The game-changing covid-19 treatments that helped slash the death rate

Faced with an unknown disease, doctors had to update best practices faster than ever before. Here’s what we now know about gold standard coronavirus treatments

By Carrie Arnold

AS MUCH as the gloves and N95 masks, Devan Kansagara‘s constant companion early last February was a sense of gnawing anxiety. As a physician at the Oregon Health Sciences University, he braced himself for a tidal wave of covid-19 cases. A few weeks later, it arrived. Like doctors around the world, Kansagara found himself having to care for patients with a deadly disease he knew very little about. “Everyone was grasping at straws,” he says.

Ideas flooded in from all corners, ranging from the medically plausible to the utterly crackpot. Various clinical insights began to emerge from cities hit early by the outbreak such as Wuhan in China and Milan in Italy. Doctors and researchers had to decide in real time which strategies to pursue and what warranted further testing.

It all happened at a blistering pace. Doctors swapped advice over WhatsApp, Facebook and Twitter, changing clinical practice in hours instead of years. Scientists launched clinical trials, enrolled participants, analysed data and rapidly disseminated results.

Some pinned their hopes on new, life-saving medicines. Yet while thousands of drugs are being tested or are in development, few have yet proven to make much difference (see “Where are the medicines?“).

In spite of this, we have made tremendous progress since those early days. Although outcomes vary by location, and new variants pose new challenges, people hospitalised with covid-19 now are much more likely to survive than they would have been at the start of the pandemic. This is largely thanks to three major changes.

The vast majority of people infected with SARS-CoV-2, the virus that causes covid-19, won’t …