why are deaths dropping but infection rate stabilizing?

I get my information from Worldometers https://www.worldometers.info/coronavirus/country/us/

In spite of the weekly spikes we’ve been seeing the infection rate in the US has stabilized at about 20,000 per day. THis has been consistent since roughly May 10th, over a month ago.
I don’t understand why the death rate hasn’t stabilize in this time period, but instead continues a gradual decline.

Is there any suggestion on why this phenomena is occuring? I would expect the death rate to lag the infection rate, but not by a month. It looks like the peak death rate followed the peak infection rate by about 13 days

One idea that I’ve seen floated is that we’re getting better at treatment. People who test positive now know they need be constantly monitoring their DO levels so they can rush to the hospital if they see a drop. I don’t know how widespread this is, but I’ve heard that in some places, patients are being sent home with pulse oximeters.

More easily available and widespread testing identifies more mild cases which leads to a lower mortality rate.

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This was my interpretation. There are actually fewer cases and those fewer cases get better treatment, so deaths are down.

Since a larger percentage of cases are being confirmed by testing, you don’t see the number of cases dropping.

The US is a big place. Might want to break it down more regionally.

In Texas, infections have definitely spiked since Memorial Day (roughly when Gov Abbott started opening things up) but not all the way back from May 10. Hoping not to see the 2-3 week lag in deaths, but only the next week or two will tell.

Arizona, Florida, and Arkansas appear to show a similar spiking trend since Memorial Day, rather than a whole month. Rising cases starting in earnest 2-3 weeks ago and hopefully not a connected spike in deaths over the next couple weeks.

If this is the case, then there have to be other states are showing a decreasing case count to have an overall stable number. I would think it’s probably biased by New York/New Jersey/Pennsylvania.

When combined with numbers from other states, it could well be the number of cases has been steady over the last month for the nation as a whole, but that’s a decline in some areas and a rise in others. Even with states, some regions (city vs rural) can show different trends.

Likewise, since deaths lag infections, the total for the nation as a whole is less informative unless there’s a uniform rise/decrease in infection everywhere, which we know is not the case.

Also, unfortunately, there’s less uniformity between states in counting deaths than one might wish. Some states only count confirmed COVID deaths, while others include estimates of probable deaths, which is what the CDC recommends. That can skew the numbers you might get if a spike occurs in a state that only reports confirmed deaths.

Worldometer includes information on how it collects statistics, and that’s worth looking into for context. It’s a nice site for an overall picture but definitely be careful about using a single number to get a nationwide picture for the US. Likewise, some of the comparisons between countries have similar known issues (different counting methods and such) so take those with the appropriate context.

Are we sure the death rates are actually declining and this drop isn’t due to more data hijinks from states trying to downplay how bad things are? Has there been a suspicious rise in pneumonia deaths anywhere?

I use worldometers for a brief look but go to 91-divoc (covid-10 backwards) if I want to play with the graphs. The last week US moving average of cases is trending up. One of the numbers I pay attention to is positive per test as that is not as dependant on number of tests. Usually a lower test number drives this up as tests are more likely then given to suspected cases. Northeast and Midwest are heading down with this metric while South and West aren’t by a long shot. So much for heat stopping this thing.

This isn’t China, and I seriously doubt that anyone could substantially suppress the numbers or hide them. Not for very long, at any rate. To a degree, I’m sure the numbers ARE under reported, but not due to any state deliberately and systematically screwing with the numbers. No one is stupid enough to think that this wouldn’t get found out…sooner rather than later, as it would be obvious in the data if someone was trying to play off Covid deaths as pneumonia for instance…especially a ‘suspicious rise’.

My WAG is a combination of factors. First, we only opened up recently, so people who got infected since we opened would only be getting to the critical levels now or in the next few weeks. Remember, this thing has a pretty long incubation period, and it takes time both to start showing symptoms and to get to the point where things are critical (except for those who have a rapid onset, but that seems fairly rare). Also, as a poster up thread noted, treatments and procedures are better now, so I think the mortality rate might be falling. Then there is the fact more people are being tested, so a lot of people (I’ve heard up to 30-40%) who have Covid but are asymptomatic are being found, as well as people who only have the mild versions. Those people weren’t tested before usually, and aren’t going to die. Finally, it’s possible that the disease will get less virulent over time due to mutation. I haven’t heard this is the case here, but it’s possible we are seeing this in the data as well (I doubt this btw but just thought I’d bring it up).

I’ve watched the daily stats closely and it does appear that the case rates climb but the death rates are not as bad.

This is understandable in the US because in March and April we were told, just stay home and isolate if you feel ill, there’s nothing a hospital can do. This was not correct. In Germany which has a much lower death rate, they were issuing steroid and albuterol inhalers to anyone who shows signs.

In other words Germany was treating the symptoms. This helped quite a lot. In the US at first you had people staying home and getting sicker and sicker until by the time they got to the hospital they needed to be headed right to the ICU.

And once in the ICU they were put on ventilators straight off. We now know that that is not always the best option. Doctors see people with low oxygen in their blood, that should prevent them from talking but these people are not even distressed. In the past they were put on ventilators, but now they are giving oxygen only.

Ventilators are very stressful to the body and while not directly causing death (most likely) they don’t help the stress of the patient.

So yes, it appears the death rates are going down because we know better how to treat people and what to watch out for (like the addition of strokes etc).

Also the spike in states like Texas and Florida are also due simply to the fact, that they didn’t get a lot of cases straight off. California is also spiking and they had the first controls in place, so they didn’t get a lot of cases straight off.

It makes sense statistically to have a rise in states that didn’t get it straight off. In absence of a vaccine, more people than not are going to eventually come down with it.

That is what flattening the curve is about, delaying the inevitable so that hospitals and doctors can cope.

I suspect part of what you see is the result of the early pandemic in NY. NY was completely overwhelmed, There wasn’t enough equipment, nor enough trained staff to use it. You remember all those “flattening the curve” graphics? NY didn’t do that fast enough, and went way over the patient load they could effectively treat. As a result, NY had a very high mortality rate for a while there.

Some states are getting close to overwhelming their hospital capacity, so we may see an uptick in deaths. But at the moment I think every state is succeeding in treading water.

Yes, and we are also getting better at treating it in general.

Where is this happening?

Well, I was paraphrasing a friend in Texas, who says his local ICU is close to capacity. Looking for a cite, it’s kinda a glass half full situation:

Here’s Houston

They are close to ICU capacity, and if the ICU trend lags the hospitalization trend, they may be in trouble. But they still show “surge capacity” that may be adequate.

While a lot of sources say that Dallas has now surpassed Houston, and that Dallas hospitalizations are up, I can’t find good data showing the actual hospital/ICU capacity. Just statements from politicians being politicians.

So… I guess I’m not actually sure. Maybe no where in the US is dangerously close to capacity for hospitals or ICUs right now. I suppose we’ll find out in a few more weeks, one way or the other.

I’ve doctor friends in the Houston, Dallas, and Austin areas. The Austin one’s hospital is full. The ones in Dallas and Houston say they aren’t but that they’re concerned it won’t be long for them given the trend in Texas.

Also, a lot of the staff have been worked hard, so they’re concerned that even if there are beds, if there will be sufficient staff to cover patients. Help will definitely need to come in from out of state should things get worse. Ventilators and PPE for staff might also fall short before surge capacity fills, though, so that’s another concern.

For what it’s worth, here’s a chart from the Texas Medical Center in Houston. They’re close to ‘normal’ ICU capacity but apparently have a fair amount of surge capacity. Where those beds come from is from other departments. So, non-critical and elective care would be suspended and medical staff diverted. That’ll cause downstream issues for those patients and staff, but needs must in an emergency.

The fact that those options may soon have to be deployed isn’t great. And certainly contradicts the messaging from Gov Abbott. At the very least, if non-critical and elective care have to be suspected, that’s not ‘business as usual’ in the sense he’s been pushing.

Arizona hospitals record 83 percent capacity as coronavirus cases spike (from 6/11)

What happens in relation to medical insurance if you end up in hospital with Covid?

Here’s a chart of AZ hospital capacity utilization. It is slowly trending upward, but I wouldn’t call the recent week a huge spike. The AP report in your link says the Arizona health officials recommend considering halting elective procedures when capacity utilization is >80%. I don’t believe it necessarily follows that hospitals are in imminent danger of being overrun by COVID patients.

Oh really?

AFlorida government data scientist who was previously managing the state’s coronavirus information dashboard before being fired last month, has created her own COVID-19 tracking website. She claims her site provides data Florida’s Department of Health (DOH) has “tried to hide or restrict from public view,” partly in an effort to speed up the state’s economic reopening.

Federal and state officials across the country have altered or hidden public health data crucial to tracking the coronavirus’ spread, hindering the ability to detect a surge of infections as President Donald Trump pushes the nation to reopen rapidly.

Infection rates were climbing at Nebraska meatpacking plants. Then health officials stopped reporting the numbers.

I guess the irony of you putting in cites for this is lost on you, so I’ll just point out what should be glaringly obvious…you can get the information, with just a quick search, about these events. Now tell me…can you get actual data on the CCP cover up? I mean outside of speculation and conjecture? No? Me either. See the difference? It’s why a cover up about trying to hide the actual numbers, which is what I was responding too, isn’t really possible in the US…while it is in China, at least they have kept a lid mostly on it so far.

I’m going to guess there are multiple factors.

  1. We know about mild and asymptomatic infections due to testing, which we didn’t before, and that has altered the rate of diagnosis : death, because you used to get diagnosed only by symptoms.

  2. A lot of the most vulnerable people have died. New infections are in a higher percentage of less vulnerable people.

  3. Lockdowns have isolated the remaining very vulnerable people, such as nursing home residents. (And people who know they are vulnerable are taking precautionary measures VERY seriously: you aren’t seeing lots of old people are BLM protests.)

  4. Treatment is better.

  5. People are seeking treatment earlier.

HOWEVER; the above, while affecting the rate of deaths, have not affected the rate of infection, partly because of the “testing” factor, but also because of the “asshole” factor-- people who won’t wear masks, won’t keep their distance, etc.

Quoting myself, but what I posted a week ago appears to be holding up. “Normal” ICU capacity is pretty much full in the Houston and Dallas areas now as well. Considering the Texas Medical Center in Houston is the largest medical district in the world (and not just Texas or the US), that’s remarkable.

And adults are being given beds at Texas Children’s Hospital now as well to free up beds at other hospitals.

COVID deaths nationwide may be dropping but that’s not the case in Texas. At best, it’s flat or slightly rising just as we’re starting to get into an exponential rise in cases and hospitalizations that started from around the Memorial Day holiday.

So, repeating what I noted earlier, nationwide stats aren’t terribly useful. We have significant regional differences that are starting to play out in a big way.