Top doctors in McLean County say they have a better handle on how to treat COVID-19 patients than they did at the start of the pandemic, but also say patient care is still very much trial and error.
Jim Nevin is chief medical officer for Carle BroMenn Medical Center in Normal and Carle Eureka Hospital. He said doctors at least know now what not to do.
Nevin said early on, many patients were treated with an antibiotic called azithromycin and hydroxychloroquine, an anti-malaria drug President Donald Trump often hyped.
“We found that the consequences of the cardiac arrythmia associated with their use were found to be totally ineffective and detrimental. It is absolutely not recommended use now and that’s a change,” Nevin said.
Nevin said the steroid dexamethasone has shown some positive results. Hospitals also have greatly reduced ventilator use. Nevin said they are too hard on the lungs. Now, patients lie on their stomachs to improve air and blood flow in the lungs.
Paul Pedersen is chief medical officer at OSF Saint Joseph Medical Center in Bloomington. He said the anti-viral remdesivir has helped some patients, but the drug maker's pledge that it would shorten hospital stays hasn't panned out.
“It certainly is not a silver bullet or a cure-all at all,” Pedersen conceded. “It may help, so we use it, because we don’t have much else.”
Remdesivir just became the first COVID-19 treatment to get FDA approval.
Pedersen said convalescent plasma, which is injecting patients with the antibodies of those who have already had COVID-19, also has shown spotty results.
Nevin said convalescent plasma is only a last-ditch option. He said doctors use guidance from the Illinois Department of Public Health, but without consistently effective treatments, it's hard to reassure patients and their families.
“It’s hard and it’s very frustrating,” Nevin acknowledged. “As a physician you want to cure and grow in confidence. We’re not curing this. We are helping the body help itself to get through it. That’s what is key.”
Both doctors believe patients are more likely to survive a bout with COVID today than in March. That's hard to measure since coronavirus cases were likely undercounted early on. Testing was so limited and many suspected of having the virus were told to stay home.
NPR reports a study to be published soon in the Journal of Hospital Medicine notes deaths rates have dropped 18% on average across all age groups since the start of the pandemic.
Nevin said underlying health problems, especially with the heart and lungs, also play a big role in a patient's chance of survival, but he noted there are exceptions that prove no one is safe.
“You still see star athletes that have no comorbidities whatsoever die from it,” Nevin said. “It’s a scary bug. It really is.”
Pedersen at OSF said expanded coronavirus testing has helped, but it could help a lot more, adding rapid testing that would more quickly isolate infected people is still in short supply.
“Health care still has challenges in getting rapid turnaround tests. If we were a Big Ten team, we could probably get that stuff every day, but we’re not, we’re health care,” Pedersen quipped.
The Big Ten conference was able to resume football and other close-contact sports after it secured daily rapid tests for all student-athletes and staff. Pedersen said he's not sure why health care lacks the same capability.
Bloomington-Normal hospitals have maintained adequate bed capacity. Carle BroMenn took down an overflow tent it set up outside its emergency room in March. The most COVID hospitalizations the county has had at any one time is 15, but Nevin said a recent increase in patients concerns him.
“When you see some of these increases, it does make me hold my breath,” he said. “I’m just really thankful that we don’t have patients on ventilators and we are able to keep them out of the ICU.”
As much of the Midwest faces a third wave of COVID cases this fall, Pedersen said he's worried holiday travel will help the disease spread.
“I’m concerned about what may happen with our holiday season and the social gatherings and family gatherings if they are not being done in a protective way,” he said.
Pedersen said until there's a COVID vaccine, prevention remains the best way to contain the virus--by wearing a mask and staying socially distant. Both Nevin and Pedersen said they have canceled their own holiday plans with extended family this year to keep everyone safe.
Nevin said five members of his extended family have contracted the coronavirus. He said nearly all of them are dealing with lingering physical and cognitive effects.
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