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Disaggregating Data to Measure Racial Disparities in COVID-19 Outcomes and Guide Community Response — Hawaii, March 1, 2020–February 28, 2021

Jennifer Rice Epstein, Media Relations Lead
Office Phone: 562-570-6818
Cell Phone: Jennifer.riceepstein@longbeach.gov

The Hawaii State Department of Health looked at detailed race data and identified important health disparities in COVID-19 cases and deaths. Pacific Islander populations had the highest percentage of COVID-19 cases and deaths among all racial subgroups. Researchers examined Native Hawaiian, Pacific Islander, and Asian race data in Hawaii to better understand COVID-19 cases and deaths within each population. They found that rates of cases and deaths were highest among Pacific Islander populations. Additionally, they found that among Asian populations, case rates were highest among the Filipino and Vietnamese populations. Using broad racial categories can hide important health disparities in specific communities. Collecting and analyzing more specific data on race helps better identify populations that are disproportionately impacted by COVID-19 and can inform how to more effectively address those disparities.

Post-Acute Sequelae of SARS-CoV-2 Infection Among Adults Aged ≥18 Years — Long Beach, California, April 1–December 10, 2020

CDC Media Relations
404-639-3286

Among people aged 18 years or older who had a positive COVID-19 test result, 1 out of 3 reported at least one COVID-19 symptom two months after their positive test result, with higher rates reported among people ages 40 years and older, females, people with pre-existing conditions, and people who are Black. Prioritizing groups at higher risk of post-COVID conditions for outreach and vaccination is necessary to prevent worsening of health disparities. The term “post-COVID conditions,” also known as long COVID, is used to describe the long-term symptoms that might be experienced weeks to months after primary infection with the virus that causes COVID-19. To identify trends in long COVID, the Long Beach (California) Department of Health and Human Services (LBDHHS) interviewed a random sample of 366 people ages 18 years and older who had received a positive COVID-19 test result from April 1–December 10, 2020. Of those interviewed, one-third reported at least one symptom two months after their positive test result, with higher rates among people ages 40–54 years, females, Black people, and those with pre-existing conditions. The largest percentages of people interviewed were 25- to 39-year-olds (39%), females (57%), and Hispanic/Latino people (66%). Reported symptoms included loss of taste (54.1%), abnormal/loss of sense of smell (50.3%), muscle/joint pain (51.4%), fatigue (48.4%), and headache (46.4%). Identifying groups disproportionately affected by long COVID can help to inform efforts to prioritize prevention and treatment strategies. These strategies include vaccination of groups at higher risk for long-term symptoms and access to testing and care. Continuing to monitor rates of long COVID in diverse populations will be critical to understanding and managing this condition.

Longitudinal Trends in Body Mass Index Before and During the COVID-19 Pandemic Among Persons Aged 2–19 Years — United States, 2018–2020

CDC Media Relations
404-639-3286

CDC authors found that children and adolescents experienced sharp increases in their rates of body mass index (BMI, kg/m²) change during the COVID-19 pandemic. Among more than 400,000 children and adolescents ages 2-19 years, the overall rate of BMI increase approximately doubled during the pandemic compared to a pre-pandemic period. Children who had overweight or obesity before the pandemic experienced higher rates of BMI increase and greater weight gain during the pandemic than children with healthy weight. BMI is a measurement that takes into account a person’s weight relative to height. Although children are expected to have increases in BMI as they grow, rapid increases can raise concerns over too much weight for health. Using data from IQVIA’s Ambulatory Electronic Medical Records database, CDC investigators compared longitudinal trends in BMI among a cohort of 432,302 children and adolescents ages 2–19 years before and during the COVID-19 pandemic (January 1, 2018–February 29, 2020 and March 1, 2020–November 30, 2020, respectively). Children’s overall rate of BMI increase nearly doubled during the pandemic compared to before the pandemic (from 0.052 kg/m² to 0.100 kg/m² per month). Children in all BMI categories except underweight had significant increases in their rates of BMI change. Children who had overweight or obesity before the pandemic experienced higher rates of increase in BMI than those with healthy weight. Younger school-aged children (ages 6–11) experienced higher rates of increase than other age groups. These findings underscore the importance of obesity prevention and weight management for all children during and following the COVID-19 pandemic, as well as during future public health emergencies. These efforts could include screening for BMI, food security, and social determinants of health by health care providers; increased access to evidence-based pediatric weight management programs; and state and community resources to facilitate healthy eating, physical activity, and chronic disease prevention.

Monitoring Incidence of COVID-19 Cases, Hospitalizations, and Deaths, by Vaccination Status — 13 U.S. Jurisdictions, April 4–July 17, 2021

CDC Media Relations
404-639-3286

Interim Estimates of COVID-19 Vaccine Effectiveness Against COVID-19–Associated Emergency Department or Urgent Care Clinic Encounters and Hospitalizations Among Adults During SARS-CoV-2 B.1.617.2 (Delta) Variant Predominance — Nine States, June–August 2021

CDC Media Relations
404-639-3286

Effectiveness of COVID-19 mRNA Vaccines Against COVID-19–Associated Hospitalization — Five Veterans Affairs Medical Centers, United States, February 1–August 6, 2021

CDC Media Relations
404-639-3286

New COVID-19 Cases and Hospitalizations Among Adults, by Vaccination Status — New York, May 3–July 25, 2021

CDC Media Relations
404-639-3286

• New COVID-19 Cases and Hospitalizations Among Adults, by Vaccination Status — New York, May 3–July 25, 2021

• Xylazine Detection and Involvement in Drug Overdose Deaths — United States, 2019

Xylazine has been detected in overdose deaths in 25 of 38 states examined. Xylazine, when mixed with an opioid, may increase risk of overdose death because naloxone is not effective in reversing the effects of xylazine, although naloxone should always be administered. Xylazine, a drug used in veterinary medicine as an animal sedative, acts as a central nervous system depressant in humans and can cause respiratory depression, slowed heart rate, and hypotension (low blood pressure). When mixed with opioids such as fentanyl or heroin, xylazine may increase sedation and respiratory depression, increasing the risk of a fatal overdose. In addition, because xylazine is not an opioid, it does not respond to naloxone. Therefore, if opioid products containing xylazine are used, naloxone may be less effective in fully reversing an overdose, although naloxone should always be administered. In 2019, xylazine, when detected in an overdose death, often contributed to the death (64.3% of cases) and almost always also involved fentanyl (98.7% of cases). Xylazine was detected in overdose deaths in 25 of 38 states that were examined. This recent emergence of xylazine in multiple jurisdictions is concerning and warrants continued surveillance to inform overdose response and prevention efforts given that naloxone administration may not be as effective when xylazine is mixed with opioids. As there is no pharmaceutical antidote for xylazine, immediate supportive care such as respiratory and cardiovascular support is especially critical.

• Xylazine, a Veterinary Tranquilizer, Identified as an Emerging Novel Substance in Drug Overdose Deaths — Connecticut, 2019–2020

Connecticut is experiencing a rising prevalence of xylazine-involved unintentional overdose deaths. Xylazine is a veterinary sedative not intended for human use. Between 2019 and July 2020, Connecticut saw an increase in unintentional drug overdose deaths with a lethal combination of fentanyl with xylazine, from 5.8% to 11.4% of cases. Recreational drugs like cocaine, heroin, and fentanyl are often mixed with agents such as xylazine to enhance drug effects and increase street value. Health care professionals should be aware that xylazine intoxication may require additional interventions and appropriate supportive measures due to enhanced toxic effects. However, because xylazine is often seen in combination with fentanyl and heroin, naloxone is still advisable for suspected intoxications to treat the effects of opioids. Surveillance efforts to track emerging substances could guide prevention initiatives and also help healthcare professionals treat patients in a more timely and effective manner. The combined effects of xylazine with recreational drugs needs further research to clarify adverse interactions and identify effective therapies.

• Age-Adjusted Death Rates for Cancer, by Urban-Rural Status and Sex — National Vital Statistics System, United States, 1999–2019

• Asthma Surveillance — United States, 2006–2018

Despite some improvements in asthma outcomes over time, the findings from this report indicate that disparities in asthma indicators persist by demographic characteristics, poverty level, and geographic location. The percentages of current asthma, asthma attacks, and emergency department/urgent care center visits, and the rate of asthma deaths differed by certain subpopulations and geographic locations. The percentage of asthma varied by state, with higher percentage in the Northeast than in the South and the West and higher percentage in small metropolitan statistical areas (MSAs) than in large MSAs. The percentage of asthma attacks differed by MSA category in some states. The percentage of emergency department/urgent care center visits was higher in the South and in large MSAs. The asthma death rate was higher in non-MSAs, specifically in noncore (rural) areas. The findings in this report provide insights that might help location-specific planning to direct public health resources, policy, and interventions to improve the health of people with asthma.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CDC works 24/7 protecting America’s health, safety and security. Whether diseases start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.