How do you treat people with a disease no one has seen before? Doctors in the early days of the pandemic faced a huge and daunting learning curve: finding ways to save lives in the dark. RacingforaRemedy
Terri Donelson, left, and her husband, Stephen, walk up their driveway to see friends and family awaiting him at his home in Midlothian, Texas on Friday, June 19, 2020, after his 90-day stay in the Zale Hospital on the UT Southwestern Campus. Donelson’s family hadn’t left the house in two weeks after COVID-19 started spreading in Texas, hoping to shield the organ transplant recipient. Yet one night, his wife found him barely breathing, his skin turning blue, and called 911.
In New York or Italy, where hospitals were overflowing, Goff thinks Donelson wouldn’t even have qualified for a then-precious ventilator. But in Dallas, “we pretty much threw everything we could at him,” she said.“It’s a tsunami. Something that if you don’t experience it directly, you can’t understand,” Italian Dr. Pier Giorgio Villani said in a series of webinars on six straight Tuesday evenings to alert other intensive care units what to expect.
They offered “a privileged window into the future,” said Dr. Diego Casali of Cedars-Sinai Medical Center in Los Angeles, who is from northern Italy and was directed to the webinars when he sought advice from a front-line friend about how to prepare.Dr. Jane Muret of the French Society of Anesthesia-Resuscitation also heard by word-of-mouth and, impressed by the breathing-tube lessons, posted a translation when France had only a handful of diagnosed COVID-19 cases.
“Every night, I would go home and I had the doubt that I had gotten something wrong,” Lorini said. “Try to imagine: I am all alone and I can’t compare it with France because the virus wasn’t there, or Spain or the U.K. or America, or with anyone who is closer to me than China.” Dr. Bin Cao of the China-Japan Friendship Hospital in Beijing explained that as the virus sneaks past the lungs into the bloodstream, it damages the lining of blood vessels, forming clots in the heart, kidneys, “all over the body.” He urged American doctors to use blood thinners protectively in the severely ill.
By April, many doctors were bowing to pressure to try a malaria drug named hydroxychloroquine that obsessed President Donald Trump. Osborn never understood why such a drug would work and, sure enough, it eventually failed when put to a real test.“We’re learning as we go,” Osborn said. “You could talk to me in two weeks and I might be telling you something that’s really different.”When Stephen Donelson arrived in the emergency room, “we had very little hope for him,” Goff said.
Ventilation is like “blowing air into a sponge and all the little holes are opening up. Walls between the holes can be very thin. If you’re putting in a lot of air, it can damage the lining of those little holes,” explained Osborn, the St. Louis critical care specialist. Hospitals that specialize in treating ARDS knew how to prone before COVID-19 hit. For many others, it was a brand-new skill their workers had to learn. Fast.
She paused to compose herself, and added: “If this is going to happen, and you can provide some comfort that maybe they wouldn’t have gotten if you weren’t there, that’s important.”Back in Dallas, Donelson spent 17 days on a ventilator. When it was removed, he was too weak to even sit without support and the breathing tube had taken away his ability to swallow.
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