Why COVID-19 death rates have declined despite fresh waves of infections

Why COVID-19 death rates have declined despite fresh waves of infections
More than 1,000 people were dying every single day in the UK during the pandemic’s April peak. (AFP)
Short Url
Updated 05 November 2020

Why COVID-19 death rates have declined despite fresh waves of infections

Why COVID-19 death rates have declined despite fresh waves of infections
  • Medical advances mean fewer people are succumbing to the coronavirus relative to new confirmed cases
  • As a second wave forces many countries return to lockdown, experts urge continuation of precautionary measures

LONDON: Western countries are in the grip of a second coronavirus wave which has defied even the most pessimistic forecasts in its speed and ferocity. It has progressed faster than the British government’s worst-case predictions, while in the US — still the world’s worst affected country — almost 100,000 new cases were recently posted in just one day.

The story is the same throughout much of Europe and elsewhere: record COVID-19 infection rates and hospitals stretched to the absolute limit.

For many, the coming winter brings a sense of deja vu, as national, regional and citywide lockdowns force people back inside their homes and away from their loved ones for the second time this year.

But while the pandemic grinds on, observers have noticed a fundamental difference between this surge and the numbers when the virus first emerged. Currently, the number of people dying is not keeping pace with new infection cases.

More than 1,000 people were dying every single day in the UK during the pandemic’s April peak. Now, a smaller number — around 300 daily deaths — are being clocked compared with the bleak early months. Tragic, yes, but notably better.

So, why the disparity? The answer provides a sliver of optimism even as hopes of a swift vaccine breakthrough fade. Dr. Stacey Rizza, an infectious disease expert at the US-based Mayo Clinic, told Arab News there is not “one single answer” as to why the disease appears to be less deadly this time around — but it is certainly not because the virus itself is any different.

“We are not, and never will be again, where we were in March,” she said. “Back in March we did not have a clear understanding of how COVID-19 was transmitted, so the most appropriate approach was just to lock everybody in their houses.




Remdesivir — the drug touted by US President Donald Trump as instrumental in his own COVID-19 recovery — is one example of existing medicines doctors are now throwing at the virus. (AFP)

“We now know that this is a droplet-mediated infection, and know that wearing masks, staying six feet apart, sanitizing high-touch items and avoiding large gatherings prevent its spread.”

These measures have come hand in hand with several significant advances in how doctors treat patients with COVID-19, Rizza says.

“The other reason why we aren't in March and never will be again is that we have a much better understanding of how the virus works, how it replicates and how we need to treat it — and we have drugs,” she said.

Remdesivir — the drug touted by US President Donald Trump as instrumental in his own COVID-19 recovery — is one example of existing medicines doctors are now throwing at the virus. “We know that this drug makes a difference and it saves lives,” Rizza said.

Medical staff in crowded hospital wards have also learned through bitter experience how to reduce the mortality rate. “We understand better how to ventilate people, and how to take measures in their critical care that we didn’t quite understand back in March — we’re much better at doing it now,” Rizza said.

Key to this was recognizing the virus moves through two distinct stages. The first seven days — the viral stage — are characterized by fever, chills and body aches. Then, at around day seven or 10, “patients either get better or they go on to inflammatory dysregulation.”

Inflammatory dysregulation is when the body’s immune response goes into overdrive and causes damage in its attempt to eradicate the virus — a major contributor to COVID-19 deaths. Now advanced drugs can target the sources of this immune response with pinpoint accuracy and neutralize it, drastically improving chances of survival.

“Around the world we have more tools in the toolbox, better understanding of the virus, and better ways to manage the critical illness than we did in March — and the mortality rate has gone down as a result,” Rizza said.

Professor Keith Neal, an infectious disease expert from the University of Nottingham, concurs, saying that “treatments have definitely improved.” However, according to him, there is more to the story than medical advances alone.

“The death rates per case are dependent on the number of people you test. So, if you’re only testing very sick people — those who end up in hospital — then you end up with a high death rate,” Neal told Arab News.

As testing has expanded beyond hospitals and into the general population, this has modified the data on mortality rates to lower the relative number of deaths. This is further amplified by the increase in testing among certain demographics.

“At the moment we’re seeing a number of effects in Britain — it’s spreading rapidly among the 20-30-year-old population, who have a very low death rate. These people weren’t being diagnosed with COVID-19 back in March and April, so the death rate per case is falling markedly,” Neal said.

This increase in testing, particularly among young people who are extremely unlikely to die after contracting COVID-19, has shifted the statistics on mortality. But Neal does not dismiss the improvements in treatment out of hand.

“The thing we know about any disease is the more you treat, the better outcomes you get — you just get better at doing it,” he said, pointing to improvements such as placing patients on their front to improve oxygen flow and holding off on ventilators until later in the virus life cycle.

These improvements have specifically led to a widespread fall in hospital fatality rates among COVID-19 patients. Using this metric avoids mortality data being skewed by huge increases in testing, and any drop in hospital mortality rates shows treatments are becoming more effective than they were just half a year ago.




Remdesivir makes a difference and it saves lives, says Dr. Stacey Rizza. (AFP)

Despite the advances in treatment and mass testing, both Neal and Rizza are clear: COVID-19 is still deadly, thousands are still dying every day, and the public cannot afford to be complacent. Even people with mild symptoms may experience long-term effects, known as “long COVID,” which are not yet fully understood.

The World Health Organization (WHO) echoes this point. “We have learnt a lot about how to care for people,” a WHO spokesperson told Arab News. “The bottom line is that a vast majority of the world’s population remains at risk. The virus has the potential to do enormous damage unless we take all the actions needed to stop its spread.”

To manage this vulnerability, “governments need to provide leadership, clear communication and strong public health measures …. Individuals need to maintain physical distancing, clean their hands frequently, and wear a mask.”

Twitter: @CHamillStewart


Arab Parliament speaker begins first visit to Pakistan to boost ties

Arab Parliament speaker begins first visit to Pakistan to boost ties
Updated 51 min 39 sec ago

Arab Parliament speaker begins first visit to Pakistan to boost ties

Arab Parliament speaker begins first visit to Pakistan to boost ties
  • Several agreements expected to be signed
  • Visit first of its kind, says parliament in tweet

ISLAMABAD: Arab Parliament Speaker Adel Abdulrahman Al-Asoumi arrived in Pakistan on Sunday for a five-day visit to boost bilateral cooperation.
The parliament is the Arab League’s legislative body, with Al-Asoumi leading a high-profile delegation that will meet President Arif Ali, Prime Minister Imran Khan, Senate Chairman Muhammed Sadiq Sanjrani and other senior political leaders.
“Several memorandum of understanding and agreements will be signed between the Arab Parliament and the Upper House of Pakistan (senate) to promote institutional cooperation,” the Senate said.
Senator Sana Jamali welcomed the delegation on its arrival and described the Arab Parliament as a “very important forum.”
“The common goal is to pave the way for the development of bilateral cooperation and mutual relations,” Jamali told Arab News, saying that the delegation’s main activities would start from Monday.
“Their first engagement is at the House of Federation (Senate), where the chairman will welcome them. After meeting with (the) chairman, MOUs and agreements will be signed there.” 
Jamali added that the group would hold talks with Alvi and Khan later in the day.
“The agreements will focus on strengthening (the) bonding between Pakistani and Arab parliaments. The main areas are bilateral parliamentarian exchanges, economic and cultural cooperation between member countries,” she said.
The parliament tweeted that the visit would be the “first of its kind.”
“This visit aims to strengthen Arab parliamentary relations with the Pakistani side, especially in light of positive developments and remarkable growth in relations between the two sides in the political, economic, security and military fields,” it said.


UK court ruling raises concerns over return of terror suspects

UK court ruling raises concerns over return of terror suspects
Updated 01 August 2021

UK court ruling raises concerns over return of terror suspects

UK court ruling raises concerns over return of terror suspects
  • High Court ruled in favor of suspected Daesh member stripped of British citizenship
  • Govt decision deemed unlawful as she had not been informed

LONDON: An English court decision on Friday could pave the way for dozens of terror suspects to return to the UK.
The High Court ruled in favor of a grandmother who was stripped of her British citizenship after being suspected of belonging to Daesh, together with her daughters.
The woman, known as D4, was a suspected national security threat and had her citizenship revoked in 2019. She now resides in a detention camp in northeast Syria.
The court ruled that the UK government’s decision to revoke her citizenship was unlawful as she had not been informed of the move.
The ruling has raised concerns that other terror suspects could return to the UK. A government source told The Times: “It will open up the prospect of people judged to be a national security risk being sent back here.”
Former Conservative Cabinet member David Davis warned: “This chaotic outcome demonstrates that we need to revisit this policy so these people are treated with justice, but people liable for crimes are dealt with under British law.”
Sources said at least 28 terror suspects could use the ruling to stage their own legal cases in a bid to return to the UK.


UK govt under fire for not retaliating against tanker attack 

UK govt under fire for not retaliating against tanker attack 
Updated 01 August 2021

UK govt under fire for not retaliating against tanker attack 

UK govt under fire for not retaliating against tanker attack 
  • Tehran blamed for drone strike off Omani coast that killed Briton, Romanian
  • British silence means ‘we have let Iran get away with murder,’ expert tells Arab News

LONDON: The UK government has been criticized for failing to retaliate after a British Army veteran was killed in an alleged Iranian drone attack on an oil tanker off Oman’s coast.
The unidentified Briton was killed on Saturday after a so-called kamikaze drone struck the oil tanker he was serving on as a security officer. 
Israeli Foreign Minister Yair Lapid blamed Tehran for the attack on the Mercer Street vessel, and urged Britain to retaliate. UK Foreign Secretary Dominic Raab, however, has remained silent on the incident.
Lapid said: “I noted (to Raab) the need to respond severely to the attack. Iran is not just an Israeli problem, but an exporter of terror, destruction and instability that hurt us all. The world must not be silent in the face of Iranian terror.” 
Sam Armstrong, director of communications at the London-based Henry Jackson Society think tank, told Arab News: “Despite Iran’s regular offenses, Britain has continued to look the other way. From the kidnapping of Nazanin Zaghari-Ratcliffe to drone attacks on Saudi oilfields, the hijacking of British-flagged boats and the support of terror activities that have killed Britons around the Middle East, we have let Iran get away with murder.”
He added: “Weakly ignoring these violations and attacks only inspires Tehran to commit worse atrocities. This policy will cost more British lives. Not only is this a naive approach, hoping blindly that this terroristic regime will go away, but it’s also a stupid one that threatens the security of our nation.”
Israel is expected to launch a diplomatic assault on Iran via the UN, but it remains unclear if London will react to the drone strike, which also claimed the life of a Romanian worker. 
US Secretary of State Antony Blinken discussed the incident with Lapid and other regional partners “to investigate the facts, provide support, and consider the appropriate next steps.”
On Saturday, Israeli media carried a quote from a military officer saying a response to the attack on the Mercer Street would be forthcoming, adding: “The only question is how and when we’ll respond.”
Armstrong said: “While the US and Israel are holding discussions to determine what happened and plan a response, London is staying silent despite the loss of a Briton’s life. This cowardly silence demeans Britain on the world stage.”
He added: “We’re leaving the important work of defending our citizens and countering Iranian aggression to other countries.”
The UK Foreign Office said in a statement on Friday: “We are deeply concerned by today’s incident off the coast of Oman. Our thoughts are with the loved ones of the British and Romanian nationals killed in the incident. Vessels must be allowed to navigate freely in accordance with international law.”
Iranian Foreign Ministry spokesman Saeed Khatibzadeh said the allegations are “baseless,” but state TV channel Al-Alam said the drone strike was a “response to a recent Israeli attack” on a Syrian military airport.
The Syrian regime has been supported by Iranian forces, with Tehran viewing its survival as crucial to its own security.
The strike on the Mercer Street shared similar tactics and procedures to kamikaze drones operated by the Iran-backed Houthi militia in Yemen, where unmanned aircraft packed with explosives detonate on or near the intended target.

The Saudi-led coalition supporting Yemen’s internationally recognized government regularly intercepts Iranian-made drones in Yemen and the surrounding region.
The tanker was in the northern Indian Ocean — beyond Iran’s usual area of activity — when it was hit.

Zodiac Maritime, which operated the Japanese-owned tanker, said it is being directed to a “safe location” with a US naval escort.
Meir Javedanfar, an Iran and security researcher at Israel’s IDC Herzliya university, said the attack was “most probably” carried out by Iran.
The strike is a sign of rising tensions and the increasing severity of assaults on tankers. The deaths are the first fatalities following years of tanker attacks.


Thai protesters demand PM resign amid surge in COVID-19 cases

Thai protesters demand PM resign amid surge in COVID-19 cases
Updated 01 August 2021

Thai protesters demand PM resign amid surge in COVID-19 cases

Thai protesters demand PM resign amid surge in COVID-19 cases
  • ‘The government failed to provide vaccines on time and many of us haven’t had any vaccine yet’
  • On Sunday, Thailand reported 18,027 new infections and 133 new deaths from COVID-19

BANGKOK: Anti-government protesters in Thailand took to the streets in cars and motorcycles on Sunday, demanding the resignation of Prime Minister Prayuth Chan-ocha over his handling of the spread of COVID-19, as the country struggles with its biggest outbreak to date.
In Bangkok, drivers honked horns and motorcyclists raised three-finger salutes — a gesture of resistance inspired by “The Hunger Games” movie — as they headed along a 20 km (12 miles) route stretching from the Democracy Monument in the center of the capital out to Don Muang International Airport.
“We can barely make a living now, all of my family members have been affected,” said a 47-year-old protester speaking from his car who only gave his first name “Chai,” for fear of government repercussions.
“The government failed to provide vaccines on time and many of us haven’t had any vaccine yet,” he said. “If we don’t come out to make our calls, the government will simply ignore us.”
There were also similar protests in other provinces.
The Southeast Asian country aims to inoculate 50 million people by the end of 2021, but so far, only 5.8 percent of its more than 66 million population are fully vaccinated, while about 21 percent have received at least one dose.
On Sunday, Thailand reported 18,027 new infections and 133 new deaths from COVID-19, bringing total accumulated cases to 615,314 and 4,990 fatalities.


Millions of Americans risk eviction as coronavirus cases spike

Millions of Americans risk eviction as coronavirus cases spike
Updated 01 August 2021

Millions of Americans risk eviction as coronavirus cases spike

Millions of Americans risk eviction as coronavirus cases spike
  • The Centers for Disease Control and Prevention feared homelessness would boost coronavirus infections

WASHINGTON: Millions of Americans could find themselves homeless starting Sunday as a nationwide ban on evictions expires, against a backdrop of surging coronavirus cases and political fingerpointing.
With billions in government funds meant to help renters still untapped, President Joe Biden this week urged Congress to extend the 11-month-old moratorium after a recent Supreme Court ruling meant the White House could not do so.
But Republicans balked at Democratic efforts to extend the eviction ban through mid-October, and the House of Representatives adjourned for its summer vacation Friday without renewing it.
House Speaker Nancy Pelosi said blocking the measure was “an act of pure cruelty... leaving children and families out on the streets,” in a tweet late Saturday.
Several left-wing Democrats had spent the night outside the Capitol in protest — calling out their colleagues over the failure to act.
“We slept at the Capitol last night to ask them to come back and do their jobs. Today’s their last chance,” tweeted Congresswoman Cori Bush, who has herself experienced homelessness and was joined by fellow progressives Ilhan Omar and Ayanna Pressley.
With the clock ticking down to Sunday, the country was braced for a heartbreaking spectacle — families with their belongings at the curbside wondering where to go.
One of those at risk is Terriana Clark, who was living out of a car with her husband and two stepchildren for much of last year, before finding a teaching job and an apartment in Harvey, Louisiana.
Jobless again and struggling to pay rent after a bout of illness, the 27-year-old told The New Orleans Advocate she applied to a local assistance program four months ago, but is still waiting for help.
“If it comes, it comes. If it don’t, it don’t,” she told the paper. “It’s going to be too late for a lot of people. A lot of people are going to be outside.”
Up north in Michigan, Mary Hunt, who makes minimum wage driving a medical taxi, likewise fell behind on her rent on a mobile home because she got sick with COVID-19.
She was served with eviction papers, and frets over what she will do with her stuff and her five cats and one dog.
“How do I choose which cats to keep? It’s not going to happen. I’m not going to leave any of them behind,” Hunt told National Public Radio this week.
“If I lose this house, then they go in the car with me. And people can think I’m a crackpot, but I’m not giving up my family,” Hunt said.
Unlike other pandemic-related aid that was distributed from Washington, such as stimulus checks, it was states, counties, and cities that were responsible for building programs from the ground up to dole out assistance earmarked for renters.
The Treasury Department said that as of June, only $3 billion in aid had reached households out of the $25 billion sent to states and localities in early February, less than three weeks after Biden took office.
Pelosi in another tweet Saturday urged “state and local governments to immediately disburse the $46.5 billion in emergency rental assistance approved by the Democratic Congress so that many families can avoid eviction.”
The Centers for Disease Control and Prevention (CDC) ordered the eviction moratorium in September 2020, as the world’s largest economy lost over 20 million jobs amid the pandemic shutdowns. The CDC feared homelessness would boost coronavirus infections.
Although more than half of those jobs were since recovered, many families still have not caught up on missed rent payments.
The Census Bureau’s latest Household Pulse survey showed that of 51 million renters surveyed, 7.4 million were behind on rent and nearly half of those said they risked being evicted in the next two months.
Nearly 80 percent of households that are behind on their rent as of early July lived in COVID-19 hot spots, according to a study by the Jain Family Institute.
“Putting people out on the street is probably not going to have good effects on community transmission rates,” the institute’s housing policy researcher Paul Williams told CBS MoneyWatch.
Immediately after taking over, the Biden administration had eased paperwork and eligibility requirements for an emergency rental assistance program, but it has stressed that management remains in the hands of state and local officials.
“There can be no excuse for any state or locality not accelerating funds to landlords and tenants that have been hurt during this pandemic,” Biden warned Friday.
The CDC eviction moratorium and other protections prevented an estimated 2.2 million eviction filings since March 2020, said Peter Hepburn, a research fellow at the Eviction Lab at Princeton University.