Here’s why experts say the U.S. is stuck in a ‘horrible plateau’ of COVID-19 deaths

What seems to make the biggest difference between people who recover from COVID and those who die is whether they get treatment within the first week of diagnosis, one expert says.

SHARE Here’s why experts say the U.S. is stuck in a ‘horrible plateau’ of COVID-19 deaths
President Joe Biden.

The antiviral Paxlovid has been effective at keeping high-risk COVID patients out of the hospital but is losing esteem among doctors and patients as public figures including President Joe Biden have reported rebound infections after taking the antiviral.

Carolyn Kaster / AP

“COVID is over” is something we’d all like to be true, but weekly U.S. death tolls tell a different story.

Despite a slight uptick in July, the pace of COVID-19 deaths has remained steady since May, at about 400 a day, according to a USA Today analysis of Johns Hopkins University data. 

“We’re sitting on this horrible plateau,” said Dr. Daniel Griffin, an infectious disease specialist with Pro Health Care in New York who is a clinical instructor of medicine at Columbia University. “It’s been this way for the past couple of months, and we’re getting used to it.”

In July, more than 12,500 Americans died of COVID, the analysis found.

The number of coronavirus deaths is similar to the number of influenza deaths normally reported during peak season, said David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. A bad flu season in the United States could see more than 50,000 deaths. 

That doesn’t mean COVID mortality has reached that of flu, Dowdy said, as peak flu season lasts only about three months. Spread over the course of the year, Dowdy said, there would be about four times as many deaths from the coronavirus as flu deaths.

COVID  is “like having to live in flu season year round, and that’s not what we do with the flu,” he said. “If we had to do that with the flu, we’d be instituting more measures than what we do.”

Most Americans who died of COVID were immunocompromised or older than 75, experts say. They included people who were unvaccinated but also those who’d gotten vaccinated and received the recommended boosters.

What appears to make the biggest difference between people who recover and those who die from COVID, Griffin said, is whether they receive treatment within the first week of diagnosis. 

“I can’t remember someone in my recent memory who did all the right things, who got the vaccine and got the proper early treatment and ended up in the hospital and died,” he said.

The antiviral Paxlovid, from Pfizer, has been effective at keeping high-risk COVID patients out of the hospital. But it’s losing esteem among doctors and patients as public figures including President Joe Biden and Dr. Anthony Fauci have reported rebound infections after taking the antiviral, Griffin said.

Though it appears more rebound infections are being reported, Dr. Ashish Jha, the White House’s COVID-19 response coordinator, said the rate of cases is probably about 5%. Most people aren’t tested as often as health officials, according to Jha.

It’s not clear whether a rebound after taking the antiviral is different from a rebound without the drug. In the trial that led to Paxlovid’s authorization, 2% of those who took the medication and nearly the same percentage of those who didn’t experienced rebounds.

The uncertainty surrounding antivirals and other treatments might contribute to preventable deaths, Griffin said.

“You have a five-day opportunity to reduce the disease progression, and once that window is closed, it’s closed.”

A monoclonal antibody called Evusheld from AstraZeneca prevented severe disease in people with weakened immune systems who might not get full protection from vaccines. It provides long-lasting protection, but Griffin said some providers don’t recommend it to eligible patients.

“It’s not an easy lift,” he said. “You can’t just write a prescription. It’s still only being sent to certain places, and there’s a whole process for getting your patient enrolled.”

Some doctors consider it “an uncompensated and time-consuming lift,” he said, and prescribe other medications that aren’t suitable for early treatment, such as high-dose steroids.

Nearly 92% of Americans over 65 are fully vaccinated, and about 70% have received at least one booster, according to the federal Centers for Disease Control and Prevention. 

Reformulated COVID-19 booster shots targeting the omicron variant of the coronavirus are likely this fall, but health experts don’t expect they’ll have a significant impact on the death rate.

“The vaccines we already have are still highly effective against serious illness and deaths … so I don’t think the bivalent vaccines are going to be a game-changer in that regard,” Dowdy said. “What they may do is help curb transmission somewhat because they may be more effective against infection.”

Experts said what will protect those at high risk of severe COVID and death is staying up to date on recommended vaccines and seeking early treatment with proven therapies. 

Read more at USA Today.

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