P.S.A. | Knowledge Is Power
Please, Family and Friends near and far . . . Take Heed . . .
Recently, a local friend, here in Eureka Springs asked me if I suffer from anxiety or poor stress management and I answered no, but as of late, I guess it shows, otherwise he wouldn't have asked me, right? Yes. Like many of us, my mind has wandered in places it's never been before and sometimes for hours at a time. Last evening, while surfing the usual spots I like to visit on the internet, I felt determined and vigilant to gain a better, factual understanding of what is going on.
Having had an international career in cruise ship entertainment (1993-2003) and in human resources with international hotel companies (2003-2018), my large Facebook friends and family span many far reaching corners of the globe.
For those that know me, I am a happy-go-lucky, usually an upbeat, positive person but last night, I seemed more focused and more glued to the many different perspectives offered to me on my social media outlets from around the globe about Covid-19, even the grim perspectives of medical professionals explaining what is going on as seen from their eyes.
Please, please know that this blog takes pride in it's core values:
Spreading joy and love
I have been very select about what to write about Covid-19 as there is so much uncertainty all around us. In the spirit of core value #5 living well, this post is written and published with good intentions; intentions to educate, inform and bring awareness. It is always my intent to share knowledge, tell stories, revisit history, and spread joy. Having properly vetted, factual, actual knowledge about Covid-19 is vital for all of us to work against it.
R E A L I T Y
The perspective shared from a Doctor in New Orleans, LA as he described the terrifying lung failure that occurs from COVID-19 (even in his young and relatively fit patients) truly hit me the hardest from all that I have read and researched.
Please note: much of the following is graphic and comes from a source that I have admired and respected for some time now - propublica.org. ProPublica is a nonprofit newsroom that produces nonpartisan, evidence-based journalism to expose injustice, corruption and wrongdoing. They were founded ten years ago to fill a growing hole in journalism. A decade (and five Pulitzer Prizes) later, ProPublica has built the largest investigative newsroom in the country.
Let's begin ...
Here is what the medical worker said in his interview with ProPublica,
“It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, Holy shit, this is not the flu. Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube."
Just days ago, on Friday 3/20, Louisiana reported approx. 479 confirmed cases of COVID-19, one of the highest numbers in the USA. Ten people had died. At the time of writing this blog post, Sunday 3/22, Louisiana has 837 confirmed cases. Twenty deaths.
The sobering reality to me as I continued to read was that New Orleans had just held Mardi Gras 2020 celebrations just two weeks before its first patient was diagnosed with Covid-19. There, at Mardi Gras, were more than a million visitors from all over the globe reveling in the streets of New Orleans, in the bars, restaurants, music venues, then at the airport, then in the airplane, at more airports, airport restrooms, restaurants, in more airplanes, around different people, then back to wherever home is for them.
Having attended Mardi Gras in 1996, and knowing what that experience is like - then it hit me. The snowball effect of this pandemic truly hit me.
I saw a Facebook post that explained it like this: (Note: I challenge you to imagine Karen attended Mardi Gras 2020.)
Since the first case in New Orleans, this dedicated Doctor has been running ventilators for the sickest COVID-19 patients. The part that shook me most about his perspective was that many are in their 40s and 50s, and have minimal, if any, preexisting conditions.
The ICU where he works has now essentially become a coronavirus unit in New Orleans. His hospital has admitted dozens of confirmed (or presumptive) coronavirus patients.
One third are on ventilators. This hospital, like most in the USA, was not prepared. Most concluded that this was just public and media over reaction. "It's just like the flu every year," they said. "The media is making it worse than it is."
“Reading about it in the news, I knew it was going to be bad, but we deal with the flu every year so I was thinking: Well, it’s probably not that much worse than the flu. But seeing patients with COVID-19 completely changed my perspective, and it’s a lot more frightening.”
Doctors and nurses report that no one is immune. This is truly hitting our elderly quite hard all across the globe and shockingly it is also having a major impact on what are perfectly fit, healthy people as well. Everyone reacts differently to it but one thing seems certain in most cases, the virus heads directly for the lungs.
“I have patients in their early 40s and, yeah, I was kind of shocked. I’m seeing people who look relatively healthy with a minimal health history, and they are completely wiped out, like they’ve been hit by a truck. This is knocking out what should be perfectly fit, healthy people. Patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and can’t breathe at all. They suddenly become unresponsive or go into respiratory failure."
This, my friends and family, is why social distancing is so important. This is not the flu. It is overwhelming to see the manifestation of the infection, both its speed and its intensity.
When patients suddenly become unresponsive and/or go into respiratory failure, this is known as ARDS - Acute Respiratory Distress Syndrome. ARDS is when the lungs become so filled with fluid, it takes over the space where air should be.
M.D.'s all over the globe manage ARDS by putting a patient on a ventilator. The additional pressure from the ventilator helps the oxygen flow into the bloodstream.
He explains further,
“Normally, ARDS is something that happens over time as the lungs get more and more inflamed. But with this virus, it seems like it happens overnight. When you’re healthy, your lung is made up of little balloons. Like a tree is made out of a bunch of little leaves, the lung is made of little air sacs that are called the alveoli. When you breathe in, all of those little air sacs inflate, and they have capillaries in the walls, little blood vessels. The oxygen gets from the air in the lung into the blood so it can be carried around the body."
Typically with ARDS, the lungs become inflamed and when that happens in your lungs, fluid and extra blood starts going into the lungs.
“In my experience, this severity of ARDS is usually more typical of someone who has a near drowning experience — they have a bunch of dirty water in their lungs — or people who inhale caustic gas.
I’ve never seen a microorganism or an infectious process cause such acute damage to the lungs so rapidly. That was what really shocked me.”
In treatment, those suffering from ARDS often try to rip the breathing tube out because it feels like it is choking them.
“The ventilator should have been doing the work of breathing but he was still gasping for air, moving his mouth, moving his body, struggling. We had to restrain him.
With all the coronavirus patients, we’ve had to restrain them. They really hyperventilate, really struggle to breathe. When you’re in that mind-state of struggling to breathe and delirious with fever, you don’t know when someone is trying to help you, so you’ll try to rip the breathing tube out because you feel it is choking you..."
At this hospital in New Orleans, they have such a large volume of patients, but it’s really hard for them to find enough people to fill all the shifts. The caregiver-to-patient ratio has gone down, and they can’t spend as much time with each patient, they can’t adjust the vent settings as aggressively because they’re not going into the rooms as often.
By minimizing their visits to the Covid-19 patient rooms it reduces infection risk of staff and it conserves personal protective equipment. There is a very real possibility that they might run out of ICU beds and at that point they will have reached maximum capacity and unable to properly care for new cases that need to be intubated and put on a ventilator.
USA hospitals do not have enough equipment to keep patients with Covid-19 and ARDS alive. Once a patient has ARDS it is extremely difficult to oxygenate. ARDS has a very high mortality rate, about 40%.
Please don't be like Karen from Mardi Gras, who innocently partied out in public and was infecting people without even knowing that she was doing so. You could be an infected carrier, like Karen was for the first 14 days of this illness, and not even be aware that you are.
“Hopefully, we don’t get there, but if you only have one ventilator, and you have two patients, you’re going to have to go with the one who has a higher likelihood of surviving. And I’m afraid we’ll get to that point . . . that’s happening in Italy.”
Stay home. Stay safe.
This is serious.
About This Blog Post
The medical details in this story were vetted by an infectious disease doctor, a cardiologist and an internist at three different hospitals. All of the information about ARDS was fact-checked against peer-reviewed articles and UpToDate, a resource for physicians to check current standards in care, clinical features, and expected complications and outcomes.
This post is intended to educate, inform, bring awareness and help to keep us all well by doing our part in stopping the spread of Covid-19.
❤️Sent With Love❤️