Covid-19 – Why does the death rate seem to be falling?
SportsIt seems to have become an article of faith for those who, for whatever reason, feel compelled to downplay the severity of the Covid-19 pandemic, which despite the apparent resurgence of the virus, is less threatening or less deadly this time around. around. While the number of cases is rising, they argue, any corresponding increase in the number of deaths has so far been negligible.
On the surface there would appear to be some evidence to support these claims. At the height of the first wave of infections, the United States saw 34,196 new cases in a single day and a pinnacle of 2,804 deaths. The second time around, daily cases peaked at 78,009, but “only” 1,504 deaths were recorded on the darkest day.
Testing increased massively
To begin with, these figures should be treated with some caution. Almost everywhere, testing has been ramped up massively since the first wave of infections triggered lockdowns across the Western world. The numbers we have only represent confirmed positive cases, and the virus was almost certainly substantially more prevalent in the US in April than it was in July. In most Western economies, at the start of the pandemic, testing was only done in hospitals, while the much larger number of infected people who were asymptomatic or had symptoms mild enough not to require hospital treatment were left to guess. . As such, the ratio of deaths to infections has not altered as markedly as the statistics seem to suggest.
Regardless, it is remarkable that at a time when thousands of people are still testing positive for the virus, the number of deaths has dropped to a surprisingly low point, especially perhaps in Europe. For most of June and July, daily deaths in Spain were in single figures, and here in the UK, the death figures remain similarly low, describing a tangible recent increase in transmission.
A more arrogant attitude
Received wisdom is that infections this time around appear to be more prevalent among younger people, particularly in the 20-29 age group. This would seem to make sense considering that younger people tend to interact more with each other, and also that very few people within this age group become seriously ill with the virus and therefore a more arrogant attitude can be expected. . But we have very little to compare it to. Since only people admitted to hospital were tested in March and April, we probably had very little idea how many people were carrying the virus, especially among the young.
Recent evidence from France and Spain is that a contagion that starts making the rounds among the young inevitably finds its way into older society after a while, followed by hospital admissions and, sadly, deaths. While deaths are thankfully nowhere near the levels we saw in the spring, these two countries have both seen significant increases, and the first stories of intensive care units nearing saturation have begun to emerge in Marseille. . In the UK, which always seems to be a few weeks behind continental Europe in these matters, an uptick in the number of hospital admissions and ventilator use has been noted in recent days.
Low survival rate
No doubt, as the pandemic has progressed, hospital staff have become more knowledgeable about how the virus works and more adept at treating patients. The gruesome process of intubation has most likely been used too enthusiastically for the first few months, and the introduction of CPAP technology has allowed many to avoid having to go through this experience with an unattractive survival rate. The successful use of remdesivir (mainly in the United States) and dexamethasone have had a positive impact in terms of reducing the duration of the disease and, in the latter case, preventing a significant number of deaths. These factors alone ensure that, as long as health services are not overwhelmed when future spikes occur, death rates should be statistically lower than in the spring.
Of course, life-saving treatments given to seriously ill patients only benefit those receiving hospital care. Its increased use is irrelevant to the question of whether fewer people with Covid-19 are actually hospitalized in the first place. If this is indeed the case (and we are too early in the last phase to say for sure), it may be due, at least in part, to the fact that the NHS has gotten better at assessing which patients need to be hospitalized after getting sick.
Is the virus getting less lethal?
All of this brings us to the final question, has there been any significant change in the nature of the virus that might have made it less deadly? On this matter, the jury is still out. There have been some tentative suggestions that a mutation has occurred that has produced a more contagious but less deadly strain of the virus. Paul Tambyah, a senior consultant at the National University Hospital of Singapore and president-elect of the International Society for Infectious Diseases, has argued that the emergence and proliferation of what has been called the D614G mutation in certain parts of the world has coincided with a reduction in deaths. .
It is certainly true that most viruses tend to become less virulent as they mutate. This helps them survive and move between hosts, something that is no longer possible once a fatality has occurred. However, the rising numbers of deaths in Spain and France seem to indicate that Covid-19 retains at least a good part of its lethal potential.