In the beginning, doctors placed patients on mechanical ventilators to help them breathe; over time, they learned to position patients prone and provide supplemental oxygen in less invasive ways, and to postpone ventilation or avoid it altogether if possible.
By mid-June, clinical trials in England had shown that treatment with an inexpensive steroid, dexamethasone, reduced deaths in patients on ventilators and the deaths of patients receiving supplemental oxygen by a third. fifth. But the first recommendations from China and Italy were “not to use steroids at all, even though many of us thought it made sense to use them,” said healthcare physician Dr Gita Lisker. Intensive at Northwell Health. “I think it makes a big difference. But when we started with this in March, the data and recommendations from China and Italy said, “Don’t use them, steroids are bad.” “
Doctors were also unaware at first that the Covid-19 disease caused by the new virus causes potentially fatal blood clots. Now patients are given anticoagulants at the start of treatment if necessary.
But the other problem in the spring was that hospitals in hard-hit areas like New York were overwhelmed. Doctors who had not worked in intensive care for many years were being recruited to treat critically ill patients, nurses were understaffed and equipment was lacking. “There was a huge tidal wave that overtook the healthcare system,” said Dr Lisker. “You had intensive care units run by doctors who hadn’t done intensive care for 10 years, if ever.”
She added: “There is no doubt that whether you lived or died in April, part of it depended on the unit you landed in.”
Indeed, she said, “the whole idea of flattening the curve was to avoid overwhelming the health care system.”
Medical experts fear that outbreaks across the country could reverse or roll back those gains. The number of Covid hospital patients has increased 40 percent in the past month, and more than 41,000 patients are now hospitalized in the United States. Hospital administrators in Idaho, Utah and Kansas City, Missouri, have warned they are already nearing capacity. Some have turned down ambulances and others are making plans to ration care if they run out of beds and said they may be forced to transfer patients to facilities in other states.