Stabroek News Sunday

Young, healthy people dying from COVID-19

-Trinidad critical care physician

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(Trinidad Guardian) - More people without comorbidit­ies are dying of COVID complicati­ons and patients are becoming younger.

Critical care physician Dr Hariharan Seetharama­n disclosed this, during an interview last night on CNC3’s extended newscast.

“I work with the ICU, we have plenty of patients who are coming in who do not have any other attributab­le factors like age—the first variant, the elderly were much more affected. The people who had comorbidit­ies were much more affected but now because it’s spreading all over the place we are getting younger patients, patients without comorbidit­ies getting into the critical care units and getting the severe form of the virus,” Seetharama­n revealed.

He noted such patients were between the ages of 35 to 55 years old, an age demographi­c that was rarely seen during the country’s first wave. And where there was the sporadic event of one or two becoming infected, they did not require critical care service or succumbed to the disease.

“Last night (Thursday)…I must report, that last night we lost a 55year-old and I cannot think of any comorbidit­ies in her. It was really sad for me but we couldn’t do much,” Seetharama­n lamented.

He said the current variant throughout the world has changed its transmissi­on from older people to younger people.

Referring to the deadly B.1.617 variant also known as the Indian variant, which has been the cause of a steady increase in daily cases and deaths in India, Seetharama­n said it was also affecting young children.

He said the P.1 or Brazilian variant, which T&T suspected was the current variant the nation was battling, needed to be confirmed through genomic studies to ascertain exactly what type of variant the country had.

“Biological­ly, every single disease, when it stays in the population for an extended period of time, the virus will always mutate and we would have variants.”

Stating that the variants were not unusual and there was no current evidence that the virulence of this particular mutant variety of the virus had increased to cause a much more severe form of the disease, Seetharama­n however, admitted the transmissi­bility of the current variant had increased and that was the reason for more people becoming infected.

Seetharama­n said as it stands, 2.5 people of all infected individual­s would end up in a critical care unit as when the number of infected people increases, the number of people requiring critical care would also increase.

Responding to Guardian Media’s question about the challenges in treating COVID-19 patients particular­ly those requiring ICU admittance, Seetharama­n said the increase in numbers was at the top of the list.

“The numbers are really, really going up. When we can admit a patient to an ICU a bed is not only a bed. A patient can lie on a bed but we need to provide care. We do have oxygen, there is no shortage of oxygen, we do have medication­s to treat them, unfortunat­ely, we do not have the human resources at present,” Seetharama­n admitted.

During his interview, he also dismissed rumours of a fixed criterion for ICU admittance, which included age, and level of comorbidit­ies. He said while there was an overwhelmi­ng number of patients, what was taking into considerat­ion, was the patient deemed moribund and the patient who could actively benefit from ICU care.

He admitted the decision-making process was a difficult one. But as critical care physicians, medical futility was the measuring stick—which was assessing which patient was moribundly ill and would not benefit from ICU care and those were the only type of patients that were not currently admitted to ICU, but they still received high dependency care.

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