Fighting the unknowns of COVID-19, one case at a time
Most serious coronavirus cases sometimes result in unexpected symptoms
With each new patient admitted to hospital, the virus that has shut down the globe reveals more about itself to doctors at Niagara Health.
But it’s not making their jobs any easier.
For 80 per cent of people infected with COVID-19, their symptoms are classified as “mild,” and while a person might feel like they have the worst flu of their life, they can recover at home.
But for the other 20 per cent, things are more serious. They need to be hospitalized and symptoms can include plunging oxygen levels, dehydration and even delirium.
For an unlucky few, the virus compromises their lungs so completely, a ventilator will be required to breathe for them.
“You have to remember this is a new disease,” said Dr. Karim Ali, head of infectious diseases for Niagara’s hospital system. “We’ve been dealing with it for three and a half months. So we are learning more every day.”
While the rate of new COVID-19 infections in Niagara continues to stabilize — save for outbreaks still raging in longterm care homes — life in unit 4A of St. Catharines hospital continues to be difficult, even harsh for patients.
They tend to be older people, Karim said, with other health problems that makes it even
more difficult for their bodies to combat COVID-19 — a virus for which there is presently no treatment or vaccine.
“It’s a pandemic, and that means that everyone is at risk,” Ali said. “But for older people with other medical issues, it is more dangerous.”
As of Tuesday, 30 people were admitted to unit 4A — the unit sometimes called the “hot zone” because it’s where all local cases needing hospitalization are treated.
Of those 30, five deteriorated to the point they have been transferred to the intensive care unit. Three of them are on ventilators.
Ali said there have not been enough local cases for him to be able to say how many patients who need to go to ICU, or need a ventilator, will survive.
“I can say that some of them have recovered and done OK,” he said. “But that is not the case for everyone.”
To date, of the 77 patients admitted to the hospital with COVID-19 26, or 33 per cent, have died. Twenty-five of those people were Niagara residents, and one was from Dunnville.
There have been 33 total deaths in Niagara related to COVID-19 among 385 confirmed cases since the first patient was discovered on March 13. At least 28 of those deaths were of residents of long-term care and retirement homes.
The last time Niagara saw this kind of death rate from an illness was in 2011, when a C. difficile outbreak at hospitals resulted in 37 deaths.
Without effective treatment, Ali said doctors try to manage the worst of the COVID-19 symptoms, ensuring a patient is getting enough oxygen and fluids. Because of their age and medical history, others may also contract secondary infections, including bacteria pneumonia, that have to be treated with antibiotics.
Beyond that, it is up to a patient’s body to fight off the virus.
Ali said while most patients exhibit “classic” COVID-19 symptoms — severe respiratory problems chief among them — the most serious cases showed atypical problems, including delirium and signs of secondary infections.
“So what you have to do is expand your clinical evaluation,” Ali said. “You start looking for other issues.”
It all can make trying to stay ahead of the virus difficult. COVID-19 is, in many respects, an unknown factor. It just hasn’t been around long enough for physicians to know exactly what it will do.
“I don’t want to use the word frustrating because, as doctors, this is what we have been trained for,” said Ali. “You are trained not just to deal with the known, but to deal as best we can with the unknown.”