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Doctors: Preventing Hospital Overcrowding Is Crucial to Reducing COVID-19 Deaths

medical workers outside NYU Langone

 

Ben Gabbe / Contributor / Getty Images

Key Takeaways

  • COVID-19 cases are increasing across the country, and the CDC thinks deaths will soon begin to increase again too.
  • Doctors have gotten much better at treating patients hospitalized with COVID-19. 
  • As COVID-19 cases go up, physical distancing and wearing masks can reduce your chance of contracting the virus, as well as keep hospitals from becoming overwhelmed.

The latest data from the Centers for Disease Control and Prevention (CDC) shows that while COVID-19 cases have been increasing nationally since September, death rates have stayed flat. Unfortunately, that could be changing.

According to the most recent CDC data shared on October 24, the percentage of deaths from pneumonia, influenza, and COVID-19 ("PIC" in CDC lingo) remained at approximately even levels from mid-September through mid-October, but “both COVID-19 related hospitalizations and PIC mortality for the most recent weeks may increase as more data are received.” 

There is some good news to temper the sobering CDC report, experts say. Amesh Adalja, MD, FIDSA, senior scholar at the Center for Health Security at Johns Hopkins Medicine, tells Verywell healthcare professionals have learned and adapted over the course of the pandemic, figuring out how to offer better care than in the earlier months.

“If you are hospitalized [now], your chances of leaving the hospital are much better because we have new tools and better strategies," Adalja says.

A recent study by researchers at NYU Langone Health in New York City, the epicenter of the COVID-19 outbreak in the U.S. last spring, bears that out. The study, published online in the Journal of Hospital Medicine on October 23, shows the death rate among hospitalized patients in New York was 25.6% in March. By mid-August, it dropped to about 8%.

One reason for the drop, according to the study, was that the hospitalized patients in the summer tended to be younger, healthier patients with less severe symptoms. 

But the study authors say that is only part of the story. They think that death rates also fell because as COVID-19 continued from spring through summer, doctors became more expert at treating it. Advancements included techniques such as having patients lie on their stomachs rather than their backs, which reduces stress on the lungs and can improve respiratory symptoms. 

Other factors that may have reduced deaths from the virus include:  

  • New drugs such as remdesivir and use of steroids 
  • Decreased hospital volume, which allows the most experienced doctors to treat the sickest patients 
  • Earlier testing and treatment 

What This Means For You

If you are hospitalized for COVID-19, you may have a better chance of surviving the disease, especially if cases in your community remain low enough that the hospital is not overwhelmed and specialists are able to take the time they need to care for you.

“Our findings suggest that while COVID-19 remains a terrible disease, our efforts to improve treatment are probably working,” said Leora Horwitz, MD, the lead author of the study and an associate professor in the Department of Population Health at NYU Langone Health, in a statement. “Even in the absence of a silver-bullet treatment or vaccine, we are protecting more of our patients through a host of small changes."

The researchers looked at 5,121 patient records of people treated for COVID-19 at NYU Langone hospitals in New York City and on Long Island between March 1 and August 31 to create a model that predicted likelihood of death for each patient. The model showed that the likelihood of death was, on average, 18 percentage points lower in August than in March for most critically ill patients. 

“Other pandemic hotspots should take hope from the lessons learned here in New York,” says study senior author Christopher M. Petrilli, MD, an assistant professor in the Department of Medicine at NYU Langone Health.

Adalja reiterates that what seems to be making a difference is that doctors know what to do to treat patients faster, “which can put patients on the correct path sooner.” But being able to treat patients effectively is contingent on hospitals not being over capacity.

Leana Wen, MD, MSc, an emergency physician and public health professor at George Washington University, agrees, adding that “where we go from here depends on how strained our healthcare systems get.”

Wen, who previously served as Baltimore's Health Commissioner, says that if hospitals continue to be stressed at the rate they are now, we could reach a breaking point. Especially with the overlap with influenza, hospitals may become overwhelmed, and not all patients will be able to receive the best possible care.

Petrilli tells Verywell this scenario serves "as a rallying call for people thinking of easing up [on precautions].” Until there’s a vaccine, the only way to keep people out of hospitals and keep the mortality rate low is to continue with physical distancing and mask-wearing.

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  1. Centers for Disease Control and Prevention. Key Updates for Week 43, ending October 24, 2020. Updated November 6, 2020.

  2. Horwitz L, Jones SA, Cerfolio R, Fritz F, Greco J, Rudy B, Petrilli CM. Trends in COVID-19 risk-adjusted mortality rates. J Hosp Med. Published Online First October 23, 2020. doi:10.12788/jhm.3552