Doctors at a hospital in Houston, Texas, have published results comparing the patients from the first coronavirus surge (March-May) to the second one (May-July), connected to the lockdown relaxation.
There’s a very strong argument against the idea that there even is a second wave in the US — the first one never actually ended. But regardless of what you may call it, this second surge is different in a number of ways. Here are some of the key differences, according to results published by researchers about the COVID-19 hospitalizations at the Methodist Hospital in Houston, Texas.
The presented results cover 774 and 2130 patients during surge 1 and 2, respectively. Here are some of the key differences and what they mean.
Demographics
Second surge patients were younger, but not by much
Patients in surge 2 were younger — mean age 57.3 vs 59.9 years, compared to the first surge. This is significant, but not nearly sufficient to explain the outcomes (as we will see).
The second wave hit minorities harder
Minorities weren’t the first group to be hit hard by the pandemic. But as things progressed, it became clearer and clearer that they are disproportionately affected by outbreaks. As of the 2010 U.S. Census, Hispanics and Latinos of any race were 38.2% of the state’s population.
Second surge patients were less affluent
It’s not just the racial disparity — the economic disparity also showed up in the second wave. People with a lower income may find it harder to socially distance or work from home. Overall, there was a significant demographic shift in the second surge.
Hospitalization data
We’re getting better at treating the disease, but the virus remains extremely dangerous even so.
Lower length of hospital stay
The first positive index in the second surge is the length of hospital stay, which was shortened from 7.1 to 4.8 days.
Mortality rates
Perhaps the biggest improvement was observed in mortality data — which was more than halved in the second surge.
ICU admission rate
The ICU admission was also lower.
What this all means
The Methodist Hospital in Houston, Texas, is a microcosm of many places in the US. It’s not representative of all places, but it offers a fairly good comparison of the first and second stages.
For starters, there’s a noted demographic shift. As expected, the disease is already disproportionately affecting minorities and the underprivileged — a shift that could further accentuate in the future. Researchers note that in the second surge there were more tests carried out, but the positivity rates were also higher, so the higher hospital census reflects the higher rates of disease prevalence.
Another important takeaway is that in the second surge, there were better outcome rates. This is partly caused by the fact that patients were slightly younger on average and had fewer comorbidities, but also because the treatment and monitoring approach has improved. Researchers also note that the second surge patients were much more likely to be treated with remdesivir, which has been shown to reduce hospitalization time and improve outcomes significantly.
“Surge 2 data indicated a demographic shift of the pandemic toward a younger, predominantly Hispanic, and lower socioeconomic patient population with an overall lower comorbidity burden, ICU admission rate, and in-hospital mortality, the researchers note in the study.”
“The overall better outcomes during surge 2 may be explained by a combination of lower comorbidity burden, lesser disease severity, and better medical management,” the researchers conclude.
The study “Characteristics and Outcomes of COVID-19 Patients During Initial Peak and Resurgence in the Houston Metropolitan Area” has been published in JAMA.
