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Summary: > Studying changes in death rate is tricky because although the overall U.S. death rate for COVID-19 seems to be dropping, the drop coincides with a c

by xpe 6y ago

Summary: > Studying changes in death rate is tricky because although the overall U.S. death rate for COVID-19 seems to be dropping, the drop coincides with a change in whom the disease is sickening. > So have death rates dropped because of improvements in treatments? Or is it because of the change in who's getting sick? > To find out, Horwitz and her colleagues looked at more than 5,000 hospitalizations in the NYU Langone Health system between March and August. They adjusted for factors including age and other diseases, such as diabetes, to rule out the possibility that the numbers had dropped only because younger, healthier people were getting diagnosed. They found that death rates dropped for all groups, even older patients by 18 percentage points on average. > The study, which was of a single health system, finds that mortality has dropped among hospitalized patients by 18 percentage points since the pandemic began. Patients in the study had a 25.6% chance of dying at the start of the pandemic; they now have a 7.6% chance.

dnautics 6y ago
Thanks! > mortality has dropped among hospitalized patients by 18 percentage points since the pandemic began. Patients in the study had a 25.6% chance of dying at the start of the pandemic; they now have a 7.6% chance. It's strange to phraseit like that; I would have phrased it as "mortality has dropped by a factor of 3"
- OJFord 6y ago
  I prefer the original - it tells me that 18% of all hospitalised patients are alive today where they would not have been before. Yours tells me 2/3 of them that were dying are no longer, but it puts me on edge like I might be being baited into clicking - a 2/3 drop isn't necessarily impressive, like in normal times if 0.5% of ED patients are dying, dropping by a factor of three might just be the difference between a good and bad month. 18pp is always a big chunk (~1/5) of the total, it's notable whether the starting point was 90% or 20%.
  - astrophysician 6y ago
    hmm..I see your point but I'm not sure I agree, saying 2/3 of people that otherwise would have died are no longer is tailored to the problem. E.g. if mortality rate from all covid infections went from 0.1% -> 0.001%, thats incredibly impressive and important since the mortality is now 1% of what it was, meaning 99% of deaths are being avoided but "the mortality rate went down by 0.099%" sounds small and insignificant.
    - petschge 6y ago
      Which is why it is good to give absolute risks before and after a change. That way you can easily compute and judge both absolute risk reductions and risk ratios.
    - LudwigNagasena 6y ago
      That’s because people mess up percentages and percentage points all the time.
  - chrisco255 6y ago
    But their odds of being hospitalized in the first place have also dropped dramatically, so their "odds of dying" dropped even further.
  - jpambrun 6y ago
    With the 18% figure I need to know the starting point to get the picture. It could still be 82% or all the way down to 0%. Three fold increase in survivability is more informative.
mrkstu 6y ago
So the remaining question is, has the virus changed (mutated) to be less deadly, or have masks lessened the viral load on initial infection enough to give the immune system a better chance of fighting it off, or have treatments become that much more effective? Or a combination of the above?
- chrisco255 6y ago
  We see the same drop in death rate across the board, by state, by country, regardless of policy choices. Regardless of mask wearing. Sweden's daily death count has flatlined at near zero per day for over three months, Florida, Wyoming, Idaho, South Dakota, etc all seeing similar drop in hospitalizations and deaths.
  - tzs 6y ago
    You say "death rate" in the first sentence, but then talk of "death count" and "deaths" in the rest. Did you mean "death rate" in the rest too? If you meant "death count" or "deaths", then it is not the cast for South Dakota. Their deaths have gone way up per capita over the last few weeks. There are two big questions most people would like answers too: 1. What are my chances of getting COVID? 2. How screwed am I if I get COVID? There are a couple of different numbers that can be used for the second. First, the death rate among people who have COVID can be given. Second, the deaths per capita due to COVID can be given. If you have the answer to the first, then either form of answer to the second can be computed from the other form of answer. What's going on in South Dakota is that they are doing very badly on the first half (getting COVID). By "badly" I mean that they make the worst in Florida, back when Florida was the epitome of mishandling COVID, look great. So even if the death rate among people who have COVID has gone down a little, the deaths per capita has gone way up. The death rate among people with COVID would have to go down way more to offset the way the number of people who get COVID is increasing in South Dakota.
    - chrisco255 6y ago
      Here's the numbers on South Dakota: https://doh.sd.gov/news/coronavirus.aspx#SD https://doh.sd.gov/news/coronavirus.aspx#SD You can see mortality rate plummeted shortly after the pandemic started and that it has stayed flat or dropped even in the face of the recent rise in cases. While cases have gone up finally in South Dakota, the mortality rate is still less than a 10th of what it was in the beginning. So meanwhile, they were open for 9 months. That is well beyond the incubation period for this virus so what changed to cause the spike? They are still ranked 40th in terms of deaths per million by state. The worst states have been New Jersey and New York, and Massachusetts, by far, who failed to protect their nursing home and assisted living patients early on in pandemic. Florida is completely open right now. Not only is there no mask orders, there are no restrictions on populations or businesses. Deaths per day are down and mortality rate is down: https://floridahealthcovid19.gov/#latest-stats https://floridahealthcovid19.gov/#latest-stats. New cases flat.
techsin101 6y ago
is the reason better treatment or weakened virus?
tinus_hn 6y ago
Surprisingly the fatality rate is dropping because of all these treatments that according to WHO have no effect.

by xpe 6y ago

dnautics 6y ago

Thanks! > mortality has dropped among hospitalized patients by 18 percentage points since the pandemic began. Patients in the study had a 25.6% chance of dying at the start of the pandemic; they now have a 7.6% chance. It's strange to phraseit like that; I would have phrased it as "mortality has dropped by a factor of 3"

OJFord 6y ago
I prefer the original - it tells me that 18% of all hospitalised patients are alive today where they would not have been before. Yours tells me 2/3 of them that were dying are no longer, but it puts me on edge like I might be being baited into clicking - a 2/3 drop isn't necessarily impressive, like in normal times if 0.5% of ED patients are dying, dropping by a factor of three might just be the difference between a good and bad month. 18pp is always a big chunk (~1/5) of the total, it's notable whether the starting point was 90% or 20%.
- astrophysician 6y ago
  hmm..I see your point but I'm not sure I agree, saying 2/3 of people that otherwise would have died are no longer is tailored to the problem. E.g. if mortality rate from all covid infections went from 0.1% -> 0.001%, thats incredibly impressive and important since the mortality is now 1% of what it was, meaning 99% of deaths are being avoided but "the mortality rate went down by 0.099%" sounds small and insignificant.
  - petschge 6y ago
    Which is why it is good to give absolute risks before and after a change. That way you can easily compute and judge both absolute risk reductions and risk ratios.
  - LudwigNagasena 6y ago
    That’s because people mess up percentages and percentage points all the time.
- chrisco255 6y ago
  But their odds of being hospitalized in the first place have also dropped dramatically, so their "odds of dying" dropped even further.
- jpambrun 6y ago
  With the 18% figure I need to know the starting point to get the picture. It could still be 82% or all the way down to 0%. Three fold increase in survivability is more informative.

mrkstu 6y ago

So the remaining question is, has the virus changed (mutated) to be less deadly, or have masks lessened the viral load on initial infection enough to give the immune system a better chance of fighting it off, or have treatments become that much more effective? Or a combination of the above?

chrisco255 6y ago
We see the same drop in death rate across the board, by state, by country, regardless of policy choices. Regardless of mask wearing. Sweden's daily death count has flatlined at near zero per day for over three months, Florida, Wyoming, Idaho, South Dakota, etc all seeing similar drop in hospitalizations and deaths.
- tzs 6y ago
  You say "death rate" in the first sentence, but then talk of "death count" and "deaths" in the rest. Did you mean "death rate" in the rest too? If you meant "death count" or "deaths", then it is not the cast for South Dakota. Their deaths have gone way up per capita over the last few weeks. There are two big questions most people would like answers too: 1. What are my chances of getting COVID? 2. How screwed am I if I get COVID? There are a couple of different numbers that can be used for the second. First, the death rate among people who have COVID can be given. Second, the deaths per capita due to COVID can be given. If you have the answer to the first, then either form of answer to the second can be computed from the other form of answer. What's going on in South Dakota is that they are doing very badly on the first half (getting COVID). By "badly" I mean that they make the worst in Florida, back when Florida was the epitome of mishandling COVID, look great. So even if the death rate among people who have COVID has gone down a little, the deaths per capita has gone way up. The death rate among people with COVID would have to go down way more to offset the way the number of people who get COVID is increasing in South Dakota.
  - chrisco255 6y ago
    Here's the numbers on South Dakota: https://doh.sd.gov/news/coronavirus.aspx#SD https://doh.sd.gov/news/coronavirus.aspx#SD You can see mortality rate plummeted shortly after the pandemic started and that it has stayed flat or dropped even in the face of the recent rise in cases. While cases have gone up finally in South Dakota, the mortality rate is still less than a 10th of what it was in the beginning. So meanwhile, they were open for 9 months. That is well beyond the incubation period for this virus so what changed to cause the spike? They are still ranked 40th in terms of deaths per million by state. The worst states have been New Jersey and New York, and Massachusetts, by far, who failed to protect their nursing home and assisted living patients early on in pandemic. Florida is completely open right now. Not only is there no mask orders, there are no restrictions on populations or businesses. Deaths per day are down and mortality rate is down: https://floridahealthcovid19.gov/#latest-stats https://floridahealthcovid19.gov/#latest-stats. New cases flat.

techsin101 6y ago

is the reason better treatment or weakened virus?

tinus_hn 6y ago

Surprisingly the fatality rate is dropping because of all these treatments that according to WHO have no effect.