The following excerpts from a New York magazine article by David Wallace-Wells (recently celebrated author of “The Uninhabitable Earth: Life After Warming“) go well beyond the recent Science magazine article describing the various ways the corona virus ravages the human body. Wells portrays a shape-shifting demon that is taking many surprising and unexpected turns.
” … while the CDC does list fever as the top symptom of COVID-19, so confidently that for weeks patients were turned away from testing sites if they didn’t have an elevated temperature, according to the Journal of the American Medical Association, as many as 70 percent of patients sick enough to be admitted to New York State’s largest hospital system did not have a fever.
“Over the past few months, Boston’s Brigham and Women’s Hospital has been compiling and revising, in real time, treatment guidelines for COVID-19 which have become a trusted clearinghouse of best-practices information for doctors throughout the country. According to those guidelines, as few as 44 percent of coronavirus patients presented with a fever (though, in their meta-analysis, the uncertainty is quite high, with a range of 44 to 94 percent). Cough is more common, according to Brigham and Women’s, with between 68 percent and 83 percent of patients presenting with some cough — though that means as many as three in ten sick enough to be hospitalized won’t be coughing. As for shortness of breath, the Brigham and Women’s estimate runs as low as 11 percent. The high end is only 40 percent, which would still mean that more patients hospitalized for COVID-19 do not have shortness of breath than do. At the low end of that range, shortness of breath would be roughly as common among COVID-19 patients as confusion (9 percent), headache (8 to 14 percent), and nausea and diarrhea (3 to 17 percent). That the ranges are so wide themselves tells you that the disease is presenting in very different ways in different hospitals and different populations of different patients — leading, for instance, some doctors and scientists to theorize the virus might be attacking the immune system like HIV does, with many others finding the disease is triggering something like the opposite response, an overwhelming overreaction of the immune system called a “cytokine storm.”
“The most bedeviling confusion has arisen around the relationship of the disease to breathing, lung function, and oxygenation levels in the blood — typically, for a respiratory illness, a quite predictable relationship. But for weeks now, front-line doctors have been expressing confusion that so many coronavirus patients were registering lethally low blood-oxygenation levels while still appearing, by almost any vernacular measure, pretty okay. It’s one reason they’ve begun rethinking the initial clinical focus on ventilators, which are generally recommended when patients oxygenation falls below a certain level, but seemed, after a few weeks, of unclear benefit to COVID-19 patients, who may have done better, doctors began to suggest, on lesser or different forms of oxygen support. For a while, ventilators were seen so much as the essential tool in treating life-threatening coronavirus that shortages (and the president’s unwillingness to invoke the Defense Production Act to manufacture them quickly) became a scandal. But by one measure 88 percent of New York patients put on ventilators, for whom an outcome as known, had died. In China, the figure was 86 percent.
“On April 15, the Washington Post reported that, in New York and Wuhan, between 14 and 30 percent of ICU patients had lost kidney function, requiring dialysis. New York hospitals were treating so much kidney failure “they need more personnel who can perform dialysis and have issued an urgent call for volunteers from other parts of the country. They also are running dangerously short of the sterile fluids used to deliver that therapy.” The result, the Post said, was rationed care: patients needing 24-hour support getting considerably less. On Saturday, the paper reported that “[y]oung and middle-aged people, barely sick with COVID-19, are dying from strokes.” Many of the patients described didn’t even know they were sick … ”
“These strokes, several doctors who spoke to the Post theorized, could explain the high number of patients dying at home — four times the usual rate in New York, many or most of them, perhaps, dying quite suddenly. According to the Brigham and Women’s guidelines, only 53 percent of COVID-19 patients have died from respiratory failure alone.”
Read full article here:
“We Still Don’t Know How the Coronavirus Is Killing Us“