“It was just touch and go. Whatever they wanted to try, we said yes, just do it, ”said Wang’s daughter Anne Peterson. “We would give anything to get him back, but if what he and we went through would help future patients, that’s what we want.
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Patients are already benefiting from it. Although more deaths are expected this fall due to the recent surge in coronavirus infections in the United States and elsewhere, there are also signs that death rates are falling and people who contract the virus are doing well. better than those of the first months of the pandemic.
“One of the reasons we’re doing better is because of progress,” Dr. Francis Collins, director of the US National Institutes of Health, told The Associated Press. Several drugs have been found to be helpful and doctors know more about how to treat the sickest patients in hospitals, he said.
We are in the “stormy adolescence” phase to learn what treatments work – beyond infancy, but not “all have grown up either,” Collins said.
The terrible toll
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The nearly one million deaths attributed to the coronavirus in nine months are far more than the 690,000 due to AIDS or the 400,000 due to malaria in 2019. They are just behind the 1.5 million from tuberculosis.
Wealth and power have failed to protect rich countries from the terrible power of the virus. The United States “has been the worst affected country in the world” with more than 7 million coronavirus infections and more than 200,000 deaths, reflecting “the lack of success we have had in containing this epidemic”, Dr Anthony Fauci, the nation’s leading infectious disease specialist, told an audience at Harvard Medical School earlier this month.
More than 40 percent of American adults are at risk for serious illness from the virus due to high blood pressure and other conditions. It’s not just the elderly in nursing homes who are dying, Fauci said.
Dr Jesse Goodman, former chief scientist for the U.S. Food and Drug Administration now at Georgetown University, agreed.
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“No one should make a mistake about it” and think that they are not at risk just because they may not personally know someone who has passed away or who has not witnessed what is happening. the virus can do first-hand, he said.
Although cases are increasing, death rates appear to be dropping, said Dr Cyrus Shahpar, a former U.S. Centers for Disease Control and Prevention scientist with the nonprofit Resolve to Save Lives.
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The true lethality of the virus – the death rate from infection – is not yet known, as scientists do not know how many people have had it without showing symptoms. What is often reported are case fatality rates – the proportion of people who have tested positive and then died. Comparing them from country to country is problematic due to differences in screening and vulnerable populations. Tracking them in a country over time also carries this risk, but it may suggest certain trends.
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“The cumulative case fatality rate in the United States in April was about 5 percent. Now we’re about 3 percent, ”Shahpar said.
In England, researchers reported that case fatality rates had dropped significantly from peaking in April. The rate in August was around 1.5 percent compared to more than 6 percent six weeks earlier.
One reason is the changing demographics: nowadays, more cases involve younger people who are less likely to die from their infection than older people.
The increase in testing is also playing a role: As more people with mild symptoms or no symptoms are detected, it increases the number of known infections and reduces the proportion that turns out to be fatal, Shahpar said. .
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It is clear that the treatments also affect survival, many doctors have said. People who have died from COVID-19, especially those who have participated in studies, have helped reveal what the drugs help and do not help.
Dexamethasone and similar steroids are now known to improve survival when used in hospital patients who need supplemental oxygen, but could be harmful to less ill patients.
An antiviral drug, remdesivir, can speed recovery in critically ill patients, reducing the average hospital stay by four days. Two anti-inflammatory drugs, one used in combination with remdesivir – the drug Wang helped test – have also been reported to help, although the results of those studies have yet to be released.
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The jury is still out on convalescent plasma, which involves using antibody-rich blood from survivors to treat others. No large, high-quality study has tested it enough to know if it works.
The value of rigorous scientific studies to test treatments has become clear, Goodman said. “We certainly see what happens” when treatments are widely adopted without them, as hydroxychloroquine has been, he said. “It exposed many people to a potentially toxic drug” and delayed the search for effective drugs.
Besides drugs, “the case fatality rate improves over time as doctors are increasingly adept at caring for these very ill patients,” said Dr. Gary Gibbons, director of the US National Heart, Lung and Blood Institute.
In hospitals, doctors now know more about ways to avoid using respirators, such as keeping patients prone.
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“We learned how to position patients, how to use oxygen, how to manage fluids,” and hospitals increased their surge capacity and supplies, said Dr. Judith Currier, a physician at the University of California, Los Angeles , in a recent webinar hosted by the American Public Health Association and the US National Academy of Medicine.
The best way to avoid dying from the coronavirus is to avoid catching it, and experience has shown that the simple measures advocated by public health officials work.
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“Prevention is the most important step right now as we wait for a vaccine and improve treatment,” Goodman said.
Wearing a face mask, washing hands, separating at least 6 feet, and disinfecting surfaces “clearly has a positive effect” in reducing the spread, Fauci said.
If more people stick to common sense measures like closing bars, “we should improve our ability to deal with this” and prevent more deaths, Shahpar said. “It should take longer to reach the next million if that ever happens. “
© 2020 The Canadian Press