Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.
COVID-related hospitalizations are clearly falling. They’re down to 94,100, the lowest rate in a month, and down 8% in two weeks.
Ohio and Pennsylvania are the outliers in this trend. Both posted big increases in COVID-19 hospitalizations. This is The New York Times’ latest data table, which I set to show the national leaders in COVID-19 hospitalizations:
But hospitalization figures may not tell us what we need to know. As people get vaccinated, they tend not to get sick enough from COVID-19 infections to be hospitalized. And people who are hospitalized with COVID-19 infections now tend to be severely ill with other health issues. A fourth of the nation’s intensive care units remain more than 90% full. And a Kaiser Family Foundation study says we have already spent $5.7 billion on preventable hospitalizations from COVID-19.
Here’s more context about current infections in the United States:
- In Florida, one person dies from COVID-19 every four minutes, 352 people a day.
- In Texas, one person dies from COVID-19 every five minutes, 280 people a day.
- These two states account for one in three COVID-19 deaths in America now.
Don’t just focus on homicide figures, pandemic-era gunshot injuries may tell a clearer story
Keep in mind as you read these next few items today that gunshot victims who arrive alive at a U.S. trauma hospital tend not to die. For that reason, gunshot deaths are an important data point when reporting on crime, but injuries may be much more telling. And injuries from gunshots are rising fast. We have new estimates of costs to victims, hospitals and taxpayers.
Axios went beyond the usual reporting about America’s gun-related homicide rate to look at a different figure: gunshot injuries. During the pandemic lockdown, gunshot injuries reported by hospitals were way down, but they have made a comeback.
According to data compiled by the Epic Health Research Network, firearm injuries that resulted in a documented health care visit began spiking in the late spring of 2020 and peaked in October at 73% higher than the monthly average in 2018 and 2019.
The initial surge coincided with the early summer protests over police violence and with a massive increase in gun purchases.
Epic Health Research Network’s data involves “patients who sought care for at least one new firearm incident. Epic Health explains:
These data come from Cosmos, a HIPAA-Limited Data Set of more than 118 million patients from 136 Epic organizations including 705 hospitals and 12,172 clinics, serving patients in all 50 states.”
Epic Health breaks the data out in a few ways that may inform your reporting:
Firearm incidents increased for patients of all races and ages, as shown in Figure 2 and Figure 3 below, but the increase was not proportional across races. To smooth month-to-month variation, we calculated 5-month rolling averages and found that incidents increased for non-White populations by between 76% and 89% while they increased for the White population by 40%.
So much attention gets focused on young men and gun injuries (as it should), but look at the increasing incidents of gun injuries to young Black women.
The cost of a gunshot injury
MedPage just reported some new data around the cost of gunshot injuries. That study looked at how much treating gunshot injuries cost one hospital, MetroHealth Medical Center in Cleveland, Ohio. The report found:
Now, thanks to a pandemic-era jump in gun violence, the per-month cost is estimated to surpass $1 million.
Over a 27-month period ending in 2018, the total cost of patient treatment for gun-related injuries reached $18.1 million, reported Heather Vallier, MD, of MetroHealth Medical Center in Cleveland, and colleagues during a poster session at the American Academy of Orthopaedic Surgeons annual meeting.
Taxpayers will eat most of that cost because victims are often uninsured.
The Epic Health data that Axios used for its report reminded me of a series of projects some time back that tried to calculate the cost of a single gunshot injury. In 1997, research found that once you calculate quality of life costs and medical expenses:
The gunshot and cut/stab totals include U.S. $40 billion and U.S. $13 billion respectively in medical, public services, and work-loss costs. Across medically treated cases, costs average U.S. $154,000 per gunshot survivor and U.S. $12,000 per cut/stab survivor.
Johns Hopkins researchers provided an updated estimate in 2017 using data from more than 700,000 patients. That study found:
The average emergency department and inpatient charges annually were $5,254 and $95,887, respectively, resulting in approximately $2.8 billion in annual charges for the group studied.
More than half of patients in the study sample were uninsured or self-paying, which means they either bear the burden of the actual hospital charges, or these charges are unrecovered and add to the overall uncompensated care provided by hospitals and health care systems.
Mother Jones also tried to calculate the cost of gun injuries in 2019. That one relied on a study by PLOS One, which provides not just aggregate data but breaks it down to self-pay, Medicare, Medicaid and insured costs of care. That study of five years of data also included a curious tidbit that “about 1 in 7 gun violence survivors in that five-year period was readmitted to the hospital within six months,” which indicates that gunshot injuries cause lasting medical problems that need ongoing care.
All of that lands us with some new data from MedPage, which reports on that Cleveland hospital:
- 941 gunshot victims who were treated at the level-one trauma center.
- Mean age was 30, 79% were male, and 85% were African American.
- Just over 80% were admitted and 8% died.
- Sixteen percent were frequent gunshot victims, with either previous or subsequent gunshot wounds.
- The average cost for all gunshot wound patients amounted to $671,541 per month.
- One-third of the patients were uninsured and 55% were on Medicaid.
- Of the wounds, 37% were to the extremities (average cost $19,294)
- 23% of the wounds were to the skin/subcutaneous tissue ($4,331)
- 7% of the gunshot wounds were to the abdomen ($58,749),
- 7% to the chest ($3,424),
- 6% to the head or neck ($68,528), and
- 20% to two or more body regions (average costs of $22,202 for two regions and $23,056 for three).
The study explained:
Why is the chest wound cost so low? “The number of those patients is pretty small, and the costs of care are much lower since they often don’t require surgery and tend to have shorter hospital stays,” Vallier said.
Other patients can be easily treated as well, such as those with superficial gunshot wounds who can be sent home with pain medication and bandages after a tetanus shot, Vallier said.
“Unfortunately, a lot of people get shot more than once and in very tenuous places such as around their chest and abdomen,” she said. “Many need surgical care because of bleeding and broken bones that need to be stabilized. All of those things are very expensive.”
Think of that every time you do a story about a shooting where nobody died. Each one of those victims will cost thousands, maybe tens of thousands of dollars to treat. And in that Cleveland hospital, more than one in 10 of those victims had been shot before or would be back with additional wounds.
That is just the financial cost, to say nothing of the human cost, which is not tidy enough to calculate on a spreadsheet.
The secret of the Stradivarius revealed
Ars Technica published a story that says scientists are convinced that they now know why Stradivarius violins sound so sweet:
A recent paper published in the journal Angewandte Chemie confirms a theory dating back to 2006: the secret lies in the chemicals used to soak the wood, most notably borax, zinc, copper, alum, and lime water.
Then again, it may all be in our heads:
In fact, a 2012 double-blind study of 21 experienced violinists found that most of the subjects preferred playing the newer instruments; the Stradivarius ranked last in their preferences. Most of them couldn’t tell the difference between the old and new instruments, with no significant correlation between an instrument’s age and its monetary value.
Old Nashville joke: What’s the difference between a musician and pizzas? Pizzas can feed a family of four.
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