It came without warning. No preparation made; none required.
An illness had entered our social order and it spread quickly to many. Infected ones were rushed to hospital. Emergency rooms soon learned that intensive care was required. Meeting immediate needs, many patients were intubated and placed on ventilators.
Ventilators are intrusive. They enter the mouth, throat and bronchial tube. Residing in the lungs, the ventilator breathes for the patient, insuring that oxygen rich air flows into the lungs under proper pressure, and the reverse flow of carbon dioxide exhausts well. Repeat the pulse of breathing to oxygenate the blood and feed the brain and heart with strong supply of oxygen.
Getting off the ventilator can be tricky. The body has become used to the violation of the equipment. The patient must adapt to the removal, and then self-ventilating to return to normal. Under anesthetic the whole while, the patient slowly rises from slumber to wakefulness. Muscles are sore. Lightheadedness present. Throat dry. Voice raspy. Sleepy. Groggy.
Survival. The disease has left the lungs. Recovering from the onslaught of debilitating effects, the patient slowly comes into his/her own focus. Days later, they are sitting up in bed, able to eat somewhat normally, and get out of bed for walking and some physical therapy. They are getting ready to go home. Time elapsed: 10 days. All in ICU. Maybe longer.
Healthcare workers still don’t know the cause, origin and trajectory of the disease. Only patient by patient do they learn what works and what doesn’t. Researchers are at work to learn more. Medications are tested for viable effectiveness. A vaccine is being worked on but won’t be available for many months or years. We work with what we know, with what is starkly in front of us.
Long term effects of the disease are not known. Those infected may live a normal lifespan, or not; we simply do not know this. Or if chronic lung or sinus illness lies ahead. What about vulnerability to other diseases? Will the immune system function well for all future attacks?
Much yet to know, learn and understand. The medical community will create proper protocols that speed their work and minimize patient harm. Time will be, as always, the prime asset in dealing with the virus. Pandemic management will move to the top of the agenda for proper preparation and management.
We learned also that state and local governments worked well together to do common battle against the virus and its deadly results. Some states and cities did better than others. They took the threat seriously from the onset. They built teams of experts in medicine, epidemiology, and organizational development to determine the best steps to follow. And how to do so.
The teams passed the baton to government authorities who communicated with the public clearly and created easy to understand actions each could and should perform to safeguard themselves, their families, and their communities. They monitored results. They urged and motivated the public to cooperate for their own good. And they diligently monitored the results: what was the infection rate and trajectory of the virus? Was it showing signs of being managed? Were infection rates and treatment successes yet apparent? Were patients survival rates improving or worsening? Were our efforts effective or not?
As days became weeks and then months, now almost 4 months of experience with the COVID-19 pandemic, lessons are emerging.
We learned a lot about the following: willingness to follow directions, social order versus political motivation, medical interdependencies, economic reliance on a healthy labor force, working from home, retail industry meltdown, cooperation among strangers, strength of social order, and resilience.
We have yet to learn about the psychological effects, the psycho-social stresses, the physiological effect of diet and lack of exercise, and so much more.
We will examine some of these going forward. Visit this site in coming days for more on these matters.
June 16, 2020
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