News Coronavirus (COVID-19) Discussion Thread IV

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The harsh reality of life on a COVID ward

“The lungs become more inflamed, leading to breathing difficulties. Fatigue and high fevers are common. Everyone is absolutely miserable.”
www.theage.com.au www.theage.com.au


The harsh reality of life on a COVID ward

Steven Tong
Infectious diseases expert
September 24, 2021 — 3.30pm




Over 200 million cases and 4.5 million deaths from COVID have been reported worldwide. Infections are quickly becoming universal to the human condition.

Among all the numbers we hear from press conferences, it is easy to forget that each number represents a unique person from a household within a community.


I am one of many healthcare workers caring for those on our COVID wards at the Royal Melbourne Hospital. We have three dedicated COVID wards plus 20 intensive care unit beds. Enough for about 70 patients. We expect patient numbers to increase and have operational plans to increase our capacity.

All staff on these wards wear full PPE – gowns, N95 masks and face shields. We’ve been ‘fit-tested’ to ensure our masks don’t leak. Strategically placed air scrubbers clean the air of aerosols containing viral particles.

It feels safe. It feels calm. It’s much better than last year when aerosol spread was not as well understood and many staff got infected. Critically, we’ve also been vaccinated.

This past week, the patients range in age from 20 to 80. Several are pregnant women. Some have other health problems that place them at higher risk of severe COVID. Many are young and otherwise fit.

Entire multi-generational households are here. Mum and dad, grandparents all sick in the hospital, kids cared for elsewhere. In another instance, mum in hospital, dad caring for a two-week-old baby at home.

Most of those hospitalised are in their second week of illness. The lungs become more inflamed in response to the virus, leading to breathing difficulties and a lack of oxygen getting from the lungs to the bloodstream. Fatigue and high fevers are common. Everyone is absolutely miserable.

Some patients improve without specific treatment as we closely monitor them. Many become hypoxic (low oxygen levels in the blood). Hypoxic patients receive oxygen therapy and we start medications. These include remdesivir (an antiviral drug), dexamethasone (a steroid), and other anti-inflammatory agents.

One of our patients is in her 30s. She is pregnant with her first child. She has been staying home and isolating during lockdown. Her husband got something for her at the chemist, was notified that that was a tier-1 exposure site, was tested, and was positive. She then got infected too. Pregnant women are at higher risk for severe COVID.

It’s week two of her illness and she is becoming hypoxic. We start dexamethasone and oxygen. Her hypoxia worsens and we turn up the oxygen.

We ask intensive care to assess her as she might need to go on a ventilator. We give her tocilizumab, a targeted anti-inflammatory drug.
Tocilizumab hasn’t been used much in pregnancy for COVID but she agrees that any potential risk is outweighed by the benefit. Over the next 48 hours she makes a stunning recovery.

Was her recovery due to the tocilizumab? The dexamethasone? I can’t truly say from this single anecdote. What I do know is that large randomised clinical trials have shown these drugs to be effective.

Among thousands of patients randomly assigned to drug or no drug (essentially by tossing a coin), those receiving the drug are less likely to die. Randomised clinical trials are the only way to demonstrate a drug works as they remove the influence of other factors.

One of our other patients is in his 40s. A father of four. He’s a tradie. He’s fit. His whole family got infected. I care for him after he leaves the intensive care unit, having been on a ventilator for seven days. It’s day 15 of his hospital admission. He still requires some oxygen and is breathing fast to get sufficient air through his lungs.

We talk footy.

He and his son support Richmond. They swapped allegiances from Essendon when Bachar Houli switched clubs.

We reminisce about the incredible grand final performances of Houli. In my patient’s community, Houli is a legend. Houli’s mother has been in intensive care with COVID and Houli has been encouraging people to get vaccinated.

Both my patients just want to get home. Isolated and alone in hospital, but connected through their phones (all our patients are on their phones), they have been telling their families and communities to get vaccinated.

“We don’t want others to go through what we have gone through. This is not just politicians talking on the TV. This is real for our community. Get vaccinated.”

Steven Tong is an infectious diseases physician at the Royal Melbourne Hospital and the Doherty Institute.
 
Yesterday we found out there were Covid traces found in our s**t around home

All day there have been rumours of Tier 1 exposure sites, now South West Healthcare have put this notice out. No word on the exposure sites yet though. Looks like it's back into lockdown for us.
Screenshot_20210924-174332_Snapchat.jpg
 

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SpiderBurton22 said:
Yesterday we found out there were Covid traces found in our sh*t around home

All day there have been rumours of Tier 1 exposure sites, now South West Healthcare have put this notice out. No word on the exposure sites yet though. Looks like it's back into lockdown for us.
View attachment 1244887
Click to expand...
Stay safe spider 💕
 
SpiderBurton22 said:
Yesterday we found out there were Covid traces found in our sh*t around home

All day there have been rumours of Tier 1 exposure sites, now South West Healthcare have put this notice out. No word on the exposure sites yet though. Looks like it's back into lockdown for us.
View attachment 1244887
Click to expand...
Oh poo!
 
B4Bear said:
I actually agree on the 4K number. It was an obviously panic move, as seen with hindsight. But I am also sure the health department are doing everything in their power to bolster their capacity and capabilities.

We live in a world where instant gratification and satisfaction is demanded, and is often delivered; until something of consequence is needed. Then you need time, and all the political bitching can not change that.
Click to expand...

18 months with the threat of a pandemic of this sort hanging over our heads is in no way instant gratification.
 
blackshadow said:
The plaza is an icon!

Where else in Melbourne can you choose from two Coles in the one building?
Click to expand...
Good Coles/Bad Coles. Better one out the back near the butchers that were pretty good (from memory).
 
Horace said:
Not only have "I lived forever", but also I work with a number of people, aged from in their late 60's to early 90's and having spoken to all of them on more than one occasion over the last 18 months, all of them, yes all of them, are fearful of contracting covid-19, all of them got vaccinated as soon as they possibly could, all of them are happy to live restricted lives in lockdown until such time as it is safer to move back closer to normal. And I want all of them to be as safe as is possible in this pandemic because they are also my good friends. They also are people with opinions right across the political spectrum.

Many of them also recall the sacrifices and hardship that had to be made during the 2nd World War. A war that lasted 6 long years. I spoke to one of them this afternoon, who is aged 84 and recalls living through that War, with blackout curtains on the windows where she lived with her parents, as just one example.

We think no generation has ever had it harder than what we are experiencing today, which is so wrong. In my opinion the reality is that for those who have only experienced living in Post War Australia, by and large we have been spoilt.

The reality also is that events of this nature, have occurred multiple times right through history; and will continue to occur for as long as this Planet circles the Sun. If we would all accept what is happening right now with a little bit of equanimity, a little bit of compassion, a high level of admiration for our healthcare workers and a little bit of patience, we will eventually get to the other side of this.

Nothing is forever.
Click to expand...

Well said Horry.

Fast forward back to this day 20 years ago and the world felt like we were on the edge of a cliff, 13 days past September 11th.
 

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Really sad thread this and some extraordinarily lack of humanity at times.

Lock it up for a while mods. This discussion has become a toxic interaction that promotes nothing more than discord and division at the minute. Nobody benefits.

This isn't a call to end discussion, it's a call for a breather on a shitfight.

Twinkletoes King Corey The Filth Wizard Flawed Genius
 
blackshadow said:
The plaza is an icon!

Where else in Melbourne can you choose from two Coles in the one building?
Click to expand...
There is a butcher in there that does some of the best spatchcocked chicken and butterflied lamb leg in town. I do my own, of course, but I'll leave that for the foodie thread. They are in the Aldi side.
 
Horace said:
Not only have "I lived forever", but also I work with a number of people, aged from in their late 60's to early 90's and having spoken to all of them on more than one occasion over the last 18 months, all of them, yes all of them, are fearful of contracting covid-19, all of them got vaccinated as soon as they possibly could, all of them are happy to live restricted lives in lockdown until such time as it is safer to move back closer to normal. And I want all of them to be as safe as is possible in this pandemic because they are also my good friends. They also are people with opinions right across the political spectrum.

Many of them also recall the sacrifices and hardship that had to be made during the 2nd World War. A war that lasted 6 long years. I spoke to one of them this afternoon, who is aged 84 and recalls living through that War, with blackout curtains on the windows where she lived with her parents, as just one example.

We think no generation has ever had it harder than what we are experiencing today, which is so wrong. In my opinion the reality is that for those who have only experienced living in Post War Australia, by and large we have been spoilt.

The reality also is that events of this nature, have occurred multiple times right through history; and will continue to occur for as long as this Planet circles the Sun. If we would all accept what is happening right now with a little bit of equanimity, a little bit of compassion, a high level of admiration for our healthcare workers and a little bit of patience, we will eventually get to the other side of this.

Nothing is forever.
Click to expand...
Great post.
 
ferball more of your favourite people. Although I've seen Adam Goodes do worse and get off

adam-goodes.gif


Let me just knee you in the spine sir.
 
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