Advances Against COVID (2) By Caterina Di Palma, DOM
SARS2, Covid-19 is not the flu. What really sets it apart from the flu and pneumonia is the slow and imperceptible progression of the disease. That allows the asymptomatic spread, shedding virus before or without ever getting symptoms. As these issues were identified, new treatment protocols were developed in NYC and Italy because they were the earliest and worst hit by the pandemic. These developments are saving lives, reducing serious progression of Covid-19, to admission to ICU, to use of ventilators in some of the best hospitals in the US. Richard Levitan, MD, Emergency Physician, made this information available to the public through his interview on PBS program “Amanpour and Company” on April 28, 2020, repeated on December 29, 2020. CBS this Morning with Gayle King on December 17, 2020
There are other interviews and articles with links listed below under references.
SARS2, Covid-19 pneumonia, unlike influenza or pneumonia progresses slowly, allowing the lungs to adapt to decreasing levels of oxygen not noticeable until Covid infection is very serious. Dr. Levitan found, through his contacts in New York City and Italy, that there were early and great gains in treatment by “turning people on their stomach, improving oxygenation, and avoidance of ventilators“. He suggests earlier identification of who is infected and those who are at risk for serious illness. By giving pulse oximeters to covid positive people, they could monitor their own oxygen level, educating them that the time to go to the ER/hospital is if/when their oxygen level drops. Then In the ER they can be treated with simple interventions to boost oxygen and decrease the work of breathing with proning (laying them on their stomachs), putting nasal cannula oxygen flows onto people. These interventions can reduce or eliminate use of ventilators. Patients will have better outcomes, spend less time in hospital, and need less strenuous care that is required when a person is in the ICU, not strain hospitals, staff and other resources.
This will take changing the message given by government agencies to the public, changing the protocols now being used in many ERs and hospitals. The official NM DOH current instructions for Covid positive people is: “If you are experiencing severe difficulty breathing or other symptoms that make it difficult to care for yourself at home, call 911 right away.” Other medical advice is: “go to the emergency department if your fingers or your lips turn blue.”
Personal comment of Caterina Di Palma, DOM, NM: Possibly if Covid pneumonia is not allowed to progress, perhaps the more serious progression to heart and kidney problems, long hauler symptoms can be decreased. There is so much more that you will receive, understand by reading the articles, listening to the interviews. The articles have bibliographies to the medical journals reporting these advances and innovations in Covid-19 treatment. Thank you.
References:
NYT article, April 20, 2020: “The Infection that’s Silently Killing Coronavirus Patients: This is what I learned during 10 days of treating Covid pneumonia at Bellevue Hospital”
By Richard Levitan, MD https://www.nytimes.com/2020/04/20/opinion/sunday/coronavirus-testing-pneumonia.html
“Pulse Oximetry As a Biomarker for Early Identification and Hospitalization of Covid Pneumonia” by Levitan, June 17, 2020 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323007/
Please note that this material is provided as a communications courtesy for our profession and does not necessarily reflect the views or policies of NMSAAM, the NMSAAM BOD, or the ASA.