The Novel Corona Virus (COVID-19) is upon us and the guys from EM Over Easy are facing it head on. In part 3; Tanner and Drew discuss what the past week has been like and how we are dealing with COVID-19 at work, at home and with our family and friends. Our hope is to discuss this in a way that brings our listeners to the front lines with us and for those that are already there, to know they are not alone.
Two of our go to sources right now for keeping track of the pandemic is the Johns Hopkins Coronavirus Resource Center which has worldwide numbers including cases, deaths and trajectory of the disease. The second from IHME provides U.S. and state modeling of the impact of the virus based on cases and precautions taken. If the modeling from them is right, states like Ohio have made a major impact in terms of both case and expected healthcare resource utilization. Keep in mind, this is just one model, but it is very encouraging that if we keep up or efforts, many lives will be saved.
Just like last week, the COVID storm has hit the coasts and is moving inland. New York and the surrounding region continue to get pummeled and other hot spots have popped-up towards the center of the country. The toll this virus takes, just to care for patients is immense. While we have not been seeing the volume in Central Ohio that others are seeing, we have seen an uptick in patients presenting to the emergency department with serious symptoms. Just a few days ago, Drew ran a code performing compressions on a suspected COVID patient. Why? In order to reduce staff exposure, sick suspected patients are placed in negative airflow rooms and limited staff go in the room. This can be both physically (easily overheating wearing full protective gear) and mentally exhausting. To get a feel for what the physicians are dealing with, check out this WSJ article and NYT video, they tell the story well.
Something we have not talked much about is the the disease itself. Symptoms from COVID can range from nothing at all to severe, with the patient suffocating because oxygen cannot pass from the lungs into the blood. This is of the reasons preventing spread can be so difficult. Recently, the CDC made the recommendation to wear a face mask in public. This is not really to protect the person wearing the mask, but rather protect others by decreasing spread of the virus. For this, almost any face covering will do, a simple surgical mask or a more fashionable one made of fabric, you can even make them yourself. However, this is not an N95 or similar mask, those need to be worn by healthcare providers when taking care of patients.
While most people that have the coronavirus will not need to seek medical care or require hospitalization, many will. The biggest cause of hospitalization is patients becoming hypoxic, not having enough oxygen in their blood. What is so crazy about this disease is that many people that are hypoxic don’t realize it. We call them “happy hypoxics” and it is unlike almost anything seen before. Think about running a 100m dash as fast as you possibly can, when you finish, you will feel winded. That feeling is relative hypoxia, your body wants more oxygen to feed the burst you just experienced and the response is faster and deeper breaths to maximize the oxygen going into your lungs and then blood. In coronavirus patients, the body doesn’t recognize the demand mismatch as well and despite the patient not getting as much oxygen into the blood, they don’t really feel short of breath. As the disease progresses, patient decompensate, sometime rapidly, as they fall off the desaturation curve. Check out this video for an explanation of what this disease does to the lungs.
What Else We Can Do
Beyond supporting healthcare providers, please be sure to show support for others in the community that are working hard to keep our lives as normal as possible. From grocers and restaurant worker, to postal workers and garbage men, these are essential services that are helping us through this pandemic. Get carryout or delivery from your favorite neighborhood restaurants, consider buying gift cards for a later use and just say THANK YOU.
For more about how we are caring for our families at home, guidelines to return to work and the need for proper PPE, please check out or COVID part 2 post.
UNTIL WE TALK AGAIN, WASH THOSE HANDS, COVER YOUR COUGH, KEEP A SAFE DISTANCE AND PLEASE REACH-OUT TO US ABOUT HOW YOU ARE DOING.