COVID-19: Why death rates are improving

The sickest coronavirus patients can live for weeks with a gripping headache, profound nausea, burning lungs, malaise, cough and waves of pain in their bones. They may be tethered to a breathing machine. But eight months into the pandemic, fewer are dying.

New data reveals that while patients are still being rushed to intensive care units, a greater proportion are coming out alive. Since the pandemic began, the cumulative death rate for Californians with COVID-19 has fallen by more than half in the past three months. In early June, it was 5.87%; bySept.13,itwasdownto 2.14%.

Some of the decline simply reflects a shift in testing, as infections in younger and healthier people are diagnosed. But that doesn’t explain all of it. There also have been fundamental improvements in how we prepare and care for the sickest patients, according to interviews with top medical experts.

“These declines in the case fatality ratios are striking,” said Dr. George Lemp, an epidemiologist and former director of the HIV/ AIDS Research Program at UC’s Office of the President, who analyzed death rates using state data.

When the pandemic first hit, only people with severe symptoms were tested. Now expanded testing is detecting milder and earlier cases, so the prognosis is better, said UCSF epidemiologist Dr. George Rutherford. We’re also diagnosing more infections in younger people, who fare better. Early on, we focused a lot of testing on outbreaks in nursing care facilities, where the sick and elderly face slimmer odds of survival.