My friend Wang almost died during the first wave of the epidemic!
In late December 2022, more and more patients were infected with new coronavirus pneumonia , and the local health commission has ordered all hospitals to collect all the patients.
In addition to the respiratory department, other departments of the hospital also began to treat patients with new coronavirus pneumonia. My friend, 66-year-old Wang, had a high fever for 7 days. He listened to experts and took antipyretic medicine at home to carry it. The fever went down and quickly rose again. He called me for consultation. As a surgeon, I had never treated COVID-19, but based on my years of clinical experience, I suggested that he undergo a CT scan immediately. The emergency CT that night diagnosed "new coronavirus pneumonia", commonly known as "mushroom lung", which has not yet developed to the stage of "white lung".
He was admitted to the cardiology department in the emergency room.
was hospitalized and given intravenous infusion of cephalosporins (antibiotics) by aerosol inhalation once in the morning and afternoon. The next day, Wang felt that his symptoms had worsened, with tightness of breath and chest tightness, but no cough or sputum . In the afternoon, a 36-year-old doctor who returned from Germany and returned to China died of COVID-19 in the next ward! Wang's family members were all panicked. Let’s see if the hospital’s treatment is still antibiotics plus atomization. But looking at Wang's face, his oxygen saturation dropped below 90% within a few minutes of deoxygenation.
We mobilized our classmates to contact the director of the intensive care unit of the provincial hospital and asked him to come for consultation despite his busy schedule. After the consultation, the director tactfully told the family: The cardiology department has no treatment experience, so it is best to transfer to the respiratory department. But it’s hard to find a bed in the respiratory department, what should I do?
contacted the external hospital ICU! The family immediately decided to transfer him to another hospital immediately. The director of the cardiology department is a sensible person. When he heard that the patient requested to be transferred to another hospital, he immediately said enlightenedly: Transfer him! We are a cardiology department. After all, we are weak in treating pneumonia . We have never treated COVID-19 and have no experience. We can only "dispose of them as they see fit".
After being transferred to the hospital, I had an emergency blood gas analysis , and the reported oxygen partial pressure was only 34% (normal 80-100%). It was really scary!
was immediately put on hormones that night, oxygen therapy plus Azivudine antiviral drug + antibiotics + thymosin (to improve immunity). A combination of punches suppressed the inflammation storm and avoided the tragedy. Otherwise, Wang would have died that night! It's probably going to be difficult to get through it.
Wang stayed in the intensive care unit for 20 days and was transferred to the general ward. Laboratory tests showed that the cellular immune indicators were alarmingly low, and the inflammation indicator C-reactive protein was ridiculously high. A follow-up CT scan showed that although the condition had not progressed, the inflammation was not absorbed satisfactorily, and I took another dose of traditional Chinese medicine. But every afternoon, low-grade fever begins at four or five o'clock in the afternoon. The patient is distressed and his family members collapse. The disease seems to have entered a strange circle: Why is this disease not getting serious? Is the current disease status in a "tug of war"? Or recovering?
This is the first time that a clinical doctor is facing COVID-19. He has no treatment experience and does not dare to discharge patients home easily. After many rounds of contact, I was contacted by a chief physician at Wuhan Union Medical College Hospital. After reading the CT films and test results, the doctor said with certainty: The patient is in the recovery period. The low fever is due to the absorption of inflammation, and the immune function is at work. It is recommended to gradually reduce the oxygen flow rate. After deoxygenation, the oxygen saturation can be maintained above 95, and then you can be discharged and go home to recover. prone position more than 12 hours a day, drink plenty of water.
After hearing the director’s explanation, the patients and their families cried with joy. That's when someone pointed out a bright road full of hope in despair!
Sure enough, after a few days of laboratory testing, the indicators tended to be quite normal.
Here comes the problem. Although the hospital opens its doors, all departments are dealing with COVID-19. However, doctors only treat symptoms and solve problems as they arise. We have absolutely no experience in treating COVID-19, we cannot have a clear understanding of it, and we cannot predict the development, direction, and outcome of the disease. To sum it up in one sentence, we have no control over the treatment of COVID-19. To use the common saying of the common people, we don’t know how to treat it if we haven’t seen it.
I once saw a post saying that barefoot doctors in rural areas only use a four-piece set: antiviral plus antibiotics plus dexamethasone hormone plus antipyretics to treat new coronavirus infection. Treat it as pneumonia in the early stage and beat the new coronavirus to death with a punch, so that there will be no large number of deaths in rural areas.
On the other hand, big cities follow the so-called scientific method and just carry the fever at home without daring to use antibiotics and hormones. As a result, the crematoriums are overcrowded with corpses.
Some experts have said that antibiotics deal with bacteria and are ineffective against viruses . However, according to big data analysis by some institutions, nearly 90% of COVID-19 positive patients have mixed bacterial infections (such as Klebsiella pneumoniae, Staphylococcus aureus, Aspergillus, etc.). The new coronavirus destroys the human body's immune system . The combination of new coronavirus infection and bacterial infection forms an infection storm, which is equivalent to the virus opening a channel for bacteria and jointly attacking to inflict heavy damage to various systems of the body.
Inflammatory storm, also known as " cytokine storm ", is an overreaction of the cytokine , that is, the body's immune system overreacts to external viral infections or drugs. The daily job of the human immune system is to clear infections, but if the immune system is activated to the limit or even loses control, it will cause harm to the body itself. Overreaction is blind and cannot distinguish between friend and foe, thus causing damage to the body itself. Inflammatory storm is the main cause of "acute respiratory distress syndrome" and multiple organ failure. It can really kill someone in minutes!
Western countries have experienced 3 to 4 waves of epidemics in a year. It seems that our fight with the new coronavirus is not a close encounter, but we must be prepared for a "protracted war." It is very necessary to let doctors who have experience in treating COVID-19 as teachers and let doctors from all specialties across the country understand, learn, and master the treatment of COVID-19.
Never forget the past and be the teacher of the future. It’s not too late to make up for the situation before it is too late...
I am Dr. Bamila, and I sincerely invite you to click " to follow ". Look at the colorful world and tell human stories.
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