Covid-19 continues to kill nearly 1,000 Americans a day. But for those who develop dangerous cases of infection, advances in medical care and the growing experience of doctors improve the chances of survival.
Since the first case hit the US earlier this year, health professionals haven’t fumbled in the dark trying to better understand what drugs work – like steroids and blood thinners, and the antiviral drug remdesivir. The allocation of intensive medical resources has improved. And doctors have learned to stop ventilators in some patients, unlike many other serious respiratory illnesses.
Doctors and experts say improved medical tactics and earlier treatment will help improve outcomes for very sick patients, said Andrew Badley, head of the Mayo Clinic’s Covid Research Task Force.
“Health care is much better today than it was in February and March,” Badley said in an interview. “We have better and faster access to diagnosis. We know more about which drugs to use and which not. We have more experimental treatments available. All of these contribute to a possible improvement in mortality rates.”
One study looked at 4,689 Covid-19 hospital stays in New York from March to June and adjusted patient death rates based on factors such as age, race, obesity and possible underlying diseases. In the first half of March, the hospital death rate was 23%. By June it had fallen to 8%. The research has not yet been peer-reviewed, a process through which other experts examine the work.
Despite the increases, the US will soon suffer 200,000 deaths and tens of thousands of Americans are confirmed to be infected every day. The number of people killed by the disease still depends in large part on how many people are infected – the more people get sick, the more die. The Centers for Disease Control and Prevention have emphasized that for most people, a mask is still the best protection available from the virus. And experts warn that the virus is still very dangerous and can kill even seemingly healthy people.
“Despite these improvements, this is not a benign disease,” said Leora Horwitz, associate professor of population health and medicine at New York University’s Grossman School of Medicine, who conducted the New York study of Covid-19 hospitalizations. “This does not mean that the coronavirus is now a safe disease. It remains a very serious public health threat.”
The right number
Public health officials, epidemiologists, amateur watchers and others have watched the pandemic evolve and looked for ways to measure the virus’s lethality. Counting the deaths as a percentage of the larger population provides information on the extent of the pandemic. Excess mortality compares deaths with the expected mortality rate. However, neither method provides any indication of whether the virus will be more or less fatal to a person with a severe case.
Even looking at deaths by the number of confirmed cases can be misleading because, according to experts, the outcome largely depends on testing. When many mild or asymptomatic cases are recorded, death rates are lower. In Europe, for example, there is anecdotal evidence of a similar trend, although much of the lower death rate may be due to more cases in younger, healthier people. There are also more infections among young people in the United States.
“You need to understand who you are testing and what the real death toll is for that population,” said Aaron Glatt, chief infectious disease at Mount Sinai South Nassau Hospital.
There is even a hypothesis that public health measures such as wearing masks and distancing themselves may help reduce the amount of viruses that people become infected, leading to less severe cases since the body does not get it right away is overwhelmed with a large dose of virus.
“Although they do become infected with the virus, they may get a lower dose of the virus and therefore get sick less,” said Horwitz.
In New York, the first major U.S. city to be badly hit by the virus, doctors’ knowledge was limited as cases came to the emergency room this spring. There have been more than 27,000 confirmed and probable Covid-19 deaths in the city, most of them at the height of the outbreak in March and April.
As the outbreak spread to other parts of the country like Texas, healthcare workers had more time to prepare and learn what worked.
“We had a playbook, so to speak, before we even saw patients in Texas,” said Robert Hancock, president of the Texas College of Emergency Physicians. “We understand the things that are working with Covid at this point in time much better.”
Since March, doctors have learned valuable lessons not only about how to make sure hospitals don’t run out of beds and ventilators in the intensive care unit, but that laying a patient on their stomach, what is known as a prone position, can help . If patients are given steroids early and treated with blood thinners, it can also improve the prognosis.
“Now that we know we may need to start these patients on blood thinners and heparin pretty quickly, that helps,” said Diana L. Fite, president of the Texas Medical Association. “Many of these Covid deaths are due to blood clotting; the clots are ruining your organs.”
While there is still no cure for the coronavirus, all improvements in treatment and preventive measures taken together contribute to an improved prognosis for patients, Fite said. There have been at least 14,590 deaths from the virus in Texas, according to the Texas Department of Health.
“Even though these things aren’t cures, they help a small percentage do better,” Fite said. “You add more of these things together and you get an overall better result.”
(Except for the headline, this story was not edited by GossipMantri staff and published from a syndicated feed.)