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Study of 17 million identifies crucial risk factors for coronavirus deaths

An analysis of more than 17 million people in England — the largest study of its kind, according to its authors — has pinpointed a bevy of factors that can raise a person’s chances of dying from COVID-19, the disease caused by the coronavirus.

The paper, published Wednesday in Nature, echoes reports from other countries that identify older people, men, racial and ethnic minorities, and those with underlying health conditions among the more vulnerable populations.

“This highlights a lot of what we already know about COVID-19,” said Uchechi Mitchell, a public health expert at the University of Illinois at Chicago who was not involved in the study. “But a lot of science is about repetition. The size of the study alone is a strength, and there is a need to continue documenting disparities.”

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The researchers mined a trove of data that included health records from about 40 percent of England’s population, collected by the United Kingdom’s National Health Service. Of 17,278,392 adults tracked over three months, 10,926 reportedly died of COVID-19 or COVID-19-related complications.

“A lot of previous work has focused on patients that present at hospital,” said Dr. Ben Goldacre of the University of Oxford, one of the authors on the study. “That’s useful and important, but we wanted to get a clear sense of the risks as an everyday person. Our starting pool is literally everybody.”

Goldacre’s team found that patients older than 80 were at least 20 times more likely to die from COVID-19 than those in their 50s and hundreds of times more likely to die than those below the age of 40. The scale of this relationship was “jaw-dropping,” Goldacre said.

Additionally, men stricken with the virus had a higher likelihood of dying than women of the same age. Medical conditions such as obesity, diabetes, severe asthma and compromised immunity were also linked to poor outcomes, in keeping with guidelines from the Centers for Disease Control and Prevention in the United States. And the researchers noted that a person’s chances of dying also tended to track with socioeconomic factors such as poverty.

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The data roughly mirror what has been observed around the world and are not necessarily surprising, said Avonne Connor, an epidemiologist at Johns Hopkins University who was not involved in the study. But seeing these patterns emerge in a staggeringly large data set “is astounding” and “adds another layer to depicting who is at risk” during this pandemic, Connor said.

Particularly compelling were the study’s findings on race and ethnicity, said Sharrelle Barber, an epidemiologist at Drexel University who was not involved in the study. Roughly 11 percent of the patients tracked by the analysis identified as nonwhite.

The researchers found that these individuals — particularly Black and South Asian people — were at higher risk of dying from COVID-19 than white patients.

An increasing number of reports have pointed to the pervasive social and structural inequities that are disproportionately burdening racial and ethnic minority groups around the world with the coronavirus’s worst effects.

New York Times

WHO director general pleads for united fight

GENEVA — World Health Organization Director General Tedros Adhanom Ghebreyesus pleaded Thursday for international unity to fight the pandemic devastating the world in the wake of President Trump’s announced intention to quit the organization.

With tears in his eyes, Tedros said the true enemy was not the virus itself but ‘‘the lack of leadership and solidarity at the global level and national levels.’’

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‘‘How difficult is it for humans to unite to fight a common enemy that’s killing people indiscriminately?’’ he asked at a briefing in Geneva. ‘‘Can’t we understand that the divisions or the cracks between us actually are to the advantage of the virus?’’

Tedros said that in most of the world, ‘‘the virus is not under control; it’s getting worse.’’ He pointed out that the health systems of some of the world’s wealthiest countries have been upended, whereas some nations of more modest means have had success at slowing the spread of the virus.

‘‘This once-in-a-century pandemic has hammered home a critical lesson: When it comes to health, our destinies are intertwined,’’ he said.

On Wednesday, the Trump administration began the process of withdrawing the United States — the organization’s biggest donor — from the WHO. The move is set to take effect in one year.

Trump’s move to quit the organization amid a pandemic has alarmed experts and put the United States at odds with its allies. But criticism of the WHO’s handling of the novel coronavirus has not been limited to the United States.

The organization, a specialized agency of the United Nations responsible for international public health, has been accused of downplaying the outbreak in its early days. Critics say its hesitation to recommend simple measures such as face masks added to a confused global response to the virus.

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More than 200 scientists from over 30 countries have signed a forthcoming paper urging the WHO to take more seriously the possibility that the virus is airborne, meaning that it can spread indoors through aerosols that linger in the air and is more infectious in smaller quantities than thought.

On Thursday, the organization conceded such transmission is possible. The WHO had described this form of transmission as rare and possibly insignificant.

But growing scientific and anecdotal evidence suggests this route may be important in spreading the virus.

In updated guidance documents, the agency also acknowledged unequivocally for the first time that the virus can be spread by people who do not have symptoms: “Infected people can transmit the virus both when they have symptoms and when they don’t have symptoms,” the agency said.

The WHO previously said asymptomatic transmission, while it may occur, was probably “very rare.”

Some experts said both revisions were long overdue and not as extensive as they had hoped.

“It is refreshing to see that WHO is now acknowledging that airborne transmission may occur, although it is clear that the evidence must clear a higher bar for this route compared to others,” Linsey Marr, an aerosol expert at Virginia Tech, said in an e-smail.

Tedros, a former Ethiopian government official and the first African to take the top position at WHO, also said Thursday that former Liberian president Ellen Johnson Sirleaf and former New Zealand prime minister Helen Clark will head a new panel tasked with giving “an honest assessment” of the global response to the coronavirus pandemic.

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Globe news services

Serbian officials ban gatherings after protests

BELGRADE — Serbian authorities on Thursday banned gatherings of more than 10 people in the capital, Belgrade, after two nights of violent clashes between police and thousands of demonstrators protesting coronavirus lockdown measures.

Serbia’s government crisis team said the restriction was intended to prevent the virus’ further spread following the clashes, where social distancing was barely observed and few people wore face masks.

In addition to limiting gatherings, businesses in closed spaces, such as cafes, shopping malls or shops, have been ordered to operate shorter hours.

“The health system in Belgrade is close to breaking up,” Serbian Prime Minister Ana Brnabic said. “That is why I can’t understand what we saw last night and the night before.”

More protests were expected Thursday as police beefed up their presence in the capital and around the downtown parliament building where the demonstrations usually start.

The clashes followed an announcement earlier this week from President Aleksandar Vucic that further lockdown measures were likely as the outbreak in the country was spiraling out of control, especially in Belgrade, where 80 percent of the new cases were recorded.

Associated Press