What doc­tors have learned

The Timaru Herald - - National News - Han­nah Martin

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.

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