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The dropping COVID-19 death rate

Rising case counts have everyone worried, but there’s good news, too


A COVID-19 testing site at the OC Fairgrounds in Costa Mesa, Calif., on Monday Associated Press/Photo by Jae C. Hong

The dropping COVID-19 death rate

A winter surge in coronavirus infections has moved many governors to tighten restrictions and ask residents to adjust their Thanksgiving plans. But the rising case counts have overshadowed an important note of hope: The disease seems to have become less deadly.

The United States set daily records of new infections for four consecutive days last week, tallying 184,000 new cases on Friday, according to Johns Hopkins University. More cases translates to more fatalities. On Nov. 17, the Worldometer site counted 1,956 COVID-19 deaths in the United States, the most seen in a single day since May. But leading public health researcher Christopher Murray believes there’s some good news amid the recent spike. The head of the University of Washington’s Institute for Health Metrics and Evaluation told Reuters that his team’s research indicated a coronavirus infection had become one-third less likely to be fatal today than in March and April.

According to Murray, COVID-19 now kills about 0.6 percent of those infected, down from a high of 0.9 percent in the spring. That would mean the difference between 1,656 and 1,104 expected deaths among the 184,000 new cases announced on Friday, or 552 fewer deaths per day now than if the United States had that many daily infections in the spring.

The United Kingdom’s National Health Service shows a similar decline in mortality rates, as do researchers at the University of Pittsburgh.

“Without question, we’ve noticed a drop in mortality,” University of Pittsburgh physician Derek Angus told Nature in November. “All things being equal, patients have a better chance of getting out alive.”

The coronavirus’s fatality rate has been the subject of contentious debate. Theoretically, the formula is simple: Divide the number of COVID-19 deaths by the total number of cases. As of Wednesday, the Worldometer count showed more than 56 million worldwide cases and more than 1.3 million deaths, which would equal a death rate of 2.3 percent.

But many who contract the virus suffer no symptoms and aren’t included in official counts, so scientists can only estimate the infection fatality rate. The Institute for Health Metrics derived its estimate of 0.6 percent by studying data from more than 300 surveys and adjusting for age. “We know the risk is profoundly age-related,” Murray said. “For every one year of age, the risk of death increases by 9 percent.”

No one has discovered a single cause for the declining fatality rate. Murray pointed to better care and treatments as possible contributing factors. Doctors have experimented and discovered best practices for delivering oxygen to patients in respiratory distress. Blood thinners have proven effective in treating COVID-19 symptoms, as have generic steroids like dexamethasone.

News about better treatments has taken a back seat to worries about the spike in the number of cases and hospitalizations across the United States. North Dakota Gov. Doug Burgum, a Republican, announced new public health rules on Friday mandating residents wear masks inside. Schools will stay open, but all extracurricular activities, including sports, are halted until at least Dec. 14. Chicago announced a new stay-at-home advisory on Nov. 12, while California, Oregon, and Washington urged their residents to cancel travel plans.

Ted Dabrowski, president of the Illinois-based public policy research group Wirepoints, said political leaders must begin considering the lethality of COVID-19 when designing new restrictions. “As a public, we’re running scared because all we hear is this massive increase of cases,” Dabrowski said. “You’ll never hear the governor talk about how the fatality rate has collapsed, and that’s an important thing for people to know.”


John Dawson

John is a correspondent for WORLD. He is a graduate of the World Journalism Institute, the University of Texas at Austin, and previously wrote for The Birmingham News. John resides in Dallas, Texas.

@talkdawson

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KWA3903

This is such an important point! What everyone wants to know, of course, is: if I get infected what is the probability of survival? If you can't tell who has actually been infected, then there is no way to calculate this. Epidemiologists say the best guess comes from testing a population sample for evidence of infection. This was first done earlier this year at Stanford University and came up with a 0.2% figure. The median of 82 subsequent studies from around the world has confirmed this finding (October, 2020 Imprimis, J. Bhattacharya). My neighbors never seem to hear about this on their cable television or social media feeds. This article is a step in the right direction. Thank you, World. 

TIM MILLER

This is why the positivity rate is also important.

WomanComeHome

The CDC has said that if you include asymptomatics in the count, the fatality rate drops to 0.26%. That's a better figure to estimate how many cases actually exist: divide the deaths by .0026 and then you know how many are actually exposed or infected; and for every person with symptoms, there are two or three others with no symptoms. The reported case figures are useless. What should be reported coincident with cases are the record-high numbers of TESTS. Here in Oregon, for the last couple weeks there have been FREE curbside tests widely publicized in the local paper. So of course when it's offered free, more people will submit to a test, and testing figures shot up along with reported cases. It is not helpful if these factors are excluded from such articles as this one.

AlanE

A few thoughts on parts of this article:

“We know the risk is profoundly age-related,” Murray said. “For every one year of age, the risk of death increases by 9 percent.”

This quote is in serious need of some context. Nine percent greater than the previous year of age (exponential growth) or nine percent greater based off of some baseline (linear growth)? And, between ages what and what are we seeing the risk of death increasing by 9% per year? Surely not all ages. As it stands, the quote is useless as it leaves some important questions dangling. It's unclear if the omission originates in the source or in the citation.

No one has discovered a single cause for the declining fatality rate.

Well, yes, and probably because there is no single cause! Certainly, we would not want to begin with the assumption that there is (only) a single cause. Grammatically, this sentence could also be interpreted as no one has discovered any cause for the declining fatality rate, but I don't think that meaning is meant to be conveyed here.

“You’ll never hear the governor talk about how the fatality rate has collapsed, and that’s an important thing for people to know.”

Collapsed? Decreasing from 0.9% to 0.6% is a noteworthy decrease, but I think "collapsed" implies something more drastic than dropping from 0.9 to 0.6 (while allowing that both numbers are still rightly regarded as estimates). This is a nice example of manipulating public opinion by the use of language. Pick a word with a strong connotation, load it into a discussion, and observe how it splits public opinion on the issue. Meanwhile, no facts on the ground have changed--only people's perceptions.

ACA5905

I've analyzed and factored in data from CMS.gov regarding nursing home cases & deaths as well as of Nov 11.

2.89% of US cases have been in NH facilities  [294,438 ÷ 10,170,846]

27.3% of US deaths have been in NH facilities  [65,446 ÷ 239,590]

Thus (using rounded numbers), only 3% of COVID cases are in NH facilities but this accounts for a whopping 27% of US deaths.