Demographic and clinical data about COVID-19 cases are reported to CDC from 50 states, the District of Columbia, New York City, and U.S. territories using a standardized case-report form (case-based surveillance) or in aggregate. Data on 52,166 deaths from 47 jurisdictions among persons with laboratory-confirmed COVID-19 were reported individually to CDC via case-based surveillance during February 12–May 18, 2020. Among the 52,166 decedents, 55.4% were male, 79.6% were aged ≥65 years, 13.8% were Hispanic/Latino (Hispanic), 21.0% were black, 40.3% were white, 3.9% were Asian, 0.3% were American Indian/Alaska Native (AI/AN), 0.1% were Native Hawaiian or other Pacific Islander (NHPI), 2.6% were multiracial or other race, and race/ethnicity was unknown for 18.0%. (Table 1). Median decedent age was 78 years (interquartile range (IQR) = 67–87 years). Because information about underlying medical conditions was missing for the majority of these decedents (30,725; 58.9%), data regarding medical conditions were not analyzed further using the case-based surveillance data set. Because most decedents reported to the supplementary data program were also reported to case-based surveillance, no statistical comparisons of the decedent characteristics between the data sets were made.

To collect more complete data on race/ethnicity, selected underlying medical conditions* by age, and clinical course, CDC solicited supplementary information from medical charts and death certificates of decedents with laboratory-confirmed COVID-19 from state, territorial, and local public health departments. The supplementary data request also sought information on locations of death, which is not collected routinely on the CDC case-report form. Among 56 public health departments contacted by CDC, 16† provided supple­mentary data on 10,647 COVID-19 deaths that occurred during February 12–April 24, 2020.

Among the 10,647 COVID-19 decedents for whom supple­mentary data were collected, 60.6% were male, 74.8% were aged ≥65 years, 24.4% were Hispanic, 24.9% were black, 35.0% were white, 6.3% were Asian, 0.1% were AI/AN, 0.1% were NHPI, 2.9% were multiracial or other race, and race/ethnicity was unknown for 6.3% (Table 1). Decedent age varied by race and ethnicity; median age was 71 years (IQR = 59–81 years) among Hispanic decedents, 72 years (IQR = 62–81 years) among all nonwhite, non-Hispanic decedents, and 81 years (IQR = 71–88 years) among white decedents. The percentages of Hispanic (34.9%) and nonwhite (29.5%) decedents who were aged <65 years were more than twice those of white decedents (13.2%) (Figure).

At least one underlying medical condition was reported for 8,134 (76.4%) of decedents for whom sup­plementary data were collected, including 83.1% of decedents aged <65 years. Overall, the most common underlying medical conditions were cardiovascular disease (60.9%), diabetes mellitus (39.5%), chronic kidney disease (20.8%), and chronic lung disease (19.2%) (Table 2). Among decedents aged <65 years, 83.1% had one or more underlying medical conditions. Among decedents aged ≥85 years, 69.5% had one or more underlying medical conditions. Diabetes was more common among decedents aged <65 years (49.6%) than among those aged ≥85 years (25.9%).

Among decedents for whom supplementary data were reported, 8,976 (84.3%) were hospitalized. Among 3,021 (28.4%) with dates of illness onset and death reported, the median interval from illness onset to death was 10 days (IQR = 6–15 days); among 7,794 decedents with hospital admission and death dates, the median interval from hospital admission to death was 5 days (IQR = 3–8 days). Among the decedents, 62.0% died in hospitals. By age group, the largest percentage who died in the emergency department (6.8%) or at home (1.0%) was aged <65 years (combined total = 7.8%), and decreased with increasing age group, whereas the percentage who died in long-term care facilities increased with increasing age and was highest among decedents aged ≥85 years (12.6%).

Among the decedents during February 12–April 24, 2020, for whom supplementary information was provided, 9,997 (93.9%) resided in New York City, New Jersey, or the state of Washington, three areas with early widespread circulation of SARS-CoV-2; the median age among decedents in these three jurisdictions was 75 years, (IQR = 64–84 years). The median age among decedents residing in the other 13 jurisdictions was similar (78 years, [IQR = 68–85 years]).

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Using national case-based surveillance and supplementary data reported from 16 jurisdictions, characteristics of >10,000 decedents with laboratory-confirmed COVID-19 were described. More than one third of Hispanic decedents (34.9%) and nearly one third (29.5%) of nonwhite decedents were aged <65 years, but only 13.2% of white decedents were aged <65 years. Consistent with reports describing the characteristics of deaths in persons with COVID-19 in the United States and China (2–5), approximately three fourths of decedents had one or more underlying medical conditions reported (76.4%) or were aged ≥65 years (74.8%). Among reported underlying medical conditions, cardiovascular disease and diabetes were the most common. Diabetes prevalence among decedents aged <65 years (49.6%) was substantially higher than that reported in an analysis of hospitalized COVID-19 patients aged <65 years (35%) and persons aged <65 years in the general population (<20%) (5–7). Among decedents aged <65 years, 7.8% died in an emergency department or at home; these out-of-hospital deaths might reflect lack of health care access, delays in seeking care, or diagnostic delays. Health communications campaigns could encourage patients, particularly those with underlying medical conditions, to seek medical care earlier in their illnesses. Additionally, health care providers should be encouraged to consider the possibility of severe disease among younger persons who are Hispanic, nonwhite, or have underlying medical conditions. More prompt diagnoses could facilitate earlier implementation of supportive care to minimize morbidity among individuals and earlier isolation of contagious persons to protect communities from SARS-CoV-2 transmission.

The relatively high percentages of Hispanic and nonwhite decedents aged <65 years were notable. The median age of nonwhite persons (31 years) in the United States is lower than that of white persons (44 years); these differences might help explain the higher proportions of Hispanic and nonwhite decedents among those aged <65 years. The median ages among Hispanic and nonwhite decedents (71 and 72 years, respectively) were 9–10 years lower than that of white decedents (81 years). However, the percentage of Hispanic decedents aged <65 years (33.9%) exceeded the percentage of Hispanic persons aged <65 years in the U.S. population (20%); the percentage of nonwhite COVID-19 decedents aged <65 years (40.2%) also exceeded the overall percentage of nonwhite decedents aged <65 years (23%) in the U.S. population (8). Further study is needed to understand the reasons for these differences. It is possible that rates of SARS-CoV-2 transmission are higher among Hispanic and nonwhite persons aged <65 years than among white persons; one potential contributing factor is higher percentages of Hispanic and nonwhite persons engaged in occupations (e.g., service industry) or essential activities that preclude physical distancing (9). It is also possible that the COVID-19 pandemic disproportionately affected communities of younger, nonwhite persons during the study period (10). Although these data did not permit assessment of interactions between race/ethnicity, underlying medical conditions, and nonbiologic factors, further studies to understand and address these racial/ethnic differences are needed to inform targeted efforts to prevent COVID-19 mortality.

The findings in this report are subject to at least five limitations. First, despite >90% completeness for age and race/ethnicity variables in the supplementary data set, the proportion of missing data for some variables, such as underlying medical conditions, clinical course, and race/ethnicity in case-based surveillance, and location of death, was higher than that for other variables; accordingly, the proportions reported for these variables should be considered minimum proportions rather than robust estimates. Second, reporting practices varied by jurisdiction, and several states bundled underlying medical conditions into organ system–specific categories (e.g., hypertension was included as cardiovascular disease) or did not code specifically for a given condition (e.g., immunosuppression was only specifically coded in 10 of the jurisdictions). These differences in reporting structure precluded evaluations of specific conditions other than diabetes using the entire data set. Third, generalizability of the findings from either data set to all deaths among persons with COVID-19, either within the individual jurisdictions or across the United States, is unknown; COVID-19 testing practices for decedents might differ among jurisdictions. Fourth, information from the supplementary data set provides additional insight into decedent demographic and clinical characteristics; however, these data are a convenience sample from 16 public health jurisdictions. Therefore, because the age-race structure of the underlying population is not known, age-standardized mortality rates could not be calculated. Although more than 90% of decedents resided in just three jurisdictions, and most are represented in case-based surveillance, they represent a subset of deaths reported during this period. Therefore, neither calculations of mortality rates nor statistical comparisons between the demographic characteristics of the decedents with available supplementary data and those from case-based surveillance were possible. Finally, these data were collected during a period before dexamethasone was shown to reduce deaths among ventilated patients; implementation of dexamethasone and other therapeutics, as well as shifts in the ages of patients and geographic locations of cases might affect the generalizability of these data to the current period.

Despite these limitations, this report provides more detailed demographic and clinical information on a subset of approximately 10,000 decedents with laboratory-confirmed COVID-19. Most decedents were aged >65 years and had underlying medical conditions. Compared with white decedents, more Hispanic and nonwhite decedents were aged <65 years. Additional studies are needed to elucidate associations between age, race/ethnicity, SARS-CoV-2 infection, disease severity, underlying medical conditions (especially diabetes), socioeconomic status (e.g., poverty and access to health care), behavioral factors (e.g., ability to comply with mitigation recommendations and maintain essential work responsibilities), and out-of-hospital deaths. Regional and state level efforts to examine the roles of these factors in SARS-CoV-2 transmission and COVID-19-associated deaths could lead to targeted, community-level, mortality prevention initiatives. Examples include health communication campaigns targeted towards Hispanics and nonwhite persons aged <65 years. These campaigns could encourage social distancing and the need for wearing cloth face coverings in public settings. In addition, health care providers should be encouraged to consider the possibility of disease progression, particularly in Hispanic and nonwhite persons aged <65 years and persons of any race/ethnicity, regardless of age, with underlying medical conditions, especially diabetes.

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A novel liquid biopsy method can detect kidney cancers with high accuracy, including small, localized tumors which are often curable but for which no early detection method exists, say scientists from Dana-Farber Cancer Institute.

The report in Nature Medicine suggests that if validated in larger trials and applied widely, the noninvasive test could find more early kidney cancers when they haven’t spread, thus reducing the mortality of the disease. “Hopefully we can scale this to a much larger level and detect cancer earlier so we can act earlier,” said Toni Choueiri, director of the Lank Center for Genitourinary Oncology at Dana-Farber and a co-senior author of the study.

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It is estimated that 73,750 new kidney cancer cases will be diagnosed in 2020, and about 14,830 will die of the disease. About 35 percent of cancers are diagnosed only after they have spread beyond the kidney and are more difficult to treat. Small, early kidney tumors usually cause no symptoms, and increasingly are found incidentally in scans of the abdomen performed for another purpose. However, there is no imaging or other screening test recommended for the general population to look for early kidney cancers. Initially, a test based on the method described in the new report might be used to screen people with a family history of kidney cancer, or who had a previous kidney cancer, said Choueiri. “We need to be specific first, before making it totally mainstream,” he said.

Noninvasive liquid biopsies, which search for cancer-related DNA shed by tumors into blood or other body fluids, are moving rapidly toward clinical use as a means of early detection for some kinds of tumors. “Kidney cancer is one of the hardest tumors to detect, because it doesn’t shed as much DNA as other tumors,” said Matthew Freedman, a medical oncologist at Dana-Farber and co-senior author of the report.

The test performs well because it can identify abnormal patterns in small amounts of tumor-shed DNA, Freedman added. “It’s a proof of principle that early stage disease is detectable.”

The test was nearly 100 percent accurate when used with blood samples to distinguish patients with kidney cancer from those known to be free of kidney cancer. The method achieves less accuracy in testing urine samples, but the researchers believe that performance can be improved. If the test is validated in larger trials and becomes widely applicable clinically, a urine sample would be even less invasive than a blood draw.

The testing method is known as cell-free methylated DNA immunoprecipitation and high-throughput sequencing, or cfMeDIP-seq. Where other liquid biopsy methods search for mutations in tumor-shed DNA that reveal the type and location of cancer, cfMeDIP-seq detects abnormal methylation — the addition of chemical tags to DNA, which doesn’t alter their genetic code but can affect their function.

The method was tested on samples from 99 patients with early and advanced kidney cancer, 15 patients with stage IV urothelial bladder cancer, and 28 healthy, cancer-free control subjects. In analyzing blood serum with the test, the study reported “near-perfect” classification of patients across all stages of kidney cancer. While urine-based classification was not as accurate, the study authors claimed that “performance can be improved through technical and computational optimization.”

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Co-first authors of the report are Pier Vitale Nuzzo, Jacob E. Berchuck, Keegan Korthauer, and Sandor Spisak.

This study was conducted with support from Rebecca and Nathan Milikowsky, the Claudia Adams Barr Program for Innovative Cancer Research, the H.L. Snyder Medical Research Foundation, the Dana-Farber/Harvard Cancer Center Kidney SPORE and Program, the Kohlberg Chair at Harvard Medical School and the Trust Family, Michael Brigham, and Loker Pinard Funds for Kidney Cancer Research at Dana-Farber Cancer Institute.

Though we use the term “blowfly” there are many different species with different growth charts and development timelines. Though adults are easy to tell apart, the maggots can look quite similar. Part of a forensic entomologist’s job is identifying which species the maggot belongs to and knowing how temperature and environment affects that growth. On average, though, the lifecycle of a blowfly goes through six stages. They are:

Blowflies often take a part in breaking down decomposing bodies and returning the nutrients back to the earth. It’s through their efforts that bodies decompose faster than they would otherwise.  Because of the specific life cycle of the blowflies, the time of death can be determined with fair level of certainty.   This is an important piece of information when investigating a death whether it’s an unattended death from natural causes, or when foul play is suspected.

Mosquito control spraying treatment is set to begin on Thursday in affected regions. People residing in affected areas are not required to relocate but urged to remain indoors to avoid exposure. The areas that are affected include the Dixon Landing Road to the north, North Milpitas Boulevard and North Abel Street to the east, Highway 237 and Bellew Drive to the west and North McCarthy Boulevard to the West, CBS reported. Locals will be informed if the treatment will be done in their area via door hangers, phone and email alerts through AlertSSC and social media.

The West Nile virus was originally discovered in 2003. More than 7,000 locals in the area have contracted the virus with 309 dying from it. There are no symptoms caused by the virus but may cause fever, headache and body aches. In extreme cases, the virus can leave people with severe neurological damage or death in some cases.

Similar to the coronavirus, the people at risk of contracting the West Nile virus are the ones aged over 50. People who also have some underlying medical condition such as diabetes, high blood pressure, cancer and kidney-related disease are also at risk of contracting the disease.

Based on the latest reports, it appears that the virus is already spreading with Elk Grove and Illinois revealing mosquitoes also testing positive in their areas. Officials from the Sacramento-Yolo Mosquito Vector Control District confirmed that their sample was taken from an area near Bond Road and Highway 99. The rise in cases is attributed to the warm weather, the time where the number of mosquitoes increase, CBS Sacramento reported.

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"It's important for residents to take these findings seriously and do everything they can to protect themselves," Gary Goodman, district manager, said.

In Illinois, the Des Plaines Valley Mosquito Abatement District collected a positive mosquito batch last May 31 from River Forest. The North Shore Mosquito Abatement District also collected a positive mosquito batch on June 5 in Evanston, KWQC reported.

No human cases have been reported so far but everyone is urged to take the necessary protective measures. This includes wearing insect repellent at all times. Locals are also urged to report dead birds and neglected pools.