Covid-19 – Why Does It Seem That the Fatality Rate Is Declining?

Despite the virus’s apparent resurgence, it has apparently become an article of faith among those who, for whatever bizarre reason, feel obligated to downplay the seriousness of the Covid-19 pandemic that it is somehow less dangerous or deadly this time around. They contend that even though the number of cases is rising, there hasn’t been much of a rise in fatalities.

There would seem to be some evidence to support these claims on the surface. In the United States, there were 34,196 new cases of the first wave of infections in a single day, with a peak of 2,804 fatalities. The second time around saw daily cases peak at 78.009, yet “only” 1,504 deaths were recorded on the darkest day.

Tests ramped up massively

These numbers should initially be treated with some caution. Since the first wave of infections caused lockdowns across the western world, testing has increased dramatically almost everywhere. The data we have only includes cases that have been officially classified as positive, but it is almost certain that the virus was much more widespread in the US in April than it was in July. When the pandemic first began, testing was only done in hospitals in the majority of western economies, leaving the vast majority of infected individuals who were either asymptomatic or had symptoms that were mild enough to not require hospital treatment to guess. Because of this, the ratio of infections to deaths has not changed as dramatically as the statistics might indicate.

Nevertheless, it is noteworthy that the number of fatalities has fallen to an unexpectedly low level, perhaps most notably in Europe, even though thousands of people are still testing positive for the virus. The majority of June and July saw daily deaths in Spain in the single digits, and here in the United Kingdom, fatality numbers continue to be similarly low despite a recent, observable increase in transmission.

A more cavalier attitude

According to conventional wisdom, younger people, especially those between the ages of 20 and 29, appear to be most susceptible to infections this time around. This would seem to make sense given that younger people tend to interact more with one another and that very few people in this age group experience serious viral illness, suggesting that a more carefree attitude can be anticipated. However, there isn’t much we can use as a benchmark. In March and April, only patients admitted to hospitals were tested, so we likely had a very limited understanding of how widespread the virus was, especially among young people.

According to recent research from France and Spain, a disease that spreads among young people eventually spreads to older people as well, which leads to hospitalizations and, sadly, fatalities. Although the number of fatalities has thankfully decreased from the levels we saw in the spring, there has been a noticeable increase in both of these countries, and reports of intensive care units nearing capacity have started to emerge from Marseilles. The number of hospital admissions and ventilator usage have increased over the past few days in the United Kingdom, which always seems to be a few weeks behind continental Europe in these matters.

Low survival rate

Hospital staff has undoubtedly improved in their understanding of how the virus operates and patient care as the pandemic has spread. With the advent of CPAP technology, many people have been able to avoid having to go through the horrifying procedure of intubation, which had an unappealingly low survival rate during the earlier months. It is quite likely that this process was used too enthusiastically. The effective use of dexamethasone and remdesivir (primarily in the United States) has reduced the severity of the illness and, in the latter case, prevented a sizable number of fatalities. These factors alone ensure that fatality rates should be statistically lower than they were in the spring, assuming that health services are not overburdened when and if future spikes occur.

Naturally, those receiving hospital care are the only ones who benefit from the life-saving treatments given to seriously ill patients. The issue of whether or not fewer people with Covid-19 are actually admitted to hospitals in the first place is unrelated to their increased use. If this is the case, at least some of it may be attributable to the National Health Service’s improved ability to determine which patients need to be hospitalized after becoming ill (although we are still early in the most recent phase to know for sure).

Is the virus growing less deadly?

All of this leads to our final query: Has the virus’s nature significantly changed in any way that might have rendered it less lethal? The jury is still out on this issue. Some speculative theories have suggested that the virus may have undergone a mutation, making it more contagious but less deadly. Paul Tambyah, a senior consultant at the National University Hospital in Singapore and the incoming president of the International Society of Infectious Diseases, has argued that the emergence and spread of the so-called D614G mutation in some regions of the world coincided with a decline in fatalities.

It is undoubtedly true that most viruses tend to lose some of their virulence as they evolve. This enables them to move between hosts, which is something that becomes impossible after a fatality, and to survive. Despite this, rising death rates in Spain and France do appear to suggest that Covid-19 still has a significant amount of lethal potential.