New treatments reduce COVID-19 deaths
Though confirmed cases of coronavirus in Oklahoma rose by more than 22,000 in July, there were fewer deaths last month from COVID-19 than in April, when new cases numbered less than 3,000.
Multiple factors may be at work: Young people, who are l ess l i kely to suffer serious symptoms, accounted for a large portion of the cases in
July, while long-term care facilities have mostly stayed locked down to protect the vulnerable. Also, deaths lag diagnosis and hospitalizations, so the picture could worsen.
But local and national medical experts point to another reason: Treatments of the most serious cases have evolved quickly and are now saving many lives.
“People are walking out of the hospital that would have died in the early( days ),” Timothy Pehrson, president and CEO of Integris Health, said last week.
Admiral Brett Giroir, the U.S. assistant secretary of health, said on NBC's “Meet the Press” on Sunday, “We know that if you get COVID now, your chances of dying are incredibly less than they were in April because our healthcare providers know how to treat it better. We have effective therapies like Remdesivir and steroids, promising therapies l i ke i mmune plasma, and a vaccine really on the horizon.”
Dr. Kersey Winfree, chief medical officer at SSM Health St. Anthony, was among the physicians who spoke on a virtual roundtable last week about the stresses placed on hospitals with the recent surge in cases.
“On the positive side, I would say that our treatment options are widely expanded from what they were two months ago and we do see what I believe are better outcomes as it relates to the length of stay in the hospital and the number of patients that wind up needing ICU (intensive care unit) care,” he said.
“And I think that is based on our access to Remdesivir, what
we know about Decadron and COVID convalescent plasma as well. So with those intervention sat our readiness, I think we're having better results with regard to the patients that we do have in the hospital.”
Remdesivir is an antiviral drug that has been undergoing tests as a treatment for COVID-19. According to an article in the New England Journal of Medicine in May, “Remdesivir was superior to placebo in shortening the time to recovery in adults hospitalized with COVID-19 and evidence of lower respiratory tract infection.”
Decadron, or dexamethasone, a corticosteroid, “can be lifesaving for patients who are critically ill with COVID-19,” according to the World Health Organization.
“For patients on ventilators, the treatment was shown to reduce mortality by about one third, and for patients requiring only oxygen, mortality was cut by about one fifth, according to preliminary findings shared with WHO.”
Dr. DaleW.Bratzl er, Chief COVID Officer at the University of Oklahoma, said, “We have drugs that have been shown to reduce mortality, two of them in randomized trials — dexamethasone and Remdesivir.
“Rem des iv ir primarily shortened hospital stays and had a trend toward reduced death rates. Dexamethasone, a drug that has been around f o r e v e r , a c t u a l l y r e d u c e d death rates, particularly i n people sick enough to be on a ventilator.
“T h e n t h e r e ' s a l o t o f research around the monoclonal antibody drugs, those drugs that attack the immune system — Tocilizumab is one — where a large observation study showed a f airly dramatic reduction in mortality. These drugs work by blunting the immune responses to the virus, so the immune system doesn't attack the body.”
Deaths climbing
The number of deaths has been climbing in Oklahoma and nationally. There were 59 deaths in Oklahoma from July 24 through July 30, an increase of 51% from the week of July 17 through July 23, according to the Oklahoma State Department of Health. Nationally, death stopped 1,000 most days last week.
But they have not reached the levels seen early in the pandemic in relation to the number of cases.
According to reports from the state Health Department, new cases from April 1 through April 30 totaled 2,899. In that same period, there were 192 deaths.
From July 1 through July 31, new cases totaled 22,375; there were 152 deaths.
Oklahoma Health Commissioner said last week that Oklahoma's fatality rate “is about in the middle of the country as far as percentage.”
Frye said that was actually a success story given the state's high rates of obesity and other conditions that contribute to mortality among patients with COVID-19.
Hospitalizations reached new high sin July and the increases have strained the system, but doctors and administrators from local hospitals said last week that patients are experiencing better outcomes.
Pehrson, with Integris, said hospitals learned a lot in April and May during the “shutdown period.”
“That helped to save lives,” he said.
Typically, when a person is admitted suffering from
respiratory distress syndrome, “we vent them,” Pehrson said. “And that's actually what you don't want to do with a COVID patient. We didn't know that at the time.”
What they learned, he said, is “you put them prone, you put them on Remdesivir and convalescent plasma.” Responding to questions from The Oklahoman about the differences between treating the flu and COVID-19, Winfree, with SSM Health, said, “It's true there are similarities between COVID-19, influenza and other respiratory illnesses; however, there are many differences, as well.
“Medical experts have had generations to study influenza and its impact on the human body, and we also have a readily available vaccine. COVID-19 is so new that experts are in the beginning stages of this process and we are learning more each day.”
Health professionals early on abandoned the use of Hydroxy chloroquine, the malaria drug touted by President Donald Trump. Gov. Kevin Stitt and the state Health Department purchased about $2 million worth of the drug, also used to treat lupus, and stockpiled it.
Giroir, the U.S. assistant secretary of health, said Sunday on “Meet the Press,” “So, from a public health standpoint, at first Hydroxychloroquine looked very promising. There were not the definitive studies. At this point in time, there have been five randomized controlled, placebo controlled trials that do not show any benefit to Hydroxychloroquine. So, at this point in time, we don't recommend that as a treatment.”
“So, from a public health standpoint, at first Hydroxychloroquine looked very promising. There were not the definitive studies. At this point in time, there have been five randomized controlled, placebo controlled trials that do not show any benefit to Hydroxychloroquine. So, at this point in time, we don't recommend that as a treatment.”
Admiral Brett Giroir, U.S. assistant secretary of health