Photo by Jungwoo Hong on Unsplash

Published in the Humboldt Independent on August 4, 2020

With case numbers rising and no vaccine expected until at least 2021, there’s not a lot of hopeful news on the COVID front, at least not in the United States. Disparity, civil unrest, and social and political tensions are on the rise in this strangest of summers, and with election season looming just around the bend, the very lively and vitriolic debates about the virus are showing no sign of slowing down. We’ve got a long way to go, but progress is more evident than anticipated.

There have been plenty of worthwhile breakthroughs, not in hand-waving the virus into the pages of history, but in the day-to-day nuts and bolts of how COVID-19 patients are being treated. Looking at the advancements in treatment seems to be one of the few places to find positive news about the virus at all, and the news is surprisingly decent. So in the name of self-care and stress reduction, let’s look at the steps we’ve made since this whole mess kicked off. A little positive reinforcement never hurts.

Progress

Early discussions on social media allowed doctors and nurses to share low-risk treatment solutions before medical studies were published.

Back in March, when COVID-19 was still in diapers, medical professionals in this country had little first-hand experience with the virus. Recommendations for treatments were in a state of constant flux as information was pooled and corroborated across countless facilities both domestic and international, all while contending with the stubbornness of early misinformation and speculation. Early discussions on social media allowed doctors and nurses to share low-risk treatment solutions before medical studies were published, and the now-standard procedure of placing COVID-19 patients on their stomachs to reduce the impact of internal organs on the lungs was developed first through social consensus: a conventional medical study was soon to follow.

Although many medications are currently in development, only two have been proven to be beneficial following controlled trials: dexamethasone and remdesivir. Both drugs have been found to reduce hospitalization time and the severity of symptoms.

Dexamethasone is a steroid used principally for its immunosuppressive and anti-inflammatory effects. According to the WHO, patients on ventilators and oxygen had mortality reduced by one-third while on dexamethasone, making it an important measure for the most severely impacted by the virus.

Remdesivir, which totally sounds like a place in Middle Earth, is an antiviral drug that has demonstrated exceptional efficacy in helping the body fight COVID-19. It works by gumming up the gears of viral reproduction by imitating chunks of the virus’s genetic information. However, remdesivir isn’t a completely reliable saboteur, and it is likely that other medications will be needed to round out a more effective treatment in the future.

While both of these medications are helpful for those patients suffering from severe symptoms, there isn’t much in the way of treatment for those with a milder but still hospital-worthy case, beyond the basics of proper hydration and supplemental oxygen as needed. Which only presents an issue when those milder cases start to turn into less-mild cases, although the rate at which they do seems to be on the decline.

Beyond medication

Some patients are going to require assistance breathing, particularly those with existing respiratory conditions. Mechanical ventilation can be relatively straightforward at first: a tube connected to a machine provides air when a patient’s lungs are no longer strong enough to draw breath. Prolonged ventilation with COVID-19 becomes more difficult as acute respiratory distress syndrome (or ARDS) sets in and it becomes harder and harder for the patient to maintain proper oxygenation, and complications such as lung injuries from continual mechanical ventilation are not unknown. A less-invasive method of ventilation (one that doesn’t require a tube down your throat) is to use a nasal cannula, but some professionals are concerned that a non-internal delivery system may increase the amount of airborne COVID-19 floating around such patients.

Death rates have not increased at all, indicating that we are getting better at treating COVID-19.

Also being discussed lately is the potential for COVID-19 treatment via convalescent plasma, which is derived from the blood of those who have already had the virus and can produce antibodies that fight it. This predecessor to vaccine technology was used for diphtheria and tetanus treatments as far back as the 1890s when guinea pig and horse blood was first used to create an “antiserum” for use in humans. While there’s all manner of buzz circulating about the possibilities for this sort of treatment, there is no word yet as to an estimated time it will be made available to the general public.

On the bright side

Although case rates in the U.S.have soared to over 50,000 cases per day, up from 10,000 at the beginning of July, the corresponding death rates have not increased at all, indicating that we are getting better at treating COVID-19, if nothing else. As of now, statistics from the WHO and the CDC seem to indicate that despite the explosive rise in cases, there has never been a better time to get COVID-19, as far as treatment goes. And the outlook is only likely to get more optimistic, given the resourcefulness of the international medical community. Whatever challenges may be presented by politics, logistics, and profiteering are yet to be seen in full, but at least humans can give ourselves credit for getting the science parts right. Most of the time.

Stay safe, and stay positive. We’ll get there.

Galen Lastko, submitted on behalf of the SoHum Health’s Outreach department.