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[44]Health
[45]Health

Coronavirus death rate falling in hospitals

By Rachel Schraer Health reporter
* 26 June 2020
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Related Topics
* [65]Coronavirus pandemic

man in mask in hospital bed with medic in full PPE Image copyright
Getty Images

Coronavirus patients in hospital in England are dying at a slower rate
now than they were at the peak of the epidemic, analysis suggests.

[66]University of Oxford researchers found the proportion of
coronavirus patients dying each day in England fell from 6% to 1.5%
between April and June.

Improvements in treatments, changes in the patient population and
seasonal effects could all play a role.

The data emerged as the government prepares to ease lockdown
restrictions.

Around the height of the outbreak, on 8 April, there were 15,468 people
in hospital in England with coronavirus of whom 899 died (6%).

By 21 June there were 2,698 hospitalised coronavirus patients, 30 of
whom died (1%), according to the most recent data compiled University
of Oxford's Centre for Evidence-Based Medicine.

Hospital case fatality is a measure used since the beginning of the
outbreak, providing consistent figures and enabling researchers to look
for trends.

Covid death rate in hospitals

% of total hospitalised coronavirus patient population dying per day
Source: University of Oxford Centre for Evidence-Based Medicine

While both the number of people in hospital and the number of
hospitalised people dying are falling, deaths are falling at a faster
rate.

The number of people in hospital with Covid-19 is halving every 29
days, while deaths are halving every 16 days.

Prof Carl Heneghan, who carried out the analysis, said the pattern of
falling death rates in hospitals was also being seen in other
countries, including Italy,

"We should be investigating what's changed," he said.

"It's a radically different disease we're looking at if the death rate
is 1% rather than 6%".

He said that translated to a difference of 500 deaths a day in April
when the disease was at its height.

"This is an encouraging trend but one that needs more work to
understand the cause," his co-author Jason Oke said.

Although the researchers were unable to determine exactly what was
behind the trend, they put forward a number of reasons.

Better treatment

One is that, as more is understood about the disease, healthcare staff
have been better able to treat it using existing drugs, even without
any major breakthrough in new treatments.

For example, doctors are now primed to expect patients with blood
clotting and overactive immune responses, whereas in the early days
they were looking to treat the symptoms of what was seen as primarily a
respiratory disease.

And in critical care patients, the common steroid [67]dexamethasone is
now being used to dampen down the out-of-control immune reactions that
can cause organ damage.

This is likely to be a key factor, but is unlikely to completely
explain the falling death rate, according to Prof Heneghan.
* [68]Third of patients develop dangerous blood clots
* [69]'Baffling' observations from the front line
* [70]Cytokine storms- When the body attacks itself - BBC Future

It may also be down to changes in the types of patients admitted to
hospital.

Less vulnerable patients

As strain on the NHS has eased, the researchers say it is possible that
there is room to admit patients who would not have met the stricter
threshold for hospital care at the height of the epidemic. And these
patients may be slightly less vulnerable and therefore less likely to
die.

More sombrely, it's also possible that the virus, having torn through
the most vulnerable populations, has left behind people who were at
lower risk to start with.

A further possibility is that there could be a group of patients in
hospital for long periods, not being discharged but also not succumbing
to the virus.

Summer might also be playing a protective role: there are fewer other
illnesses in circulation to compromise people's immune systems, and
more sunlight means more [71]Vitamin D.

Follow Rachel [72]on Twitter
[73]View comments

Related Topics

* [74]Dexamethasone
* [75]Coronavirus pandemic
* [76]University of Oxford

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* Coronavirus UK map: How many confirmed cases are there in your
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26 June 2020
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