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Longview Doctor: Confidence In the way to Treat COVID-19 Grows, But Unknowns Remain
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| How to treat coronavirus at home now |
Local health care professionals have learned tons since then, said Dr. Venkatesh Donty, who focuses on pulmonary critical care at Longview Regional center. There, he’s been helping treat a number of the sickest COVID-19 patients.
“At the start, there was no definite treatment,” he said. “We didn’t know what’s getting to work, but we were doing everything.
It was stressful for people working in health care, he said, as they worried not only about caring for patients but other concerns, like whether or not they themselves would get sick.
Now, he said, they’re more confident. They’ve been ready to look after COVID-19 patients without getting sick themselves, and that they know more about what does and doesn’t work when treating the illness.
They have confidence now, Donty said, but that hasn’t changed the seriousness of things.
“Still, in spite of all of that, we've very sick and important patients with COVID within the ICU,” he said. “It’s hard to mention whether they’re getting to make it or not. That’s still a reality…. Now, we all know quite a bit, but that doesn’t make it any less serious. Still, it’s a nasty disease in selective people, nobody, but in selective people.”
Donty said he rotates working within the hospital every three weeks, usually caring for about six to eight COVID-19 patients within the medical care unit, but sometimes outside of the ICU. Typically, two to four of these ICU patients are going to be on some quite life-support.
How to treat coronavirus at home Today
He’s one among a gaggle of various sorts of doctors who cared for Jesus Mancha, a Longview man who was hospitalized for 3 months with COVID-19, including about two months on a ventilator. Ventilators help patients breathe — or breathe for them.
As a doctor who focuses on the systema respiratorium, Donty also sees patients on an outpatient basis. He’s had a few of patients therein capacity who were diagnosed with COVID-19 who recovered reception without hospitalization.
COVID-19, though, maybe a respiratory and vascular illness that affects the blood vessels also, he said.
“Basically, the potential for affecting tons of"> numerous organ systems means a lot of monitoring and testing and being watchful that involvement,” Donty said. “If you think that it’s only lungs, then you don’t perform the required tests to deal with if there’s any heart involvement. you'll miss out on something. you would like to try to do a radical evaluation and management.”
Some people that are diagnosed with COVID-19 haven't any symptoms, he said, and most COVID-19 patients have mild symptoms. Those symptoms can run the gamut of pharyngitis, flu-like symptoms, diarrhea, or simply headaches.
“The people that get really worse have pneumonia-like shortness of breath, shortness of oxygen,” Donty said. “People who have underlying disease seem to suffer tons of. If they’re heavier or obese, have diabetes or heart condition — they have a tendency to possess severe manifestations.”
One thing doctors have seen is younger people that have “significantly low oxygen levels” but don’t feel that bad, beyond a touch shortness of breath. Typically patients with such extreme hypoxia, or low blood oxygen levels, would look ill and desire they have help breathing.
“That’s something unique” that doesn’t happen altogether cases, Donty said. “It’s not an honest thing — just masking (the severity of the illness), I guess.”
He said 60% to 70% percent of individuals who contract COVID-19 won't have any symptoms, and another approximately 15% will have mild symptoms. the remainder may need severe symptoms that need hospitalizations. The sickest are cared for within the ICU, while the others are cared for elsewhere within the hospital, he said. (Note that hospitals report the amount of hospitalized COVID-19 patients to the local health authority, but that number isn't weakened by whether or not they are within the ICU or if they require ventilation.)
Treatments for hospitalized patients can include transfusions of plasma from people that have recovered from COVID-19 or with the anti-viral drug Remdesivir. Oral or IV steroids are an alternative choice that helps reduce the systemic inflammation the body generates in response to the virus. That inflammation can affect everything from the kidneys and therefore the brain to the liver, Donty said. He described how the treatment has changed as a study from the UK, as an example, provided information about what doses work best.
He said there haven’t been any formal studies about another treatment people are talking about – inhaled steroids. He added that might work for a patient who has mainly lung involvement, but not if the virus is causing more systemic problems.
He said fewer than half the people that are hospitalized require the ICU, and about two-thirds of these people might need ventilation. Those numbers can vary, though, counting on the patients and their ages and underlying health conditions.
Ventilation isn’t a choice, he said.
“If somebody needs a ventilator and you don’t put them on a ventilator, they’re getting to die 100% (of the time),” Don't say. “Without that, they wouldn’t be alive. It’s a final resort. It’s the last item the patient must stay alive.”
Patients on ventilators still might die 40% to 50% of the time, he said, explaining that patients at that time are in “very critical condition.”
“Everybody has got to do a very good job to stay them alive and keep them going therefore the body can heal,” Donny said. “That’s what happens once they get on the ventilator.”
What the area people have heard from a number of the nurses who helped in NY when it had been experiencing high numbers of COVID patients was that the hospital system was “heavily overrun.” Extremely sick people were being cared for by non-ICU nurses and non-critical care physicians, Donny said. a number of the outcomes there might be attributed to the system that broke thereunder load, he said.
“Luckily, we didn't get overrun,” Donny said, explaining that the seriously ill COVID-19 patients are difficult to manage and sometimes require extreme measures to treat them.
Months into the pandemic, there's hope, and therefore the medical profession has confidence about its ability to treat COVID-19 patients, Donty said.
But there are still unknowns.
“I don’t think complete understanding went on yet,” Donty said. “It’s evolving as we come to understand more and more.”
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