By December 2022, China had ended its strict zero-COVID policy, which resulted in a wave of infections. A new analysis published in Emerging Infectious Diseases estimates that 1.41 million COVID-19 deaths occurred in the 35 days following the relaxation of China's policy.

The number comes from a model researchers in the US and Hong Kong developed using daily test positivity reports from the Chinese Center for Disease Control and Prevention (China CDC) sentinel household surveillance system from December 16, 2022, to January 19, 2023. Those numbers were paired with known data on vaccination numbers in China, infection fatality rates, vaccine effectiveness, and rates of immunity waning.

90% of population infected

According to the researchers, the sentinel surveillance report from China CDC suggests that roughly 90% of China’s population were infected during the study’s 35-day period. Based on the model, this would have caused 1.41 million deaths (95% credibility interval [CrI], 1.14 to 1.73) across China; 0.80 (95% CrI, 0.60 to 1.05) million of those deaths occurring among those 80 years and older.

China's official reports may underestimate the COVID-19 death toll by a factor of 17 (95% CrI 14 to 22), the authors said. The findings are in line with another model estimate published last week in JAMA Network Open, which suggested 1.87 million excess deaths within 2 months of the end of zero-COVID. China reported 60,000 excess deaths in December 2022.

The decision to relax China's zero-COVID policies without adequate measures to protect high-risk populations had severe consequences.

"The decision to relax China's zero-COVID policies without adequate measures to protect high-risk populations had severe consequences," the authors of the current study wrote. "Other countries prioritized vaccines for older age groups and other vulnerable populations, and many studies have indicated that targeting medical countermeasures and protective measures toward groups with high infection-fatality rates can be life and cost saving."

Yesterday in JAMA, researchers analyzed data from the Pennington Biomedical Research Center and Woman's Hospital in Baton Rouge, Louisiana, to show that more women exceeded the recommended gestational weight gain (GWG) during the pandemic.

The hospital, the largest in Louisiana, attended to 23,000 deliveries from March 2019 to March 2022. Of women included in the study, 38% were Black, 51.2% were white, and the mean maternal age was 28.9 years.

After the pandemic began, pregnant women were 3% to 7% more likely to exceed the recommended GWG, seen in 45.4% of pregnant women in 2021, at the peak of the pandemic, and 44.0% later in the pandemic. To compare, only 42.0% of women in 2019 exceeded weight-gain recommendations.

Women started pregnancy heavier later in pandemic

For women who delivered toward the end of the study period (March 13, 2021, to March 12, 2022) GWG mirrored prepandemic numbers, but women began pregnancy slightly heavier than before the pandemic. The average for starting weight was higher by 0.82 kilograms (roughly 2 pounds) compared to prepandemic weight.

"The pandemic had a wide-reaching impact, beyond the spread of the virus itself, and the resulting increase in gestational weight gain may present further indirect impacts of the virus into the future for women and babies," said Leanne Redman, MD, the associate executive director for scientific education at Pennington Biomedical and Professor of Reproductive Endocrinology & Women's Health, in a Pennington press release.

The resulting increase in gestational weight gain may present further indirect impacts of the virus into the future for women and babies.

Excessive GWG, even by 5 pounds, can lead to an increased risk for cardiovascular disease in mothers and increase the likelihood of lifelong obesity in the child.

In its latest arbovirus surveillance report, the Florida Department of Health (Florida Health) reported one more locally acquired dengue cases and a second infection involving eastern equine encephalitis (EEE) virus. The report covers the epidemiologic week ending August 26.

The dengue case is in Miami-Dade County, where most previous cases have been from. The new illness raises the total for the year to 16. Florida often reports sporadic local dengue infections, and Florida Health has noted that infected travelers can pass the virus to local mosquito populations.

In other mosquito-borne illness developments, Florida health reported its second EEE case of the year, which involves a person from Suwannee County, which is located in the north-central part of the state. The first EEE case of the year was reported in a patient from St Johns County, home to St Augustine. Florida typically reports one or two human EEE cases each year.