Diminishing COVID-19 death rate sparks hope

The enemy is always fear. Something new and unknown throws us off balance and creates fear, but in time we should learn to cope, adopt and even flourish.

The world is reporting 32 million COVID-19 infections out of which three percent or 981,899 have died, while 24 million recovered. The US, with a population of 331 million; and Brazil, with a population of 213 million, both have two percent infected.

To compare, the Philippines have .3 percent of our approximately 110 million people infected. Of course, we can counter that it is because we are so far behind in testing. But even if we multiply that 10 times, which is almost like how we compare for testing per one million people, then it will only be 3 percent. What is interesting to note is that out of the numbers infected, 2.9 percent did not survive the disease in the US compared to 1.7 percent here.

If you think about it, the cases of dengue fever globally is much larger than COVID-19. It is reported that as high as 100 million dengue cases occur worldwide annually. A hefty 70 percent or 70 million was recorded in Asia.

Yes, time has given the medical community the advantage of research and development for dengue infection management and cure. And that’s what’s happening with COVID-19. There is a global mad rush to understand the disease and improve care and management.

In one of my many talks with the officers of the Philippine Medical Association (I have a project with them, which I will write about soon), I learned that almost 80 percent of their colleagues in active duty, who passed away due to the disease, did so in the early months of the pandemic. The sheer number of cases gave the medical community the experience and understanding to prevent COVID-19 deaths.

Worldwide, mortality rates and the need for ICUs have greatly decreased compared to the first two months of the global pandemic. Different hospitals have varying data but a range of 20 percent to 50 percent of reduction in mortality rate has been tallied. While early patients have been treated with little experience and knowledge about COVID-19, by now medical management is almost routine.

Last June, a major research study in the United Kingdom led by the University of Oxford claimed that using steroids such as dexamethasone reduces death by up to one third in severely ill hospitalized patients. The British government has since authorized the drug’s use across the country.

In the study, the drug was administered either orally or through an IV for 10 days. The result showed a 35-percent reduction in deaths in patients with breathing machines and 20 percent in patients needing supplemental oxygen.

US virus expert Dr. Anthony Fauci welcomed the great news, but he explained in an interview why it only helps more serious cases.

Dr. Fauci said that in the early stages of fighting the virus, the immune system should be as intact as possible and the use of steroids can slow down clearing the virus. However, at an advanced stage when the virus causes too much inflammation, the use of steroids makes perfect sense.

While the Oxford research talked only about dexamethasone, experts believe that two other steroids (prednisolone and hydrocortisone) will likewise work. While steroids have known side effects, the research only used and prescribed a low dose for a short period of time, which is generally considered safe.

This good news adds to the only other known drug that works, Remdesivir from Gilead Sciences, which is known to block an enzyme the virus uses to copy its genetic material. The drug has shortened recovery time for severely ill hospitalized patients to 11 days compared to an average of 15 days for those getting usual care.

During the first few months of the pandemic, governments were scrambling for ventilators. Now, it is believed that intubation may not be required and may even lead to complications that actually decrease chances of survival. Patients are asked to lie down on their stomachs to allow more oxygen into the lungs.

Physicians have also realized that the disease may thicken a patient’s blood resulting in blood clots that can cause strokes and heart attacks. It is estimated that as much as 40 percent of COVID-19 deaths are caused by this, which is now prevented by administering anticoagulants.

The generous sharing of observation, insights and experiences among doctors and scientists all around the world is credited for the improvement in COVID-19 disease management and care.

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