What doctors have learned

Turning patients on to their stomachs and using plasma from recovered people are among things those on the frontline have learned about successfully treating Covid-19.

Covid-19 did not exist 10 months ago and doctors had little knowledge about the virus or how to treat it.

Clinicians ‘‘started off in a vacuum’’ with treatments ‘‘very much unguided by evidence’’, Auckland City Hospital intensive care specialist Dr Colin McArthur told Stuff. While clinicians had limited information about treating existing coronaviruses, such as Sars and Mers, they were essentially building the plane while flying.

With no treatments for Covid-19, the focus was largely supportive – boosting oxygen through cannulas, masks or via a ventilator, McArthur said.

A key difference now is steroids. Early on, doctors were ‘‘hesitant’’ to use steroids to lower inflammation in people with Covid-19. Previous experiences suggested steroids were not likely to help, and could even make coronaviruses linger longer. However, steroids – particularly dexamethasone and hydrocortisone – have become important tools in the fight against Covid, used in anyone moderately unwell in hospital. Research published this month, led by McArthur, found fewer patients died and fewer needed intensive care support when they received steroids.