Coronavirus

New Evidence Suggests Better Treatment Is Contributing to Falling COVID-19 Fatality Rates

Even after adjusting for age and comorbidities, researchers in New York and England found large improvements in patient survival.

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The fatality rate among COVID-19 patients in the United States has fallen dramatically since last spring, from 6.1 percent in mid-May to 2.6 percent yesterday. That downward trend partly reflects a younger, healthier mix of patients, whose median age fell from 46 in May to 38 in August. But two new studies suggest that improvements in treatment also have helped reduce the case fatality rate.

Leora Horwitz and other researchers at NYU Langone Medical Center in New York City looked at outcomes for more than 5,000 hospitalized COVID-19 patients, taking into account age, sex, comorbidities, vital signs at admission, and the results of laboratory tests. Controlling for those variables, they found that the fatality rate fell from 25.6 percent in March to 7.6 percent in August—a 70 percent drop.

"Changes in demographics and severity of illness at presentation did not fully explain decreases in mortality seen over time," Horwitz and her collaborators note in the Journal of Hospital Medicine. "Even after risk adjustment for a variety of clinical and demographic factors, including severity of illness at presentation, mortality was significantly and progressively lower over the course of the study period."

Horwitz et al. acknowledge the possibility of "residual confounding," such as "a higher proportion of particularly frail patients admitted in earlier periods." But they note that "we observed declines across all age groups," which "mitigates this concern." They add that criteria for hospital admission may have changed during the study period, such that patients admitted later were less seriously ill. But they note that "our inclusion of several highly predictive clinical and laboratory results likely captured many aspects of disease severity."

A study scheduled to be published in the journal Critical Care Medicine found a similar improvement among COVID-19 patients in England. University of Exeter Medical School statistician John Dennis and several other researchers analyzed outcomes for nearly 15,000 patients who required critical care between March 1 and May 30. Adjusting for various potential confounding variables, they found "a sustained decrease in mortality risk" between the first week of April and the end of the study, amounting to a drop of 9 percent a week for patients in intensive care units and 11 percent a week for patients in high intensive units.

"Our analysis, using the largest available COVID-19 specific national critical care database, shows a substantial recent improvement in mortality for people admitted to critical care with COVID-19 in England, with markedly lower mortality in people admitted in mid-April and May compared to earlier in the pandemic," Dennis and his co-authors report. "Adjustment for all recorded patient level demographic and clinical features suggests this improvement does not reflect a change in patient demographics or comorbidities."

Dennis et al. say "possible causes" of declining mortality among English COVID-19 patients include "the introduction of effective treatments" and "a falling critical care burden." Horwitz et al. suggest several possible explanations for the trend they found in New York: "Incremental improvements in outcomes are likely a combination of increasing clinical experience, decreasing hospital volume, growing use of new pharmacologic treatments (such as systemic corticosteroids, remdesivir, and anticytokine treatments), nonpharmacologic treatments (such as placing the patient in the prone position, or proning, rather than on their back), earlier intervention, community awareness, and, potentially, lower viral load exposure from increased mask wearing and social distancing."

As far as treatments go, Horwitz told The New York Times, "We don't have a magic bullet cure, but we have…a lot of little things that add up." For example, "We understand better when people need to be on ventilators and when they don't, and what complications to watch for, like blood clots and kidney failure. We understand how to watch for oxygen levels even before patients are in the hospital, so we can bring them in earlier. And of course, we understand that steroids are helpful, and possibly some other medications."

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133 responses to “New Evidence Suggests Better Treatment Is Contributing to Falling COVID-19 Fatality Rates

  1. I would certainly hope so. It was a new virus. Doctors had to guess how to treat it initially. After 8 months of trial and error on tens of thousands of cases, it would be surprising if treatment results didn’t drastically improve.

    1. Tens of thousands? Have you not been watching the news? Try Tens of billions of cases… and just wait until the third wave hits us when teachers are forced to march to their deaths and become super-spreaders.

      1. We’ll be stacking dead bodies like cordwood.

        1. The dead will have to take turns STACKING THEMSELVES!!!!

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            1. The first or the second time?

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      2. For a teacher that is a very ignorant comment!
        Children do not get covid much, they carry LOW viral loads and in Europe have proven that they do not tend to infect teachers or others.

        Covid , except for the frail elderly ,is LESS deadly than the yearly flu……yet you are in panic mode. Pay more attention instead of letting the media alarm you.

        I imagine you are being paid to do nothing and think that is fine, most of the rest of us do not think it is fine!

        1. You’re either very good or very bad with sarcasm… I can’t quite tell.

          1. Everything he said is correct.

      3. “Tens of billions of cases…”? Really? On a planet with a human population of less than 10 billion?
        Is that you Joe Biden?

        1. Ha, I thought the tens of billions was a good clue I was making a joke, and figured the “death march” thing would really drive it home.
          /Shrug

    2. “New Evidence Suggests Better Treatment Is Contributing to Falling COVID-19 Fatality Rates”

      Well, duh.

      1. If they had used old evidence, the results would be sketchy.

        1. Dont trust a word that comes out of this lying coward mormons mouth.
          Burn in hell you goddamn piece of shit. Fuck mormons

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  2. I haven’t read the study, but it seems to disagree with a different study that attributed COVID death rates strongly to “dry tinder” in a population. That is, populations with lots of vulnerable people will see higher death rates. They supposedly predicted death rates solely on this metric, and matched historical rates pretty well.

    Above, the new study authors say that they controlled for this theory by observing that the decline in deaths seemed to match all age groups. The problem there is that “Dry Tinder” isn’t based on age- it is based on co-morbidities. It just so happens that co-morbidities are strongly correlated with age, but it doesn’t change the fact that those co-morbidities still exist in other age groups. And if COVID killed those people off, you would see broad declines in death rates.

    1. It is almost certainly both. One does not preclude the other.

    2. The low hanging fruit has been picked.

      1. Also viruses always evolve into less deadly strains over time. The really deadly mutations kill their hosts and don’t spread while the less deadly mutations do not and do spread. Over time that means the virus becomes less and less deadly.

        1. Don’t worry.

          They are already lining up COVID-20.

          https://sports.yahoo.com/covid-strain-could-coming-america-153755075.html

          1. Covid II Electric Bugaloo.

          2. Yeah, no shit it’s going to be like flu. And we should deal with it like the flu. Which means that most people don’t think about it or change anything about their lives, and vaccine makers do their best to make a vaccine that people can take if they want to and probably won’t be all that highly effective.

            1. Does anyone know how long an immunity lasts, after having gotten over the Chinaflu?
              Since vaccines rely on antibodies, produced in response to a weakened, or dead form of a virus, how long one is immune after recovery will be the benchmark for how often we will need to be vaccinated, to remain protected.

              1. Not sure, but I believe that, so far, there has been only one confirmed case in the United States of an individual being infected twice.

              2. T cell immunity. It’s purported to be long-lasting.

                Really though, the seroprevalence, T cell immunity conversation has been going on for months.

                I guess it’s no different than any other deeply buried, positive outlook regarding this virus.

              3. I had it at the end of March and I always use the same mask, but I reverse every time I wear it so I definitely get whatever’s in the air sucked down y windpipe. I also bite my nails without washing before and I smoke. Gross? No, it’s fucking great. And my immunity to the seasonal flu formerly known as Covid has never been better.

        2. But that’s true of pathogens that were very deadly to start with and did not have long incubation periods. You take something like rabies: very deadly but also long enough incubation period to allow presymptomatic and weakly-symptomatic spread; that hasn’t mutated into a milder form.

          SARS-CoV2, if it was ever very deadly, was so only in the first few human hosts. Regardless, it also has a long incubation period.

          1. CUJO!

    3. The story of co-morbidities is strongly exaggerated. The key health matter seems to be the overall strength of a patients immune function. While there are screen to estimate that strength semi-quantitatively, they are not tabulated in any systematic way. The strength of the immune response is the best explanation of correlation of death rates with age, but even that correlation is not very strong in industrialized countries with well developed health care systems.
      https://medrxiv.org/cgi/content/short/2020.09.30.20204990v1

      1. The inflammatory response you get from the various maladies that contribute to metabolic syndrome degrades the immune system and since inflammation is so high, the cytokine storm is much worse. So comorbidities definitely contribute to bad outcomes.

  3. Well damn, humans can learn.
    Whodathunkit?

  4. New Evidence Suggests Better Treatment Is Contributing to Falling COVID-19 Fatality Rates

    Next you’ll be telling us that Vancomycin is better at balancing humours than leech therapy.

  5. more people positive + less people dead = falling fatality rates

  6. Glenn Greenwald resigns from The Intercept (which he co-founded), because the editors censored his article critical of Joe Biden.

    1. Joe Biden is a crook.

    2. Look for a bUt bOtH SiDes!!! take from Reason staff any time.

      1. No. I’m sure REASON is in the Russian disinformation camp.

  7. Glenn Greenwald just quit The Intercept because they censored his article on Hunter Biden’s emails:

    https://twitter.com/ggreenwald/status/1321869227226222593

    1. This happened to former Reason contributor Glenn Reynolds as well, when he wrote about the emails and his USA Today editors were too scared to run it:

      https://pjmedia.com/instapundit/407934/

      1. White House Correspondent Emerald Robinson says that;
        “Corporate media outlets have been warned not to cover Tony Bobulinski & Hunter Biden’s laptop or they will be blacklisted by any future Biden/Harris Administration”.

        https://twitter.com/EmeraldRobinson/status/1321439391848562691

        1. I think the mystery of why Reason is ignoring the emails and Bobulinski has just been solved.

          1. ?? Since when has Reason ever had “access” to any administration? They have reported twice on it- in oblique ways. It says more that there was no business reason for them to ignore it, I guess.

            1. They never have. You are right. But, the reason staff would someday like to stop pretending to be Libertarian for a paycheck and go full Dave Weigal and live the dream of being employed by a publication that has access to the administration.

              1. And the cocktail parties. Don’t forget the cocktail parties, charity performances and gala luncheons for .

                1. Journalists never have the money to go to charity galas. You have to have a real job for that.

              2. Well, maybe 4 or 5 of the younger ones. I think the longer standing Reason staff are sincere, if a bit soft in some places, libertarians for the most part.

                1. Ron Bailey, of all people, obviously sold himself to judge from his last two articles.

            2. I was referring to the reasons presented in all three links. Not just the last.

              – Greenwald blames intense partisan political zealotry and a overwhelming desire to fit in.
              – Reynolds blames fear of ostracization.
              – Robinson blames DNC threats.

              1. AND they are all big Joe Biden fans.

                All the shit that Democrats do or partisans do for the Democrats Party and people still vote for Democrats.

                1. Slavery
                2. Started American Civil War
                3. Segregation
                4. Vote rigging and poll denial
                5. Drug war
                6. Progressivism
                7. Socialism/Communism
                8. Japanese-American Internment
                ….

                1. Meh, Republicans ain’t much better. There’s hardly a difference any more. I remember last election they started in with abortion debate. I couldn’t believe it – not one person gave a shit about fucking abortion – the economy was wrecked.

                  But that’s how they pretend they’re different. A fucking bortion. There’s no point in voting at all.

        2. Emerald Robinson is hot. Man is she hot.

          And that the media can be bullied like that shows that they just want to be a state run media.

          1. Candace Owens hot? Michelle Malkin 15 years ago hot?

    2. Unbelievable.

    3. Glenn Greenwald may the only leftist in existence who has actual integrity.
      Nobody at Reason does.

      1. Jimmy Dore?

        He’s not a very enlightened economist or anything, but he does (seem to) have integrity.

      2. Matt Taibbi

      3. I’ve always read Greenwalds shit. I appreciate anyone who fucks off authority. Sometimes his articles are promoting things I disagree with, but he seems to be pretty reasonable making his points.

    4. Whelp, I’m not surprised, but I don’t think this is going to end well for him. Leaving gives other journalist a reason to claim anything he reports on can be ignored.

    5. Greenwald should have quit journalism entirely after his #TrumpRussia denialism was proved wrong by the Mueller Report.

      1. You’re getting really good at the “brazen presentation of the opposite of the truth” Technique. Impressive.

        1. He’s like a crappy college lecture course. You’re almost always better off skipping it, but you know that about 5% of the time you’ll be sorry you did.

          1. Not bad socks, not bad at all.

  8. Anyone want to predict when covid-19 will be memory holed by the mainstream media and press if Harris-Biden is elected?

    Day of inauguration sounds right. Maybe they will call it Russian disinformation.

    1. I think that they want an eternal pandemic.
      The total societal control is just too delicious for the establishment left to give up.

      1. Yeah, I’m afraid this is the more likely outcome. I hope I’m wrong.

        1. The problem with an eternal pandemic is eventually you run out of everyone’s tax contributions.

      2. That’s definitely true. But come Inauguration Day they’ll have another falling sky for us to mock. The gig is up if trump is the one getting inaugurated.

    2. It’s their single best enabler. They can use it as an excuse to do anything, including completely and obviously unconstitutional stuff. No way will they just let it go.

    3. They’ll treat it like Reagan treated the Iran hostage crisis. Take all the credit for victory in January.

      1. There will be no victory in january or February at the peak of the flu season.
        You (and they) have seen nothing yet.

        1. Correct. What makes you think we won’t continue to see nothing? There’s only so many deaths from regular flu you can attribute to covid. They don’t even try to tell us about deaths anymore – this whole charade has been nothing. I do like the extra time spent with the kids tho.

    4. This is a possibility. The Dems need to revive the economy to pay off their constituents and shutting everything down again will make that impossible. When Jane Fonda said that the pandemic was a gift from God to the left, it became obvious what the game was.

      1. Most of us figured it out before Fonda said anything. Just like we all knew there was no real racism going on. The left needed black votes because trump was taking literally all of them before the BLM came around.

    5. Democrats have been trying to control things like they do under Kungflu protocols and it never happened until now.

      Harmless virus hysteria is the new Lefty go-to.

    1. The Left is now eating their own young.

      1. The respect I have for Greenwald just jumped to eleven.

        1. Yeah, he went up on my scale too.

          Normally, I detest liberal ‘thinkers’ because they are insincere. This guy truly and sincerely holds progressive beliefs. This, I respect.

  9. in other words it wasn’t Trumps fault all those people died it was the hospitals fault

    1. All those people? You mean the alleged 220,000 people? We don’t miss them, they were gonna die anyway. Shit we should be so lucky they’re not sucking our Medicare and social security dry. 220,000 is an unnoticeable amount of people. We could lose that many every year and never have a single complaint if there weren’t any lockdowns.

  10. They’re giving no credence to the hypothesis that the virus has developed less-lethal strains? This is the evolutionary path of most successful viruses (virii?), ref: the flu and the cold.

    But they aren’t much reporting on the news of lowering death rates, so I don’t think they’re gonna publicly float this possibility.

    1. There is certainly evidence of viral mutation but if that were the reason the changes in rates would be more consistent than they actually are.

      1. Rates have been highly time dependent in a manner that differs considerably from country to country.
        Almost uniformly the highest initial rates have been in countries with the most highly developed health care systems.

        1. There also seems to be some correlation with the BCG vaccine for tuberculosis causing lower COVID-19 rates. See September 6, 2020
          Politics Before Science
          By S. H. Chambers in http://www.libertyunbound.com/

        2. Explains Africa.

  11. So jamming incubation tubes down peoples throats with a near 90% death rate was probably bad?

    1. intubation…

    2. In fact the early treatments with ventilators were almost certainly too aggressive and cause significant lung damage.

    3. That was all part of Trump’s plan. These new treatments are part of Biden’s plan. Do you see now?

  12. Not a surprise at all. We’ve had 9 months for health systems all over the world to share what works and what doesn’t.

    But mortality RATE doesn’t negate the importance of mortality raw numbers. And we are at over 200K deaths now, heading to maybe 300K by the end of the year. Maybe more. Certainly more into the new year. Mortality rates usually decrease over time. Raw numbers just grow. Right now COVID is the number 3 cause of death in the US. Behind only heart disease and cancer. For a while in April it was number 1. We might get back there soon.

    1. Since you’re big into numbers, how many fingers am I holding up?

    2. But mortality RATE doesn’t negate the importance of mortality raw numbers. And we are at over 200K deaths now, heading to maybe 300K by the end of the year. Maybe more. Certainly more into the new year.

      Funny you mention that, because the Spanish Flu had both higher numbers AND a higher mortality rate.

      1. And a more accurate accounting of those numbers I’m sure…

    3. We might get back there soon.

      You can practically smell the thirst for suffering here. Progressives really are the world’s most miserable people.

    4. Right now COVID is the number 3 cause of death in the US.
      It hasn’t yet, even reached the yearly number of deaths from medical accidents ≈ 250,000.

      1. “Right now…”
        He picked 3:47:41 PM; hardly anyone else was dying.

    5. “We might get back there soon”.

      Well, we can only hope, eh jack?

  13. I am surprised to see that JesseAz and Don Nico seem to know that intubation was a death sentence in Covid patients.

    It was an eye-opener to us in my hospital that patients with extremely low O2 saturation‘s did not require intubation.

    I don’t know what new treatments they’re talking about, other than avoiding endotracheal intubation we are still using hydroxychloroquine and zinc, remdesivir Decadron, and convalescent serum.

    1. I am surprised to see that JesseAz and Don Nico seem to know that intubation was a death sentence in Covid patients.

      That came out way back in the early weeks of this global shitshow, it’s just that it took a while for hospitals to move past their instinct of putting people on a vent that had trouble breathing and just giving them oxygen. We don’t know if it was the venting that was specifically killing people, but the correlation was so high that they realized that if someone had to go on a vent, they were pretty much on death’s door anyway and let the patient and their families decide what to do.

      1. Yes it did. I very clearly remember thinking when Cuomo was blabbering about 30,000 ventilators he needed, that means he was expecting 25,000 deaths.

        Soon after he threw covid patients into nursing homes.

        He should write a book on how good he did.

      2. Low pressure CPAP like devices that also carried O2 seem to be the best treatment.

    2. I recall that it was back in April when it began to be reported from different centers around the word. It was a big surprise that these patients with low O2 sats did better without mechanical ventilation.

      It is proposed that the lungs in these patients are more compliant than in other conditions like ARDS. The pattern in radiology is “ground glass opacities” so some kind of gunk filling up the alveoli. It seems with this particular gunk higher pressures makes things worse in many cases.

      That and the high dose steroids is making a huge difference in survival.

      1. exactly.

    3. Intubation was not an automatic death sentence.
      However, the overly aggressive high pressure settings used were not consistent with the type of pneumonia induced by covid. Consequently, patient with damaged lungs were subjected to even great pulmonary damage.

      1. I would not put it that way. We are talking about the most critical patients who were treated with what was known at the time. In some it was found that less invasive methods improved outcomes. Still true that despite what is known this is a disease that despite heroic efforts can result in result in serious morbidity and mortality.

        This is a bad bug. Prevention is the goal.

    1. ^^^^ 1,000 TIMES THIS

  14. Falling death rates and still we are treated like rabid animals.

  15. I hope people will note that by taking actions the rate of infection was slowed and gave the medical establishment (doctors, nurses, etc.) the time to find better techniques for treatment. This has resulted in a lower death rate. Some have argued that the action taken only delayed the infection but that delay was important and the time was well used. Every day we delay the spread we get closer to a vaccine and we improve treatment.

    1. Perhaps, but in the UK the death rate was lowered by having ~12,000 deaths removed from the tally sheet. If you look at the rate of decline in the UK now, it is far faster than anywhere else in the world. Simply, it is not believable.

    2. Spot on as usual mod.

    3. You bet! Locke those people down!
      “As infectious disease epidemiologists and public health scientists we have grave concerns about the damaging physical and mental health impacts of the prevailing COVID-19 policies, and recommend an approach we call Focused Protection. ”
      https://gbdeclaration.org/

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  18. Good news? I don’t like the sound of that.

    Better lockdown and mask up. Just in case.

    Millions can still die.

    1. Over a million so far worldwide Rufus. In a very short time.

      1. 1/1000 of 1%!!!!!!!!!!!!!!!!!!!!!!!!!!
        Go crawl in a hole and stay there.

  19. I mean yes, probably, but you’d expect some decrease in mortality anyway. The most vulnerable are already dead or recovered. There’s evidence that degrees of partial resistance are conveyed by infection with other coronaviruses (4 of which are common colds) – mediated not by antibodies but t-cell familiarity and the like. So its a good chance at least some of the signal is driven by people with low partial resistance dying early, and leaving only people more resistant to Covid-19 for later in the pandemic. (This kind of thing is precisely why pandemics spike and then tail off).

    1. I follow COVID news closely. Rare surprises do occur. Today it’s Germany. Long touted as the standard bearer for dealing with COVID-19. After an extended “victory”, new cases are through the roof. When will they understand that this “novel” virus must run its course?

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  22. The CCP Flu has already claimed the most vulnerable,
    the ones succumbing now are either already ill or just
    an outright lie and they die from something else.

  23. This is a mass delusion constructed by the intelligence agencies. In May, a memo from the German Interior Ministry leaked that said the CDC’s “Epidemic Intelligence Service” advised the government to inflate death numbers – we have the documents (in German) that misleading statistics were and are official government policy. I urge reading the book “Corona: False Alarm” by Dr. Sucharit Bakhadi, one of the most cited physicians in German history.

    Here is the best article on how this mass delusion is constructed:
    https://theinfectiousmyth.com/book/CoronavirusPanic.pdf

    1. Actually, it was developed by Elvis’ alien love-child.
      Tin foil hats are a blue-light special on aisle #6.

  24. Want To Work From Home Without…READ MORE

  25. Fortunately, my friends and acquaintances helped me to get good psychological help, or panic attacks and so on started against the background of this pandemic. It was a real nightmare. At least then, my friends, who have already undergone a course of assistance, told me that you can even find good psychologists online at https://calmerry.com/ , so you should think about applying if you also have increased anxiety now. It is not surprising, but still. Because I hope that I can help with it. Good luck.

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