The chances of dying from COVID-19 have fallen precipitously since the pandemic began, according to two new peer-reviewed studies.
One study, from researchers at New York University's Grossman School of Medicine, found that the death rate has gone down substantially among
all age groups.
Patients treated by NYU's health system had a 25.6% chance of dying
when the pandemic began but that number has fallen to 7.6% in recent
weeks, according to the study, which will be published in the Journal
of Hospital Medicine next week.
The researchers identified multiple reasons for the drop, including
increased experience with the virus among health workers, lower
hospital capacity, the availability of new treatments, earlier
intervention, higher community awareness, and "lower viral load
exposure from increasing mask wearing and social distancing." The
researchers added that it is also possible that "earlier periods had a
more virulent circulating strain."
"Our findings suggest that while COVID-19 remains a terrible disease,
our efforts to improve treatment are probably working," co-author Leora Horwitz said in a statement. "Even in the absence of a silver-bullet treatment or vaccine, we are protecting more of our patients through a
host of small changes."
While the NYU study only looked at about 5,000 cases in a single health system in New York, another analysis by Bilal Mateen, a researcher at
the Alan Turing Institute in the United Kingdom similarly found that
the death rate has fallen about 20 percentage points since the pandemic began.
The study, which was released as a preprint before it is set to appear
in the journal Critical Care Medicine, looked at data from more than
20,000 hospitalizations in the UK.
"This trend remains after adjustment for patient demographics and comorbidities suggesting this improvement is not due to changing
patient characteristics," the analysis said. "Possible causes include
the introduction of effective treatments as part of clinical trials and
a falling critical care burden."
To be clear, the death rate is "still higher than many infectious
diseases, including the flu," Horwitz told NPR. And many patients still
have severe symptoms months after first testing positive. "It still has
the potential to be very harmful in terms of long-term consequences for
many people," she said.
Horwitz acknowledged that "people who are getting hospitalized now tend
to be younger" and have fewer health conditions but even when adjusted
for age and other diseases, the study found that the death rate among
older patients has dropped by about 18 percentage points.
"Clearly, there's been something [that's] gone on that's improved the
risk of individuals who go into these settings with COVID-19," Mateen
told the outlet.
Doctors who were not involved in the studies agreed that there were
numerous reasons for the drop.
Khalilah Gates, a critical care pulmonologist at Northwestern Memorial Hospital in Chicago, told NPR that patients in the early days of the
pandemic were put on ventilators and breathing machines and perhaps
offered enrollment into critical trials but "six-plus months into this,
we kind of have a rhythm, and so it has become an everyday standard
patient for us at this point in time."
Amesh Adalja, an infectious disease expert and emergency medicine
physician at the Johns Hopkins Center for Health Security, added that
doctors have also learned to quickly identify patients at risk of blood
clots or "cytokine storms," when the body's immune system attacks
itself.
"We know that when people are getting standardized treatment, it makes
it much easier to deal with the complications that occur because you
already have protocols in place," he said. "And that's definitely
what's happened in many hospitals around the country."
Mateen stressed that hospital capacity has been key in reducing the
death rate in the UK because when "staff are stretched, mistakes are
made."
"It's night and day to take care of someone with a disease you've never
seen before, than taking care of someone where you've seen hundreds,"
Horwitz told The Wall Street Journal. "It's also probably that the
hospitals are not overwhelmed, but that can change."
Indeed, the number of new cases in the United States hit a record high
of more than 77,000 on Thursday and hospitalizations hit record highs
in numerous states like Ohio, Iowa, Utah, and Oklahoma. Hospitals in
Utah, Wisconsin, Idaho, and others are already nearing full capacity.
As hospitals in hot spots are stretched thin, Horwitz stressed that
wearing a mask could mean the difference between life and death.
A study by researchers at the University of California, San Francisco
and Johns Hopkins Bloomberg School of Public Health published in the
Journal of General Internal Medicine found that masks may reduce the
amount of the virus the wearer is exposed to, "leading to higher rates
of mild or asymptomatic infection."
"Masks, depending on the material and design, filter out a majority of
viral particles, but not all," the study said. The researchers found
that in some cases, "if 80% of the population wears a moderately
effective mask, nearly half of the projected deaths over the next two
months could be prevented."
Countries that had high levels of mask-wearing before the pandemic have
fared better than other nations and subsequent resurgences have been
less deadly.
"The more virus you get into your body, the more sick you are likely to
get," said study co-author Monica Gandhi, an infectious disease expert
at UCSF.
"Masks can prevent many infections altogether, as was seen in health
care workers when we moved to universal masking. We're also saying that masks, which filter out a majority of viral particles, can lead to a
less severe infection if you do get one," said Gandhi. "If you get
infected, but have no symptoms – that's the best way you can ever get a virus."
The study compared outbreaks on two cruise ships in the winter. In
February, 18% of 634 people who tested positive aboard the Diamond
Princess cruise ship in Japan were asymptomatic. But a cruise ship in Argentina, where workers handed out surgical masks to all passengers
and N95 masks to all staff after the first passenger tested positive,
had an 81% asymptomatic rate among 128 people who tested positive.
Likewise, as hundreds of food processing plant workers died from the coronavirus, plants that distributed masks to workers saw high
asymptomatic rates. A seafood processing plant in Oregon and a Tyson
chicken processing plant in Arkansas had 95% asymptomatic rates among hundreds of infections after giving workers masks.
Gandhi said that public health agencies like the Centers for Disease
Control and Prevention should stress these findings along with the
current messaging that wearing a mask prevents asymptomatic people from spreading the virus to others.
"We messaged that mask wearing will protect other people, and that did
not seem to convince our country as much as we would have hoped," she
said. "If you think something's going to help you or your family, you
are going to do it more than if you think you're helping others."
On 10/26/20 8:05 PM, Ubiquitous wrote:
The chances of dying from COVID-19 have fallen precipitously since the
pandemic began, according to two new peer-reviewed studies.
One study, from researchers at New York University's Grossman School of
Medicine, found that the death rate has gone down substantially among
all age groups.
Patients treated by NYU's health system had a 25.6% chance of dying
when the pandemic began but that number has fallen to 7.6% in recent
weeks, according to the study, which will be published in the Journal
of Hospital Medicine next week.
The researchers identified multiple reasons for the drop, including
increased experience with the virus among health workers, lower
hospital capacity, the availability of new treatments, earlier
intervention, higher community awareness, and "lower viral load
exposure from increasing mask wearing and social distancing." The
researchers added that it is also possible that "earlier periods had a
more virulent circulating strain."
"Our findings suggest that while COVID-19 remains a terrible disease,
our efforts to improve treatment are probably working," co-author Leora
Horwitz said in a statement. "Even in the absence of a silver-bullet
treatment or vaccine, we are protecting more of our patients through a
host of small changes."
While the NYU study only looked at about 5,000 cases in a single health
system in New York, another analysis by Bilal Mateen, a researcher at
the Alan Turing Institute in the United Kingdom similarly found that
the death rate has fallen about 20 percentage points since the pandemic
began.
The study, which was released as a preprint before it is set to appear
in the journal Critical Care Medicine, looked at data from more than
20,000 hospitalizations in the UK.
"This trend remains after adjustment for patient demographics and
comorbidities suggesting this improvement is not due to changing
patient characteristics," the analysis said. "Possible causes include
the introduction of effective treatments as part of clinical trials and
a falling critical care burden."
To be clear, the death rate is "still higher than many infectious
diseases, including the flu," Horwitz told NPR. And many patients still
have severe symptoms months after first testing positive. "It still has
the potential to be very harmful in terms of long-term consequences for
many people," she said.
Horwitz acknowledged that "people who are getting hospitalized now tend
to be younger" and have fewer health conditions but even when adjusted
for age and other diseases, the study found that the death rate among
older patients has dropped by about 18 percentage points.
"Clearly, there's been something [that's] gone on that's improved the
risk of individuals who go into these settings with COVID-19," Mateen
told the outlet.
Doctors who were not involved in the studies agreed that there were
numerous reasons for the drop.
Khalilah Gates, a critical care pulmonologist at Northwestern Memorial
Hospital in Chicago, told NPR that patients in the early days of the
pandemic were put on ventilators and breathing machines and perhaps
offered enrollment into critical trials but "six-plus months into this,
we kind of have a rhythm, and so it has become an everyday standard
patient for us at this point in time."
Amesh Adalja, an infectious disease expert and emergency medicine
physician at the Johns Hopkins Center for Health Security, added that
doctors have also learned to quickly identify patients at risk of blood
clots or "cytokine storms," when the body's immune system attacks
itself.
"We know that when people are getting standardized treatment, it makes
it much easier to deal with the complications that occur because you
already have protocols in place," he said. "And that's definitely
what's happened in many hospitals around the country."
Mateen stressed that hospital capacity has been key in reducing the
death rate in the UK because when "staff are stretched, mistakes are
made."
"It's night and day to take care of someone with a disease you've never
seen before, than taking care of someone where you've seen hundreds,"
Horwitz told The Wall Street Journal. "It's also probably that the
hospitals are not overwhelmed, but that can change."
Indeed, the number of new cases in the United States hit a record high
of more than 77,000 on Thursday and hospitalizations hit record highs
in numerous states like Ohio, Iowa, Utah, and Oklahoma. Hospitals in
Utah, Wisconsin, Idaho, and others are already nearing full capacity.
As hospitals in hot spots are stretched thin, Horwitz stressed that
wearing a mask could mean the difference between life and death.
A study by researchers at the University of California, San Francisco
and Johns Hopkins Bloomberg School of Public Health published in the
Journal of General Internal Medicine found that masks may reduce the
amount of the virus the wearer is exposed to, "leading to higher rates
of mild or asymptomatic infection."
"Masks, depending on the material and design, filter out a majority of
viral particles, but not all," the study said. The researchers found
that in some cases, "if 80% of the population wears a moderately
effective mask, nearly half of the projected deaths over the next two
months could be prevented."
Countries that had high levels of mask-wearing before the pandemic have
fared better than other nations and subsequent resurgences have been
less deadly.
"The more virus you get into your body, the more sick you are likely to
get," said study co-author Monica Gandhi, an infectious disease expert
at UCSF.
"Masks can prevent many infections altogether, as was seen in health
care workers when we moved to universal masking. We're also saying that
masks, which filter out a majority of viral particles, can lead to a
less severe infection if you do get one," said Gandhi. "If you get
infected, but have no symptoms – that's the best way you can ever get a
virus."
The study compared outbreaks on two cruise ships in the winter. In
February, 18% of 634 people who tested positive aboard the Diamond
Princess cruise ship in Japan were asymptomatic. But a cruise ship in
Argentina, where workers handed out surgical masks to all passengers
and N95 masks to all staff after the first passenger tested positive,
had an 81% asymptomatic rate among 128 people who tested positive.
Likewise, as hundreds of food processing plant workers died from the
coronavirus, plants that distributed masks to workers saw high
asymptomatic rates. A seafood processing plant in Oregon and a Tyson
chicken processing plant in Arkansas had 95% asymptomatic rates among
hundreds of infections after giving workers masks.
Gandhi said that public health agencies like the Centers for Disease
Control and Prevention should stress these findings along with the
current messaging that wearing a mask prevents asymptomatic people from
spreading the virus to others.
"We messaged that mask wearing will protect other people, and that did
not seem to convince our country as much as we would have hoped," she
said. "If you think something's going to help you or your family, you
are going to do it more than if you think you're helping others."
Based upon this, it may be time for me to reevaluate my position on masks.
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