mortality for January through July 2020. We quantified historical errors stemming from reporting delays and estimated empirically derived 95% prediction intervals (PIs). We found that 9192 (95% PI = 8988, 9397) people died from drug overdose in May 2020-making it the deadliest month on record-representing a 57.7% (95% PI = 54.2%, 61.2%) increase over May 2019. Most states saw large-magnitude increases, with the highest in West Virginia, Kentucky, and Tennessee. We observed low concordance between rolling 12-month aggregates and monthly pandemic-related shocks. Unprecedented increases in overdose mortality occurred during the pandemic, highlighting the value of presenting monthly values alongside smoothed aggregates for detecting shocks. Drastic exacerbations of the US overdose crisis warrant renewed investments in overdose surveillance and prevention during the pandemic response and postpandemic recovery efforts.
为了确定美国在 COVID-19 大流行期间每月与药物相关的过量死亡人数增加的幅度。我们利用疾病控制与预防中心提供的临时记录，这些记录是滚动的 12 个月总和，有助于平滑数据，但可能掩盖了与大流行相关的过量死亡人数的激增。我们将这些滚动总和与之前的每月数据交叉参考，以估计 2020 年 1 月至 7 月的每月与药物相关的过量死亡人数。我们量化了由于报告延迟引起的历史误差，并通过经验推导估计了 95%的预测区间 (PI)。我们发现，2020 年 5 月有 9192 人（95%PI=8988，9397）死于药物过量，这是有记录以来最致命的一个月，比 2019 年 5 月增加了 57.7%（95%PI=54.2%，61.2%）。大多数州都看到了大幅增长，其中西弗吉尼亚州、肯塔基州和田纳西州的增幅最高。我们观察到滚动 12 个月总和与每月与大流行相关的冲击之间的低一致性。在大流行期间，过量死亡人数出现了前所未有的增加，这突出表明，在检测冲击时，提供每月数值和平滑总和都具有重要价值。美国过量用药危机急剧恶化，这在大流行应对和大流行后恢复期间，需要对过量用药监测和预防进行重新投资。
