Two months into the epic battle against this devastating disease, there is so much we do not yet know about COVID-19 -- but are we really listening to the doctors revealing discoveries that might help us get ahead of it?
Dr. Richard Levitan is an emergency room doctor with 30 years of experience who invented an imaging system for teaching intubation, the procedure of inserting breathing tubes. When coronavirus cases and COVID-19, the disease it causes, exploded in New York City, Dr. Levitan traveled from New Hampshire to serve at Bellevue Hospital, the facility where he trained.
In a 10-day span, the doctor made some intriguing and potential crucial observations about the way COVID-19 attacks the body. Yet outside of CNN and The New York Times, much of this important information has eluded the limelight.
Different people experience different sets of symptoms when sickened by this disease, but one stands out from the others: Respiratory problems. From the beginning, patients were flooding into New York hospitals in respiratory distress, struggling to breathe, and desperately needing help from ventilators in order to survive. So many, in fact, that President Trump ultimately invoked the Defense Production Act to compel companies like General Motors to produce ventilation equipment.
According to Dr. Levitan, these patients and more were suffering from COVID pneumonia, the true culprit of the coronavirus. Amazingly, though, many patients did not even know it.
Unlike "traditional pneumonia," in which air sacs within the lungs fill with fluid or pus and make patients experience chest discomfort, pain with breathing and more, Dr. Levitan reported that "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."
As it turns out, COVID pneumonia is stealthier in its attack, overwhelmingly killing through the lungs without making its victims feel short of breath -- until it is very nearly too late. Here is how it works (via The New York Times):
The coronavirus attacks lung cells that make surfactant. This substance helps the air sacs in the lungs stay open between breaths and is critical to normal lung function. As the inflammation from COVID pneumonia starts, it causes the air sacs to collapse, and oxygen levels fall. Yet the lungs initially remain “compliant,” not yet stiff or heavy with fluid. This means patients can still expel carbon dioxide — and without a buildup of carbon dioxide, patients do not feel short of breath.
Patients compensate for the low oxygen in their blood by breathing faster and deeper — and this happens without their realizing it. This silent hypoxia, and the patient’s physiological response to it, causes even more inflammation and more air sacs to collapse, and the pneumonia worsens until oxygen levels plummet. In effect, patients are injuring their own lungs by breathing harder and harder. Twenty percent of COVID pneumonia patients then go on to a second and deadlier phase of lung injury. Fluid builds up and the lungs become stiff, carbon dioxide rises, and patients develop acute respiratory failure.
By the time patients show up at the hospital, their bodies have already taken such an internal beating that they need outside help to breathe -- ventilators.
But what if there was a way to detect changes in the body's oxygen levels regardless of how it "feels" to breathe? What if people could catch the problem early enough to keep COVID from conquering their lungs and lessen the severity of their bout with the disease?
According to Dr. Levitan, that could be a real possibility, one that does not require waiting for a coronavirus test.
"It requires detecting silent hypoxia early through a common medical device that can be purchased without a prescription at most pharmacies: a pulse oximeter. Pulse oximetry is no more complicated than using a thermometer. These small devices turn on with one button and are placed on a fingertip. In a few seconds, two numbers are displayed: oxygen saturation and pulse rate. Pulse oximeters are extremely reliable in detecting oxygenation problems and elevated heart rates."
Now, it is important to consult with a doctor to properly understand how to read and interpret readings from the device, but it is a simple way to monitor your body and spot any potential problems early enough to take action before symptoms advance. Read Dr. Levitan's full set of discoveries at NYT.