I have not seen those numbers but regardless, ARDS is not the only morbidity we need to worry about.
What if, of the 10% of hospitalized cases, half of those patients permanently lose a noticeable portion of their lung function? Not supplemental oxygen dependent but can’t walk as far or exercise the same way they could before. That’s a major life change for a huge number of people, when you extrapolate it out to the entire world.
The threat of minor but permanent disability should not be ignored, especially in those who spent weeks on a vent.
From what I got, lung damage was actually caused by unnecessary ventilators. We now know that the vast majority of people are out of oxygen because of their blood and not lungs.
This is an extremely mild disease, I would assume that in a few months we'll know enough to make it a minor inconvenience for most people (more than it already is, since most people don't even experience symptoms today).
What long-term damage you know of (not saying there isn't, just curious)?
Prolonged ventilation is damaging to the lungs. But ventilation is not given lightly - usually it is for an acute deterioration and is life saving (ie without it, patient would have died in that instance).
Interestingly in COVID it appears that positioning and CPAP/BIPAP can be more effective that venting in edge cases. This is a very new phenomenon in medicine, and we probably over vented in the early course of the pandemic. We were acting in what we knew of other severe respiratory diseases, and the case data from COVID hadn’t had enough time to present best treatment modalities.
However, to suggest that the lungs are not being absolutely ravaged by the virus infecting, replicating and rupturing lung cells is ludicrous
> However, to suggest that the lungs are not being absolutely ravaged by the virus infecting, replicating and rupturing lung cells is ludicrous
I was talking about permanent damage. I actually read my comment again, and that isn't really clear.
Doctors in Italy are saying that ventilators were thought to be useful because people complained that they couldn't breath, but now they're saying that it's not the lungs that aren't working, but it's oxygen that is not carried out in the blood, and that ventilators can actually cause permanent damage in many cases.
I'm not a doctor, so I just base everything on what the (supposed?) experts are saying. As far as I know they might very well say that on TV because there aren't enough ventilators, no idea.
One of the reasons we worked out we could get people through without ventilators was because we ran out of ventilators. And people with COVid are being vented for 2 weeks plus. A normal time (and a time that would minimise Kung damage from a vent) would be several days.
But if someone has saturation’s in the shithouse, they’re going to die. Lack of oxygen (Hypoxia) in the blood is many many fold more common than severe thrombosis or whatever else was suggested; and the answer is right there - if the oxygen isn’t getting to the blood it’s because the lungs are shot.
If we have enough gear, we put someone in ECMO to solve the gas exchange problem.
Lung damage severe enough to do this is caused by the effects of the disease, not the ventilator
As far as I know nowhere ever ran out of ventilators, not even in Lombardy. But I sure saw that claim made a lot of times back when people thought that would happen. Spent a lot of time pointing out the authorities were denying it'd happened too. I concluded it's very easy for people to mix up "we think this is about to happen" with "this has happened".
Lombardy was utilising operating theatres and had ICUs and trauma bays full (70-80% is full because you have lost lost of your surge capacity), using the vents in all these areas.
There was a shift to NIV because once you have no vents you let people die
Most people don't even have symptoms! In Italy—at least according to the government—you have a higher chance of getting hit by a meteorite than not dying from COVID, unless you live in Lombardy, are over 60 years old, and have 2-3 preexisting conditions.
I know that people die, and even 1 person dying is a tragedy, but if you compare with Spanish flu, Polio, Ebola, AIDS it _is_ an extremely mild virus.
As for being an expert, I never claimed to be. I didn't know you needed a degree to post on a forum. If you're asking for a recommendation, I would recommend plasma. We are having great success in Italy, with 2 hospitals in Modena and Verona completely erasing deaths.
