COVID-19 death rates decline as treatments improve

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The percentage of people infected with the coronavirus who die from COVID-19 is declining in most states, a sign that the battle against the virus is entering a new phase.Across the country, that percentage – known as the case fatality rate – has been falling for weeks and in some states for months. It’s a promising indicator, but one that health experts warn is fraught with uncertainty.

In Arizona, about 5% of those who tested positive for the coronavirus at the end of May have died. The case fatality rate is now about half that figure. In California, the rate was 4% at the end of May and is now 1.6%. In April, 7.5% of those who tested positive in Minnesota died, a rate that fell to 2.7%, according to analysis of state data by The Hill.

Health experts have pointed out several reasons for the decline: Doctors are discovering better methods of treating sick people. People who contract the virus are now more likely to be younger than older people who are most likely to die. And more popular tests identify cases among those with little or no symptoms.

In the early days of the pandemic, as hospital wards filled up in places like New York and New Jersey, overwhelmed doctors and nurses put thousands of patients on ventilators. A huge percentage of these people never came out of the fans.

Today, according to some doctors, fewer patients are intubated and sicker patients are being treated with drugs like remdesivir and dexamethasone, treatments that can help reduce the risk of death.

Doctors also use more basic methods like pronation, in which patients lie on their stomachs. This method helps them access more of their lung capacity, thus avoiding the suffocation associated with the build-up of fluid caused by pneumonia.

“I think we are improving in dealing with COVID-19. The experience gained over the past few months by these people who have worked with incredible determination and energy in the intensive care units has made possible the people we may lose in March and April during the terrible epidemic of New York. be saved, ”Francis Collins, director of the National Institutes of Health, told The Hill in an interview. “It’s now easier to understand how to stop people from using ventilators, unless you absolutely have to because of all the complications that come with it.”

The main vectors of virus transmission have also changed. In March and April, outbreaks in assisted living facilities targeted the elderly who were more likely to suffer from the underlying conditions that led to the worst outcomes.

But as states report a smaller number of cases among the elderly, the number of cases among young people has increased dramatically. The average age of a coronavirus patient has been cut in half in some states.

“Young people tend to deal with this virus better, which is why we are seeing lower death and hospitalization rates,” said Scott Lindquist, Washington State epidemiologist for communicable diseases. Still, he said: “It is concerning that we are seeing an increase in the younger age group.

Health officials fear that a drop in the death rate could create a false sense of security in the face of an illness that can cause significant damage to the heart, lungs and other organs.

“We focused a lot on mortality, and one of the things I’ve really seen in theaters is that the morbidity, the disease that comes with it, is pretty serious. Even if they survive, the number of people with long-term health effects that can truly be crippling is being ignored by the media, ”said Celine Gounder, clinical researcher at the Grossman School of Medicine at the University of New York. York who practices at Bellevue Hospital. “Even in elite athletes, we have seen long-term effects on their breathing.”

The country’s increased screening capacity is also partly responsible for the decline in the case fatality rate. At the start of the pandemic, the lack of capacity meant that only the sickest patients – and therefore the most likely to die – were tested.

Now, hundreds of thousands of new tests are performed every day. While still not enough to allow health officials to contain the virus, these tests are finding more cases among those with few symptoms, the people most likely to survive.

But the case fatality rate has not declined evenly across the country. In Massachusetts, the rate remains just north of 7%. In New Jersey, the 8.4% death rate is still near its peak. Even in New Hampshire, which has never seen a massive spike in cases, 6% of those confirmed to have contracted the virus have died.

The United States remains behind much of the rest of the world in the fight against the coronavirus. More than 170,000 people in the United States have died from COVID-19, a higher death toll than any other nation.

Even taking population into account, the United States has lost more people than any but a handful of countries. Only Peru and Chile have lost larger percentages of their populations, and Brazil’s toll is almost equal to that of the United States.

“I’m really a lot more mindful of what’s happened to our death rate in the United States based on our overall population, and it’s still quite disturbing,” Collins said. “We are still losing 1,000 or more people a day, more than six weeks ago.”



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