By Marilynn Marchione - AP
Nearly a million people have died worldwide from COVID-19, but thanks to desperate efforts to save their lives, scientists now have a better understanding of how to treat and prevent this disease.
And with it, millions of people will be able to survive.
[The United States exceeds 200,000 deaths from coronavirus. Experts warn that the figure may double]
Ming Wang, 71, and his wife were on a cruise ship from Australia, taking a break after decades of running the family's Chinese restaurant in Papillion, Nebraska, when he became infected.
During the 74 days he was hospitalized before his death in June, doctors frantically tried various experiments, including enrolling him in a study of an antiviral drug that showed promise.
"Everything they wanted to try, we said 'yes, do it," said Wang's daughter Anne Peterson, "we would give anything to have him back, but if what we went through with him would help future patients, that's what we want."
Ming Wang in Sydney, Australia, in March Lu Wang via AP
"Part of the reason we're doing better is because of advances [in science]," said Dr. Francis Collins, director of the National Institutes of Health.
Various medications have proven helpful, and doctors know more about how to care for the sickest patients in hospitals.
We are in the "stormy adolescence" phase of learning the treatments that work, Collins said.
A very expensive price
The nearly one million deaths from coronavirus in nine months exceed 690,000 from AIDS or 400,000 from malaria in all of 2019. And they are just behind the 1.5 million deaths from tuberculosis.
Wealth and power have not protected countries from the terrible power of the virus.
The United States "has been the most affected country in the world" with more than 6 million infections and more than 200,000 deaths, reflecting "the lack of success in containing this outbreak," said Anthony Fauci, a leading infectious disease specialist. from the country, to a Harvard Medical School audience earlier this month.
[Latino and young black Californians are dying of coronavirus at higher rates]
More than 40% of adults in the United States are at risk of serious illness from the virus due to other health conditions such as high blood pressure.
It is not just the elderly in the nursing homes who are dying, Fauci stressed.
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Jesse Goodman, a former chief scientist for the Food and Drug Administration (FDA) who now works at Georgetown University, agreed with him.
"No one should be wrong about this" and think that they are not at risk just because they do not personally know someone who has died or have not witnessed what the virus can do first hand, he said.
Hopeful signs
Although cases are increasing, death rates appear to be declining, said Cyrus Shahpar, a scientist who worked for the Centers for Disease Control and Prevention (CDC) and is now part of the nonprofit Resolve. to Save Live.
[Coronavirus cases have skyrocketed but deaths have not: what is happening and how many people are in mortal danger]
The true lethality of the virus - the death rate from infection - is not yet known, because scientists do not know how many people have suffered it without showing symptoms.
What is usually reported are death rates, that is, the portion of people who have tested positive and then died.
Comparing them from one country to another is problematic due to the differences between the tests and vulnerable populations.
Following them within a country over time also carries that risk, but it can suggest trends.
"The cumulative death rate for the United States in April was about 5%. Now we are close to 3%," Shahpar said.
In England, researchers reported that death rates have dropped substantially since they peaked in April.
The rate in August was around 1.5% compared to more than 6% six weeks earlier.
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One reason is demographic change: these days most cases are in young people who are less likely to die from their infection than older people.
Increased testing is also playing a role: As more people with mild or no symptoms are detected, the number of known infections expands and the proportion that are fatal decreases, according to Shahpar.
Better treatments
It is a fact that treatments also affect survival.
People who have died from COVID-19, especially those who participated in studies, have helped reveal what drugs do and do not do to help.
["He can kill us chubby ones": Juan Pedro Salas was the fattest man in the world. He overcame the coronavirus but lost his parents]
Dexamethasone and other similar steroids are known to improve survival when used in hospitalized patients who need extra oxygen, but could be harmful for less ill patients.
An antiviral drug, remdesivir, can speed recovery for seriously ill patients, reducing the average hospital stay by four days.
Two anti-inflammatories, one of them used in combination with remdesivir - the one Wang helped test - have also been reported to have helped, although the results of those studies have yet to be published.
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Experts are still investigating convalescent plasma, which involves using the antibody-rich blood of survivors to treat others.
No large, high-quality study has tested this well enough to see if it works.
[A panel of health experts does not recommend convalescent plasma to treat coronavirus]
The value of rigorous, scientific studies to test treatments has become apparent, according to Goodman.
"We certainly see what happens" when treatments are widely adopted without them like hydroxychloroquine was.
"That exposed a lot of people to a potentially toxic drug" and delayed the search for effective ones, he said.
Medications aside, "the death rate is improving over time as physicians become more adept at caring for the sickest patients," said Gary Gibbons, director of the National Heart, Lung, and Blood Institute. .
In hospitals, doctors now know more about ways to avoid using respirators, such as keeping patients face down.
Activists from the COVID Memorial Project mark the deaths of 200,000 people in the United States from the coronavirus with thousands of American flags on the grounds of the National Mall National Park in Washington DC, Tuesday, September 22, 2020.AP / J.
Scott applewhite
"We have learned how to position patients, how to use oxygen, how to handle fluids," and hospitals have increased their capacity and emergency supplies, said Judith Currier, a Ph.D. from the University of California, Los Angeles, at an organized seminar. by the American Public Health Association and the National Academy of Medicine.
The future
The best way to avoid dying from the coronavirus remains to avoid contracting it, and experience has shown that the simple measures recommended by health authorities work.
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"Prevention is the most important step right now as we wait for a vaccine and improve treatment," Goodman said.
Wearing a mask, washing hands, maintaining a separation of at least six feet and disinfecting surfaces "are clearly having a positive effect" in slowing the spread, Fauci said.
If more people stick to common sense measures like closing bars, "we should improve our ability to handle this" and prevent more deaths, Shahpar noted, "it should take longer to get to the next million, if it ever happens."
