WHAT WE LEARNED
GREENWICH — Medical professionals have learned a lot about COVID-19 since it surged across the region this spring.
As a second wave of the coronavirus pandemic is expected to crest in December, and the number of cases in the state continues to quickly rise, those lessons learned are saving lives and shortening hospital stays for many patients stricken by the virus that ravages lung tissue and lowers oxygen levels.
“We have better therapeutics, and we know more about the disease, and we’re preventing a lot of complications,” said Dr. Sandra Wainwright, a physician at Greenwich Hospital who is working on coronavirus patients.
In addition to the valuable experience garnered by medical professionals around the world, new medication is being rushed into use and offering another tool to save lives and in some instances keep mild cases from worsening, according to medical experts.
Among the most effective treatments for COVID-19 is a combination of an anti-viral medication, remdesvir,
which the Food and Drug Administration approved in October, and a steroid treatment that suppresses inflammation.
“Back in the spring, remdesvir was an emergency use authorization. Now there’s expanded access,” said Dr. Gavin McLeod, the section head for infectious diseases at Greenwich Hospital. “If anyone comes into the hospital with pneumonia or needing oxygen, they get put on that right away, along with the (steroid) dexamethasone. It is helping to shorten the stay. And we’re seeing less patients going on the ventilator.”
Medical professionals have been making a concerted effort to keep COVID-19 patients off ventilators, Wainwright noted.
“Once they’re on the ventilator, it leads to extended dependence upon the ventilator,” she said. “Then they end up staying in the hospital for a very, very long time, and it’s very difficult to get them off the ventilator. So we do everything we can to avoid it, that’s the best treatment plan for the patient.”
Some strategies to help patients recover from COVID-19 are decidedly low-tech.
“We do things like ‘proning,’ and all type of oxygen deliveries, with various masks. Proning means you sleep with your belly down. And what that does, it takes the weight of the organs off the lungs. It allows the blood and the air to circulate through the lungs better,” said Wainwright.
Other treatments are experimental and showing promise. The hyperbaric unit at Greenwich Hospital is where Wainwright and medical staff have been using a pressurized container to force oxygen into a patient’s body. Hyperbaric medicine has been used to treat scuba divers for decompression sickness, and it has developed new treatments for burns and wounds. Now the unit at Greenwich Hospital, the only one in Connecticut, is exploring its use for COVID-19 cases.
“We’re able to dissolve oxygen into the plasma, more than what the red-blood cells can carry, and it’s good enough to sustain life. For Covid patients, you put them in the chamber, and they’re able to cough and bring up phlegm, and breathe and drink water. And their color looks good,” said Wainwright. “That’s another innovation we’re trying at Greenwich to keep people off of ventilators.”
Hospitals have also adapted to the pandemic by making changes to their
buildings and operations. Greenwich Hospital received a major grant from an unidentified donor for a specialized coronavirus unit, and the 30-bed facility opened last week.
“It allows for the cohorting of the patients, so there won’t be any spread. Double-doors can be kept closed, and patients who are in the hospital for other reasons won’t be at risk. It helps protect others in the hospital,” said McLeod.
While medical staff have been attentively studying the coronavirus and learning the many tricks it can play on the human body, doctors say the public should re-learn some obvious lessons as the second wave builds.
“I hope people don’t get complacent and drop their guard,” said Wainwright.
“It can still be a fatal disease, it’s important people are aware of that. Wear a mask, do the physical distancing and be careful of large crowds We’re concerned about the way the curve is going up. There’s been a gradual increase over the last few weeks, hopefully it won’t be the spike we saw in March and April,” said McLeod. “That’s what we’re hoping for.”