In the fall of 2020, the first year of the pandemic, doctors treating hospitalized COVID-19 patients said they were starting to make diet a science. They’ve learned when to put patients on ventilators, administer steroids, and roll out a growing array of new drugs.
Yet the latest data from Pennsylvania and the United States shows that as of December 2021, one in seven people in hospital with COVID are still dying – a rate not much better than when they started.
Experts say comparing in-hospital death rates from yesterday and today isn’t necessarily appropriate, in part because the data doesn’t indicate patients’ other health conditions, or whether, once the vaccines were available, they were vaccinated. But the numbers are nonetheless a reminder that even now a steady stream of people are going to hospital with COVID, and many are so sick they won’t survive.
Improvements in outpatient therapy have prompted some doctors to change their thinking about who to admit to hospital, said Lewis J. Kaplan, a professor at the University of Pennsylvania’s Perelman School of Medicine.
“These days, if you’re admitted to hospital with COVID,” he said, “you’re usually very sick.”
State data, from the Pennsylvania Health Care Cost Containment Council, also reveals a trend that has changed little since the start: Older COVID patients are more likely to need to go to the hospital — and once there, they are more likely to die. Between March and June 2020, figures from the agency show that 28.2% of people over 85 who ended up in hospital died there. By the end of 2021, that death rate had dropped to 20%, which is still sobering.
The US data, extracted from 59 hospitals by the CDC’s National Center for Health Statistics, is not disaggregated by age. But generally, people currently hospitalized with COVID either have underlying health conditions, haven’t been vaccinated, or both, said Kaplan, who served as president of the Society of Critical Care Medicine for the first year. chaos of the pandemic.
The Pennsylvania and US numbers stop at the end of 2021, when the omicron surge was beginning. Cases and hospitalizations fell sharply in the spring of this year, but lately they have risen again. And the death rate, while low by pandemic standards, persists at nearly 500 deaths per day.
If current trends continue, 39,000 people could die of COVID from July 11 to November 1, according to the latest model from the Institute for Health Metrics and Evaluation (IHME), a research center at the University of Washington.
And many of those deaths will occur in hospital, even with the latest treatments, said IHME researcher Sarah Wulf Hanson.
Like Kaplan, she cautioned against reading too much into trends in hospital death rates, as data from Pennsylvania and the United States includes patients with “accidental” cases of COVID – that is. another medical condition was the primary reason for admission.
Studies suggest that death rates may also increase due to overcrowding in hospitals during pandemic outbreaks, as hospitals scramble to stretch their resources, she said.
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Still, the continued death toll is a clear sign that better treatments are still needed, Hanson and Kaplan agreed. And even those who survive may still experience long-term disability.
Along with improved care, Kaplan called for continued precautions outside of the hospital.
It’s no secret that most people have long since stopped wearing masks, but face coverings and other precautions are still important in some situations, he said. Healthy 30-somethings might not have much to fear from COVID these days, especially if they’re vaccinated. But they can still pass it on to others at higher risk.
“This simple message: take care of each other. It’s a social relationship that I think we need to reclaim,” he said. “In high-risk places, look out for vulnerable people.”