COVID-19: Episode 10: Still here
It's been a month since anyone but the three residents have been in the house -- Colleen's caregiver, V, was the last "outsider". I've done a couple of curb-side pickups, Colleen has had two MAC clinic appointments, and a few people have come to the door with deliveries. But we're as safe as anyone can be in this pandemic.
Meanwhile our daughter E is on the front lines -- she started work as a checker at Safeway around the beginning of March.
All the links under the cut will be repeated in Sunday's "Done Since" post, but I want to highlight this one in particular:
Even patients without respiratory complaints had Covid pneumonia. [...]
And here is what really surprised us: These patients did not report any sensation of breathing problems, even though their chest X-rays showed diffuse pneumonia and their oxygen was below normal.
We are just beginning to recognize that Covid pneumonia initially causes a form of oxygen deprivation we call “silent hypoxia” - “silent” because of its insidious, hard-to-detect nature. [...]
Patients compensate for the low oxygen in their blood by breathing faster and deeper - and this happens without their realizing it. This silent hypoxia, and the patient’s physiological response to it, causes even more inflammation and more air sacs to collapse, and the pneumonia worsens until oxygen levels plummet. In effect, patients are injuring their own lungs by breathing harder and harder.
In other words, by the time you notice that you're out of breath, you've already damaged your lungs and are low enough on oxygen that you'll probably need to go on a ventilator immediately. With predictably bad consequences.
The reason I'm telling you this is to convince you to go out and get a pulse oximeter now and check your blood oxygen level every damned day whether you feel sick or not. If it starts going down, call your doctor no matter what other symptoms you don't have.
In one of my last trips into Rite Aid before we isolated, I bought myself a pulse oximeter and have used it almost every day, feeling somewhat silly about it. Turns out it isn't silly at all.
Notes & links:
@ Is the Virus on My Clothes? My Shoes? My Hair? My Newspaper? - The New York Times @ ‘Five-Second Rule’ for Food on Floor Is Untrue, Study Finds - The New York Times Longer Contact Times Increase Cross-Contamination of Enterobacter aerogenes from Surfaces to Food | Applied and Environmental Microbiology " Although we found that longer contact times result in more transfer, we also found that other factors, including the nature of the food and the surface, are of equal or greater importance. Some transfer takes place “instantaneously,” at times of <<1s, disproving the five-second rule. " @ UW coronavirus model says Washington state could potentially start safely reopening the week of May 18 | The Seattle Times -> depends on how quickly the curve starts dropping off, the availability of testing, adequate hospital space and equipment, the ability to trace and isolate contacts of people who test positive, and continuing to prohibit large gatherings. @ Coronavirus: Advice From the Middle Ages for How to Cope With Self-Isolation @ Keep your home free of coronavirus with these cleaning, disinfecting tips @ Opinion | The Infection That’s Silently Killing Coronavirus Patients - NYT " Patients compensate for the low oxygen in their blood by breathing faster and deeper - and this happens without their realizing it. This silent hypoxia, and the patient’s physiological response to it, causes even more inflammation and more air sacs to collapse, and the pneumonia worsens until oxygen levels plummet. In effect, patients are injuring their own lungs by breathing harder and harder. " " Widespread pulse oximetry screening for Covid pneumonia - whether people check themselves on home devices or go to clinics or doctors’ offices - could provide an early warning system for the kinds of breathing problems associated with Covid pneumonia. " -> so I've been doing exactly the right thing by measuring my O2 level every day. -> the time to call for help is _before_ one starts feeling short of breath @ National coronavirus response: A road map to reopening - AEI [pdf published 3/28 @ guidance document to support governors’ efforts [PDF] (COVID-19 Updates - April 20) " States should consider initiating the reopening process when (1) the number of new cases has declined for at least 14 days; (2) rapid diagnostic testing capacity is sufficient to test, at minimum, all people with COVID-19 symptoms, including mild cases, as well as close contacts and those in essential roles; (3) the healthcare system is able to safely care for all patients, including providing appropriate personal protective equipment for healthcare workers; and (4) there is sufficient public health capacity to conduct contact tracing for all new cases and their close contacts. " We'll see how that goes. @ A parade that killed thousands? (thnidu | Déjá vu all over again)
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