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United State of Terror: Is Drone War Fair?

Tuesday, April 21, 2020

The High Cost of Being Exceptional.



Dr. Richard Levitan, writing in the NYT's about the intensity of New York's COVD-19 disaster, notes that:

"Even patients without respiratory complaints had Covid pneumonia. The patient stabbed in the shoulder, whom we X-rayed because we worried he had a collapsed lung, actually had Covid pneumonia. In patients on whom we did CT scans because they were injured in falls, we coincidentally found Covid pneumonia. Elderly patients who had passed out for unknown reasons and a number of diabetic patients were found to have it."

"And here is what really surprised us: These patients did not report any sensation of breathing problems, even though their chest X-rays showed diffuse pneumonia and their oxygen was below normal. How could this be?"

Well, I can tell you how:

"Zhou Qing still remembers the dismay she felt on Jan. 22 as she walked into Wuhan No. 7 Hospital to begin her emergency assignment.

Zhou, an intensive care specialist with three decades of medical experience, had been dispatched to No. 7 Hospital — a mid-ranking facility in the central Chinese city — to lead its intensive care unit during the epidemic."

“They were not aware this was a serious issue,” says Zhou, as though she were referring to New York's medical personnel a full three months later.

She goes on to say,

"The lack of protective measures quickly led to a wave of cross-infections that swept through No. 7’s medical team, making it even harder for the hospital to cope with its large influx of COVID-19 patients. Yet doctors in the city remain haunted by the chaos of the early stages of the outbreak, when hospitals were overrun by a sudden surge of pneumonia patients."

And echoing what the NYT's article referenced above as, " here is what really surprised us:", Dr. Qing noted,

"One of the first things we noticed was that our COVID-19 patients had a higher tolerance for hypoxia, a kind of oxygen deprivation, than typical viral pneumonia cases. Patients with other viral pneumonias, such as H1N1, typically develop fevers and feel weak after just 20% of their lungs are affected. But COVID-19 patients could develop severe pneumonia while experiencing only mild respiratory issues. Most patients I treated only had trouble breathing after 60% of their lungs or more were affected.

Thus, the majority of patients displayed relatively mild symptoms in the first week. But this made the second week all the more critical, as patients’ conditions would deteriorate rapidly."

Notice the phrase, 

"One of the first things we noticed ... "

In other words Dr. Qing remarked on and explained the exact phenomenon in January what right now, in late April, has New York Doctors wondering why:

"These patients did not report any sensation of breathing problems, even though their chest X-rays showed diffuse pneumonia and their oxygen was below normal. How could this be?"

He then explains that,

 "We are just beginning to recognize that Covid pneumonia initially causes a form of oxygen deprivation we call “silent hypoxia” — “silent” because of its insidious, hard-to-detect nature."

If, however, my good Dr, you, or your colleagues, or the NIH, or the CDC had had the least bit of interest as to what was befalling China, you could have read this where I did, not in a medical journal or a textbook, but in the newspaper (and no, I don't read Chinese, this data was published in an English version of  a Chinese journal that anyone could have picked up and informed you about (But what would have been the point, since you would not have paid the least bit of attention if we had. After all, what do lay people know? Only the much-vaunted opinion of Experts matters).

The article continues:

" ... when Covid pneumonia first strikes, patients don’t feel short of breath, even as their oxygen levels fall. And by the time they do, they have alarmingly low oxygen levels and moderate-to-severe pneumonia (as seen on chest X-rays). Normal oxygen saturation for most persons at sea level is 94 percent to 100 percent; Covid pneumonia patients I saw had oxygen saturations as low as 50 percent".

That is almost verbatim what Dr. Qing, had we cared to listen, described long before the first patient testing positive for the coronavirus showed up in an emergency room in NYC.

But while the press has been so assiduous in their documentation of how feckless the White House response has been, there has been no remarks as to why this vital data wasn't already known and acted upon. As the author, Dr. Richard Levitan, goes on to explain,

"There is a way we could identify more patients who have Covid pneumonia sooner and treat them more effectively — and it would not require waiting for a coronavirus test at a hospital or doctor’s office. It requires detecting silent hypoxia early through a common medical device that can be purchased without a prescription at most pharmacies: a pulse oximeter."

Being a Doctor, he couches that statement in those terms, but what the real situation is, is that,

There was a way we could have identified more patients who had Covid pneumonia sooner and treated them more effectively — one that would not have required waiting for a coronavirus test at a hospital or doctor’s office. It requires detecting silent hypoxia early through a common medical device that can be purchased without a prescription at most pharmacies: a pulse oximeter.

So while blaming Trump and watching him squirm, or seeing him react like a child might be fun, the fact that a simple devise such as this could have been used, not in emergency rooms, but in CVS clinics, for example, instead of just waiting passively for a stampede of patients from a virus that was known by professionals, (I assume that if I knew that what Trump was stating about the virus was right out of fantasyland that they did too) to threaten the very functioning of the hospital itself, simply by talking to the Doctors on the Front line, despite their country of origin, the worst part of this pandemic could well have been avoided.

Which isn't to say I am pointing a finger of blame at the NYC Dr's, but surely the NIH/CDC must have had some inkling of this phenomenon, and if not, why not?, if so, why put doctors and hospital systems under this strain?

The author opines that it was just this type of early detection that saved Boris Johnson, so this has been known for weeks, but the emphasis is still on testing, as though there is no other alternative, even as one graces the pages of the NYT.

Of such laxity are right-wing conspiracies hatched.

But why I felt compelled to point this out is that this same Dr. Qing made another observation that I have been wondering about as the northern hemisphere's weather heats up and Air Conditioning units begin to get snapped on in the coming months:

"The air conditioners were left running, despite the risk of spreading viral droplets." (Although why the A/C would be on in January is a bit baffling).

Are we going to follow the same trajectory with air conditioning as we followed with the virus? Are we going to simply ignore already known data until the second wave "inexplicably" turns into a tsunami?

India Today is running an article that I found posted on Yves Smith's Naked Capitalism site, that theorizes about this same vector of dispersion.

With all the nursing home deaths we've already seen occur, wouldn't it perhaps be worthwhile to examine this possibility before the need for A/C starts circulating the coronavirus among this most vulnerable of populations?















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