The nearly 1 million people around the world who lost their lives to COVID-19 have left us a gift: Through desperate efforts to save their lives, scientists now better understand how to treat and prevent the disease – and Millions of others can survive.
71-year-old Ming Wang and his wife were on a cruise from Australia on hiatus after running the family’s Chinese restaurant in Papillion, Nebraska, for decades when he was infected. In the 74 days that he was hospitalized before his death in June, doctors desperately tried various experimental approaches, including being included in a study of an antiviral drug that ultimately showed promise.
“It was just touching and walking. Anything they wanted to try, we said yes, do it, ”said Wang̵
Patients are already benefiting. Although more deaths are expected this fall due to the recent surge in coronavirus infections in the US and elsewhere, there are also signs that death rates are falling and that the people who get the virus are doing better than they were in the first few years Months of the pandemic.
“Some of the reasons we’re doing better is because we’re making progress,” said Dr. Francis Collins, director of the US National Institutes of Health, told The Associated Press. Several drugs have proven useful and doctors know more about how to care for the sickest patients in hospitals, he said.
We’re in the “stormy youth” phase where we’re learning which treatments work – beyond childhood, but not “all of them, too,” said Collins.
The terrible toll
The nearly 1 million deaths attributed to coronavirus in nine months are far more than the 690,000 from AIDS or the 400,000 from malaria in all of 2019. They are just below the 1.5 million from tuberculosis.
Wealth and power did not protect the rich countries from the terrible power of the virus. The United States “was the hardest hit country in the world” with more than 7 million coronavirus infections and more than 200,000 deaths. This reflects “the lack of success we have had in containing this outbreak,” said Dr. Anthony Fauci, the best infectious disease specialist in the country, told a Harvard Medical School audience earlier this month.
More than 40% of adults in the US are at risk of serious illness from the virus due to high blood pressure and other medical conditions. It is not just old people in nursing homes who are dying, Fauci emphasized.
Dr. Jesse Goodman, a former chief scientist in the US Food and Drug Administration at Georgetown University, agreed.
“Nobody should go wrong” thinking they might not be at risk just because they might not personally know someone who died or didn’t see what the virus can do firsthand, he said.
Although cases are rising, death rates appear to be falling, said Dr. Cyrus Shahpar, a former scientist with the US Centers for Disease Control and Prevention who now works for the nonprofit group Resolve to Save Lives.
The true lethality of the virus – the infectious death rate – is not yet known because scientists don’t know how many people had it without showing symptoms. What is often reported is death – the percentage of people who tested positive and then died. Comparing these from country to country is problematic due to different tests and vulnerable populations. Tracking these values within a country over time also carries this risk, but it can indicate some trends.
“The cumulative death rate in the United States in April was around 5%. Now we’re around 3%, ”said Shahpar.
In England, researchers reported that the death rate has fallen significantly since the peak in April. The rate in August was 1.5%, down from over 6% six weeks earlier.
One reason is demographic change: Today, there are more cases among younger people who are less likely to die from an infection than older people.
Increasing testing also plays a role: the more people detected with mild or no symptoms, the more known infections there are, and the proportion that turns out to be fatal decreases, Shahpar said.
It’s clear treatments also affect survival, many doctors said. People who have died from COVID-19, especially those who participated in studies, have helped uncover what drugs do and don’t do.
Dexamethasone and similar steroids are known to improve survival when used in hospitalized patients who need supplemental oxygen but can be harmful to less ill patients.
An antiviral drug, remdesivir, can speed recovery for critically ill patients and shave four days before the average hospital stay. Two anti-inflammatory drugs, one in combination with remdesivir – the drug Wang tested – have also been reported to help, although the results of these studies have not yet been published.
The jury is still not preoccupied with convalescent plasma, which uses antibody-rich blood from survivors to treat others. No large, high quality studies have tested this well enough to know if it works.
The value of rigorous scientific studies to test treatments has become clear, Goodman said. “We’ll definitely see what happens” when treatments without them become widespread, like hydroxychloroquine was, he said. “It exposed many people to a potentially toxic drug” and delayed the search for an effective one.
Drugs aside, “the death rate actually improves over time as doctors take better care of these very sick patients,” said Dr. Gary Gibbons, director of the US National Heart, Lung and Blood Institute.
In hospitals, doctors now know more about how to avoid the use of breathing equipment, such as breathing apparatus. B. To hold the patient on their stomach.
“We learned how to position patients, how to use oxygen, how to handle fluids,” and hospitals have increased their surge capacity and supply, said Dr. Judith Currier, a doctor at the University of California at Los Angeles, at a recent webinar organized by the American Public Health Association and the US National Academy of Medicine.
The best way to avoid dying from the coronavirus is not to get it, and experience has shown that the simple measures advocated by public health officials work.
“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, staying at least 3 meters away, and disinfecting surfaces “are clearly beneficial in reducing the spread,” Fauci said.
If more people adhere to sensible measures like closing bars, “we should improve our ability to handle this” and prevent more deaths, Shahpar said. “It should take longer to hit the next million if it ever happens.”
Marilynn Marchione can be followed on Twitter at http://twitter.com/MMarchioneAP
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