More hospitalized patients are surviving than early in the pandemic. Improved treatments make a big difference, but so does flattening the curve to keep hospitals from overfilling, researchers say.



Now for some good news about coronavirus treatment - two studies soon to be published show that hospitalized patients in the U.S. and U.K. are much less likely to die from the virus than they were at the start of the pandemic. NPR's Geoff Brumfiel reports.

GEOFF BRUMFIEL, BYLINE: Critical care physician Khalilah Gates remembers the first time she saw a COVID patient back in March.

KHALILAH GATES: I can still replay that scene today.

BRUMFIEL: It was an older woman. She was very sick, and Gates and her colleagues needed to put a tube in her throat to help her breathe.

GATES: It's not that we didn't know what we were doing. We absolutely knew 100% what we were doing. But there was that unknown element there.

BRUMFIEL: Gates is at Northwestern Hospital in Chicago. There were lots of unknowns. Was the procedure the best thing she could do for this patient? Was it safe for her and her team to do it? Fast forward to today, and Gates has seen a lot of COVID patients. She feels much more confident.

GATES: Six-plus months into this, we kind of have a rhythm. And so it has become an everyday, standard patient for us at this point in time.

BRUMFIEL: All over the world, physicians have been finding their rhythm with this virus. They've systematized care using checklists. They've learned which drugs work best, and so it might seem obvious that they're saving more lives. But Leora Horwitz, a doctor who studies population health at New York University's Grossman School of Medicine, says it's not so clear because while death rates have dropped, the people getting infected today are healthier than those who were infected in March.

LEORA HORWITZ: The people who are getting hospitalized now tend to be much younger and tend to be less frail than people who were hospitalized in the early days of the epidemic.

BRUMFIEL: So have death rates dropped due to what doctors are doing, or is it the change in who's getting sick? To find out, Horwitz and her colleagues looked at over 5,000 hospitalizations in the NYU Langone health system between March and August. They adjusted for factors including age and other diseases, like diabetes. And what they found was good news.

HORWITZ: We do find that the death rate has gone down substantially.

BRUMFIEL: For all groups, even older patients - 18 points on average. So a patient with a 25% chance of dying in March would have just a 7% chance of dying later in the year. The work will be published online next week in the Journal of Hospital Medicine.

BILAL MATEEN: I would classify this as a silver lining to what has been quite a hard time for many people.

BRUMFIEL: Bilal Mateen is a data science fellow at The Alan Turing Institute in the U.K. He has conducted a study of 21,000 hospitalized cases in England, which found a similarly sharp drop in the death rate.

MATEEN: Clearly, there has been something gone on that's improved the risk of individuals who go into these settings with COVID-19.

BRUMFIEL: In fact, Horwitz believes it's actually many things that have led to the drop in the death rate - the use of steroids such as dexamethasone, decisions about when to put patients on oxygen or blood thinners. Each of these choices makes a slight improvement that adds up.

HORWITZ: All of the above is often the right answer in medicine. And I think that's the case here, too.

BRUMFIEL: But there is still no cure for this disease. Patients who recover can have long-term side effects. And if hospitals fill again this winter, mortality rates might rise once more. For all these reasons, Horwitz and Mateen emphasize people still need to wear masks and social distance.

HORWITZ: I do think this is good news, but it does not make the coronavirus a benign illness. It does not mean that it is not still important to do everything possible to prevent getting it. It doesn't mean that the people who survive without complications.

BRUMFIEL: And people will still die. A recent estimate suggests the total death count could reach well over 300,000 Americans by February.

Geoff Brumfiel, NPR News.