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As COVID-19 cases surge, patients are dying at a lower rate. Here's why

Soumya Karlamangla, Los Angeles Times on

Published in News & Features

LOS ANGELES -- When the number of people being sent to the hospital with COVID-19 began to creep up in Los Angeles County early this summer, officials warned that a major increase in deaths was inevitable. A record-breaking number of cases could result in a record-breaking number of deaths, they predicted.

But nearly two months later, that has not materialized. The coronavirus continues to kill hundreds of people every week in L.A. County, but the death toll has remained lower than expected.

The trend is due in part to younger people falling sick, as well as better control over the disease's spread in high-risk settings, such as nursing homes. But doctors say there's another factor pushing up survival rates: better treatments.

"It was so grim in the beginning," said Dr. Armand Dorian, an ER physician and chief medical officer for Verdugo Hills Hospital at USC. "Now we actually have regimens of treatments that do help. ... Since the beginning, say, February to now, we've learned a lot."

The trends are not limited to L.A. County. In California, 3.6% of people diagnosed with COVID-19 between March and May died of the disease. Among those diagnosed between June 1 and Aug. 3, that figure dropped to 1.2%, according to a Times analysis of state data. Expanded testing, changing patient demographics and better patient care all played a role in that drop, experts say.

The statistic is what epidemiologists call the case-fatality rate: the number of deaths divided by the number of cases. This measures how deadly the disease is once people catch it -- the chance of surviving. While the pandemic remains bleak, the lowered case-fatality rate is a glimmer of progress, experts say.

 

The case-fatality rate exists alongside another statistic: the mortality rate -- deaths divided by the total population -- which reflects the spread of the disease within the population.

In an interview with Axios released last week, President Trump discounted the nation's mortality rate, which is worse than most other countries', while lauding its case-fatality rate, which is better than most countries'.

But an improved case-fatality rate cannot offset the vast spread of the deadly virus, experts say. California's mortality rate is rising as the state's death toll from COVID-19 surpassed 10,000 on Thursday. If many people keep falling ill, then many people will die, even with improvements in survival rates.

Dr. Tim Brewer, an infectious disease specialist and epidemiologist at UCLA, said that even the medical improvements could be negated if the number of patients continues to grow. An overwhelmed healthcare system could hamper physicians' ability to provide l lifesaving care, he said.

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