Things seemed to be improving, but Mr. Sierra Macias took a turn for the worse. He was 49.
Mr. Alvarado said it was difficult to contend with such loss even as people around him seemed not to be taking the virus seriously, believing it was being overhyped or thinking, somehow, that it was not dangerous.
“It seems like people think the news are overthinking, overtalking,” said Mr. Alvarado, who said he was waiting for paperwork to send his father-in-law’s body for burial in Ciudad Juárez, Mexico, where cemeteries are running out of room. “You don’t realize the situation until you live through it.”
Improved medical treatments for the virus have emerged in the months since it first arrived in the United States, offering hope that even if cases soared before a vaccine was available, deaths might be held off.
A steroid, dexamethasone, has been shown to help the seriously ill; a new antibody treatment, similar to a therapy given to President Trump shortly after he contracted the coronavirus, just won emergency approval from the Food and Drug Administration; and doctors now know to turn patients on their stomachs to improve oxygen flow, one of the many best practices that have emerged over months of contending with Covid-19. The case fatality rate — a crude measure that looks at the share of people who die out of those who are known to have tested positive — has fallen throughout the pandemic, according to public health experts. That is in part because the country is conducting far more tests, and also because the age demographics have changed, with more cases among young people, who are less likely to get seriously ill.
Still, hospitals are now filling with patients, threatening the limits of medical systems in some regions. More than 68,000 people are in the hospital with the virus, greater than two earlier peaks in the spring and summer. Even the best medicines and techniques lose their usefulness if too many people get sick at the same time, taxing staffing and supplies.
“When you’ve overwhelmed the health care system, nobody is going to get optimal care,” said Dr. Jessica Justman, an epidemiologist at Columbia University.
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