Monday, March 30, 2020

Covid-19: When in Doubt - Innovate (for those you can't intubate)

From the Times of Israel, March 29:

Israeli doctor in Italy says innovative treatments offering hopes of recovery
Carmi Sheffer describes connecting patients to ventilators via scuba gear, placing them on stomachs, in battle with unpredictable virus which ‘spreads like wildfire’ among elderly

An Israeli doctor in northern Italy says a number of new treatments appear to be helping some COVID-19 patients, offering a rare glimmer of hope in the hard-hit epicenter of the global coronavirus pandemic.
Carmi Sheffer, a doctor at the University Hospital of Padua, told The Times of Israel’s Hebrew-language sister site, Zman Yisrael, that as recently as last week he had been pessimistic.

“We were in the height of the outbreak, emergency rooms filled up, and the condition of patients on respirators with danger to their lives simply didn’t improve. I felt despair,” said Sheffer. 

“But in the past few days, people have begun to recover, in part due to new medications and also as a result of the fact that it takes some two weeks to recover from the virus,” he added.
The city of Padua has fared better than other nearby cities, with 1,552 confirmed COVID-19 patients, of whom 136 of them were hospitalized and 13 have died. Sheffer said the region of Veneto had more time to prepare for the outbreak than the neighboring hard-hit Lombardy.

He attributed the high death rates in Italy to the long life expectancy in the country and high percentage of elderly, as well as the spread within geriatric hospitals. “The moment the virus arrives in a place where an elderly population is concentrated, it spreads like wildfire,” he said.

In Padua, the autoimmune medicine Tocilizumab has proven effective, but can only be used once it is established that no other viruses or bacteria are present in the patients’ bodies, he said. The hospital where he works has also seen positive results from the antiviral drug Remdesivir, he added.

He said medics have been forced to be creative, giving an example from the city of Parma where patients who couldn’t be put on a respirator using a tube were attached to it using a snorkeling mask, with a part that connects it to the machine being printed in a 3D printer....

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