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The reasons for this steep and continual decline in the deaths per day in the hospital of patients with COVID-19 are unknown and should be explored. Potential reasons could include:

Older patients who had recovered from COVID-19 but could not be discharged to care homes have places that have over recent weeks become available. This would not, however, explain the decline that started from 9 April 2020.

Patients with COVID-19 in late March and early April included a significant proportion of patients who caught the infection in hospital. These patients, because they were in hospital, were more likely to be sicker and more vulnerable than patients who acquired infection in the community and so more likely to die from COVID-19. As patients with community-acquired infections became a greater proportion of patients in hospital the hospital death rate fell. However, this would not explain why the death rate has fallen continually for approximately 8 weeks with no signs that the decline has yet plateaued.

Clinicians have become more skilled and adept at treating patients with COVID-19.
Patients overtime being admitted are becoming younger with fewer comorbidities, although there is no evidence of this in the daily hospital death data which, if anything, suggests a greater proportion of deaths in hospital are over the age of 60 than at the peak of deaths in early April.

Patients are entering the hospital with less severe disease, which could be a reflection of either the disease becoming less severe or hospitals that are now less concerned with being unable to manage peak infections being more willing to admit patients with lower disease severity than they would admit in early April.

The reasons for the declining death rate in hospitals may be a combination of one or all of these factors or due to some other reason, we have not considered. In either case, further research is warranted to understand why the hospital death rate has declined so markedly over the past 8 weeks.

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jamey said:

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Seems obvious to me.


In march when they only tested the very sick there was a higher death rate among positives. The positive cases also trended older back then, when only the very sick were tested



If a disease selectively kills the older then testing only the very sick selects the older too

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"In summary, what our experience shows is that fewer people are being admitted, and when they are, they tend to be much less sick than at the beginning or at the peak phases of the pandemic," he said.

Yealy said the declines might result from factors such as doing a good job of protecting the elderly and others who are highly vulnerable, and a rising portion of new cases involving younger people who are healthier and less likely to need hospitalization.

He also said UMPC has improved tools for helping the sickest patients, including the drug Remdesivir, and has "gained experience in how to best care for" COVID-19 patients. He noted that early in the pandemic, doctors usually put the sickest patients on breathing ventilators. But UPMC learned "it was difficult for them to successfully come off, and their outcomes simply aren't as good."

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