A protester wears a helmet decorated as the COVID-19 virus at Los Angeles’ “Defeat the Mandate” rally to protest vaccination mandates designed to slow the spread of COVID-19 outside Los Angeles City Hall on Sunday, Dec. ‘April 2022. California battled a deadly winter coronavirus surge linked to the omicron variant, but began easing masking and vaccination requirements this year as cases and rates fell of hospitalization, which public health officials attributed in large part to widespread vaccination and other safety measures. (AP Photo/Damian Dovarganes)
Today’s hypertransmissible strain of the COVID-19 virus has caused cases to skyrocket in the United States.
But the rise in deaths, the grim marker of previous dangerous waves, has not kept pace, and the average risk of dying from an infection is falling to levels almost as low as seasonal flu, leading epidemiologists say.
Is the COVID virus, which has killed more than 1 million Americans, losing its fangs?
George Lemp, an infectious disease epidemiologist who has analyzed public health data from California during the pandemic, thinks so. He said death rates have fallen steadily over the past two and a half years.
“The case fatality rates of COVID-19 are substantially lower and are rapidly approaching those of the annual flu,” said Lemp, former director of the California HIV/AIDS Research Program in the Office of the President from the University of California.
Case fatality rates, or case fatality ratios, reflect the number of reported deaths as a percentage of known cases. The Centers for Disease Control and Prevention reported about 29 million flu illnesses and 28,000 deaths nationally in 2018-19, a case fatality rate of 0.1 percent. For the previous season, there were 41 million flu-related illnesses and 52,000 deaths, a rate of 0.13%.
Lemp said data from the California Department of Public Health show that California’s COVID-19 death rate early in the pandemic, from February 2020 to May 2021, was 1.7 percent in general and dropped to 1.11% when the delta variant arrived from July to December 2021.
When the even more transmissible omicron variant BA.1 arrived from December to February, the rate dropped to 0.34%. The most recent data with omicron subvariants BA.4 and BA.5 from June and July show a rate of 0.38%.
That’s still about three times more deadly than the official flu rates of recent pre-Covid seasons. But Lemp noted that many people use rapid antigen test kits at home and don’t report the results, so experts estimate the actual number of cases is likely two to four times higher.
That would conservatively put fatality rates for the current omicron BA.5 variant at about 0.19 percent, a more flu-like level, he said. Although death rates are progressively higher with age, they have decreased in all age groups.
National data show similar results. Our World in Data project, a public online data center based at the University of Oxford, estimates the current US death rate from COVID-19 at 0.36%, down from a peak of 2 .88% in March 2021, using case and death data from Johns Hopkins University. .
All these calculations are, of course, subject to considerable uncertainty due to the limitations of the available data. Influenza case numbers are even less accurate than those for COVID-19. The CDC and state public health officials had no comment on the death rates from COVID-19.
Although epidemiologists agree that the current virus is proving to be less lethal than previous variants, it is still a killer and has made many people who were recently infected and recovered absolutely miserable. The virus is killing an average of nearly 400 Americans and 40 Californians a day.
“COVID is the third leading cause of death in the US this year,” said Dr. George Rutherford, an infectious disease specialist at UC San Francisco. “This is not trivial.”
He and Lemp agree that there are many reasons why the virus is killing less today than in years past: increased vaccination, booster shots, improved patient care techniques and better treatments like the antiviral drug Paxlovid play an important role.
The way the virus has mutated to become more transmissible is also a factor. Earlier versions tended to cause infections deep in the lungs. This prevented them from spreading as easily, but often led to life-threatening lung infections. The current omicron variant tends to settle in the upper respiratory tract of the body, which allows it to spread much more easily, but often results in less severe disease.
Rutherford said her elderly mother got the latest version and recovered.
“He was hoarse for two days and he was fine,” Rutherford said. “But it could just as easily have gone south.”
Today’s dominant BA.5 version accounts for about nine out of 10 cases nationally, and no other variant has yet emerged that seems to oust it, yet. But after repeated waves of COVID-19 infection spawned by new variants, health experts don’t believe BA.5 is the last hurray for COVID.
The virus has shown to mutate easily and circulates both in people and in many animals that live around them. And while vaccine makers are planning an updated injection this fall based on the omicron BA.1 variant that broke out over the winter, there’s no telling how it will work and for how long against any new variants.
Rutherford said the virus mutates to evade our immune system to continue spreading, and the resulting mortality is haphazard. But it doesn’t take much for a mutation in the virus to make it more transmissible, more deadly, or both.
“This is just one mutation that doesn’t happen,” Rutherford said.
—John Woolfolk and Harriet Blair Rowan, The Mercury News
RELATED: COVID triples in Europe, hospitalizations double
RELATED: Boost Now or Wait? What you should know as BC counts down to its upcoming COVID shots
Coronavirus