NOEL KING, HOST:
Six months ago, COVID-19 was spreading fast in this country. And there was a lot we still didn't know. Dr. Deborah Birx of the White House coronavirus task force went on NBC's "Today" in March. And she made this prediction about the death toll.
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DEBORAH BIRX: If we do things together well, almost perfectly, we could get in the range of 100,000 to 200,000 fatalities.
KING: We did not do things almost perfectly. And it'll be higher than 200,000 fatalities. Today, almost 200,000 people in the U.S. have died from the virus. NPR's Allison Aubrey has been following this story from the beginning. And she's with us now. Good morning, Allison.
ALLISON AUBREY, BYLINE: Good morning, Noel.
KING: How do you put this number in perspective six months later?
AUBREY: You know, I mean, even as new cases decline nationwide, the U.S. has the largest number of deaths of any country in the world. Consider India, a country that has about four times as many people, has less than half the number of documented COVID deaths. So as a nation, Noel, we've been hit really hard.
Early in the pandemic, when it was concentrated in urban areas - specifically, New York City - most Americans didn't know anyone who had died or been sick with COVID. It felt like a distant threat to many people. But in recent months, we've seen there's been this distinct shift. Cases dispersed all through the country, including many small towns from the Sunbelt, including hotspots in the Midwest now.
KING: And now it sort of seems like we all know someone.
KING: The virus affected your family, didn't it?
AUBREY: Yes. My father-in-law died from COVID complications earlier this summer. And like so many families who've dealt with this loss, the hardest part was just knowing he would die alone. He'd been in a long-term care facility. So we couldn't go see him or hold his hand. We just received a copy of his death certificate. And when I saw that term COVID-19 printed there as the cause of death, it was a chilling moment because this term did not even exist eight months ago.
KING: I'm so sorry to hear about your father-in-law. And it's...
AUBREY: Thank you.
KING: ...Really terrifying to think of that, you know, 200,000 times in this country. You know, we've hit a point...
AUBREY: That's right.
KING: ...Where doctors are learning how to treat COVID more - certainly, more than they were back in March. Does that mean...
AUBREY: That's right.
KING: ...Fewer people are dying?
AUBREY: Yes. Doctors have more tools in their toolkits, medicines from steroids to remdesivir. And some hospitals, yes, I've seen a significant decline in the mortality rate. There aren't totally solid numbers on that yet. And it's also important to point out, Noel, given this milestone of deaths that more than 6 million people in the U.S. have recovered. I mean, lots of us know people who've tested positive for the virus who barely had any symptoms at all, especially teens or young adults. The flip side to this is that the virus has turned out to be very unpredictable. I spoke to Silky Singh Pahlajani. She's a physician and the daughter of a COVID survivor. Her 65-year-old mom went from being a picture of health to being in the ICU on a ventilator back in the spring.
SILKY SINGH PAHLAJANI: This disease ran the gamut on her, from her heart to her stomach, to her liver, to her brain. So I think that that is the unpredictability of this disease. It's not just COVID itself. It's like the hurricane that comes through. And this is the mess it leaves behind. That's how I would describe COVID and which is why it's so unpredictable. Every COVID patient is different.
AUBREY: And she says, as a doctor, it's been so humbling because for months it wasn't clear how best to treat her mom or if she'd make a strong recovery. Her mom does have some ongoing neuropathy that causes weakness in her limbs. So she's still in rehab.
PAHLAJANI: I think being the daughter and a doctor is where - for a lack of a better way to put it - messes with your head because you hear about your colleagues treating patients in the ICU. And here I am. I was having conversations several times a day with the hospital about what's going on.
AUBREY: Trying to help determine the best kind of care. So it's been really tough.
KING: And that is compounded by the fact that, for some people, there are longer term health problems from COVID-19. They don't just get better.
AUBREY: Yes, I mean, many. Most people recover fully with no long-term issues. There's still a lot to learn here. So there aren't solid numbers yet. Yet some physicians say a small minority - but, perhaps, thousands of people - have ongoing health issues from intense fatigue to lung damage, to heart issues, a whole range of complications. I did speak to Silky Singh Pahlajani's mother. Her name is Susham Singh. She's optimistic about a full recovery. She told me when she was in the hospital at Houston Methodist, there were moments that it wasn't clear if she would survive. But she was actually released within a day of the birth of her granddaughter. And she says that's what's given her motivation to work hard at her recovery.
SUSHAM SINGH: That was my happiest day. And I was so excited to see her. So when I got better, I went to her house. And I hold her. Oh, my gosh. She's so precious, so loving. I was feeling so good. And I was feeling I'm so fortunate I'm alive with my family. And I'm able to see my grandchild.
AUBREY: So she says she has a long way to go. She's not back to work or cooking yet because it's tough to stand for long periods. But her strength is coming back slowly.
SINGH: I am doing exercises at home - stationary bike, some yoga - to get better very soon. And it is helping me.
AUBREY: So you can really just hear that optimism.
KING: Yes, you can - stationary bike and yoga.
KING: Ms. Singh is in her mid-60s.
KING: We know that older adults are more vulnerable. But there are cases of young adults getting very sick, too.
AUBREY: Yes. I spoke to a 25-year-old nurse in Houston. Ashlee Phan is her name. She thinks she was probably exposed at work. She was hit very hard by COVID. She also ended up in the ICU on a ventilator. Turns out she had an underlying chronic condition. Her blood sugar was very high. She said she was not living a healthy lifestyle. So this fits with one of the most alarming findings during this pandemic, Noel. People with chronic conditions, including diabetes and heart disease, are up to 12 times more likely to die compared to healthier people. So Ashlee Phan says knowing this and having this experience has been a huge wake-up call.
ASHLEE PHAN: I think health care workers are probably the worst at taking care of themselves because I was so focused on work and, like, the patients. But now that I've been through all of this, I feel like it really was a wake-up call for me that I do need to take care of myself, too.
AUBREY: So she's really thinking about making some major changes - to try to eat better, to exercise - because she knows, as a nurse, that it is actually possible to reverse Type 2 diabetes - or pre-diabetes, as she had - with these kinds of changes. So she says she's just really committed.
KING: NPR's Allison Aubrey. Allison, thank you so much for the update. We appreciate it.
AUBREY: Thanks, Noel.
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