Some Ironclad Best Medical Practices Tossed Out The Window In Face Of COVID-19’s Chaotic Destruction
Doctors talk about what they would have liked to know about the progression of the illness a month ago when they started treating severe cases. In other news: rationing care, viral loads and the life span of the virus.
The New York Times:
What Doctors On The Front Lines Wish They’d Known A Month Ago
Just about a month ago, people stricken with the new coronavirus started to arrive in unending ranks at hospitals in the New York metropolitan area, forming the white-hot center of the pandemic in the United States. Now, doctors in the region have started sharing on medical grapevines what it has been like to re-engineer, on the fly, their health care systems, their practice of medicine, their personal lives. Doctors, if you could go back in time, what would you tell yourselves in early March? (Dwyer, 4/14)
The New York Times:
‘What Disease Are We Treating?’: Why Coronavirus Is Stumping Many Doctors
Doctors say the coronavirus is challenging core tenets of medicine, leading some to abandon long-established ventilator protocols for certain patients. But other doctors warn this could be dangerous. (Stein and Tiefenthaler, 4/14)
Who Gets The Last Ventilator? Pondering The Unthinkable Amid Covid-19
The patient was around 80, an immigrant from the Dominican Republic, his medical record filled with the accumulations and erosions of old age. His blood pressure was high, his spinal cord narrowing to a pinch. He had a history of alcohol addiction, but was no longer drinking. A prostate cancer had been burned out with radiation, and he had yearly appointments to make sure it wasn’t coming back. He had type 2 diabetes. (Boodman, 4/14)
How Much Of The Coronavirus Does It Take To Make You Sick?
Infectious respiratory diseases spread when a healthy person comes in contact with virus particles expelled by someone who is sick — usually through a cough or sneeze. The amount of particles a person is exposed to can affect how likely they are to become infected and, once infected, how severe the symptoms become. The amount of virus necessary to make a person sick is called the infectious dose. Viruses with low infectious doses are especially contagious in populations without significant immunity. (Hogan, 4/14)
Study Finds Evidence Of COVID-19 In Air, On Hospital Surfaces
A study published late last week in Emerging Infectious Diseases found a wide distribution of COVID-19 virus genetic material on surfaces and in the air about 4 meters (13 feet) from patients in two hospital wards in Wuhan, China, posing a risk to healthcare workers. While the findings of the environmental sampling study do not indicate the amount of live virus, if any, or precisely determine the distance of aerosol transmission, the authors say that they confirm that the virus spreads in aerosols in addition to large respiratory droplets. (Soucheray, 13)