COVID ICU

It’s time for my next round on a COVID-19 floor. This time it’s the ICU. I have been on General and Intermediate Care on my previous tours. ICU is for the sickest of the sick. My patients are on ECMO (Extra-Corporeal Membrane Oxygenation). This isn’t merely a ventilator that assists you to breathe or breathes for you. This is an artificial lung. Your blood leaves your body via a ½ inch or so diameter line, runs through a machine to remove CO2 and add O2, then sends it back into your body via another line. (That’s what “extra-corporeal” means – outside the body.) One line comes out of your neck and the other your groin. Mobilization is a bit tricky. You don’t want any leaks.

Ready for action as soon as you add gown and gloves. The conehead look isn’t the most comfy, but it’s cheaper than the 3M PAPR (Powered Air-Purifying Respirator). There is no patient information on the wall behind me.

Some of these folks have been in this hospital for two months. They came from smaller hospitals that didn’t have the means to provide the treatment they need, after exhausting all options available to them. At least one has been sick since August – 3 months and counting. They are young and unvaccinated. Will they survive? Beats me. Are they anti-vaxxers? Beats me. My job is to help them, not to second-guess them.

(But since you ask, let’s just say that, if I were a betting man, my money would be on “yes” to surviving. As to whether they are anti-vaxxers or just think they are immortal, that one’s a tossup. This batch of patients are young enough to be my children and have survived two months in the ICU.)

A friend and spouse are vaccinated. One of their two adult children is vaccinated. The other is not, along with spouse and kids. We’ll call my friend Vac and the child Not. Vac was at Not’s house and Not confessed (after several hours together) to feeling ill. Vac had a home COVID test handy – Not was positive, confirmed by another test the next day in a health care facility. Not’s spouse and children are all sick. Vac remains well and has tested negative twice since that exposure. Vac’s spouse and other child are also fine. Do you think maybe the vaccine works?

One of the anti-vaccine arguments is based on “natural immunity”. People want their own immune systems to fight it out with the novel coronavirus. Note that name: novel. Our immune systems work by developing antibodies against invaders. If an invader is known, we have the means to develop a specific defense rapidly. If the invader is unknown (novel), we toss stuff at it while we try to figure out what to do. If the virus is strong enough, we may die first. (Or, in the case of the polio virus, just some motor neurons die. If enough die, we die. If we’re lucky, we’re paralyzed.)

What does a vaccine do? It enables our body to recognize the invader and develop specific antibodies. If we then come in contact with the disease, our immune system is up to the task. The vaccine enables our natural defenses to work.

Did you go to public school? You probably had a bunch of vaccines before you were allowed to attend. We don’t want you to come into close quarters with others and infect them with measles, mumps, rubella, diphtheria, pertussis, poliomyelitis, etc. It’s what we call Public Health. That’s why you should get the COVID-19 vaccine. On one level, I don’t care whether you get the disease. You are “free” to get sick and die if you so choose. Should you also be free to infect others or use scarce resources by running to the hospital when you get sick? Should you be free to demand that said hospital treat you with horse dewormer or a “cleaning” with an injection of a disinfectant like bleach?

Don’t tell me you “did your own research“, like a certain professional football player. Those of us who use research in our lives know that research involves experimentally testing a hypothesis. Before you do your research, you do a literature review, to see what has already been done. Is that what you did? A lit review? Did you actually read the literature, or just listen to a talk radio host talking about the literature? When you do a critical review of the literature, you appraise it against a set of criteria. There are what we call “levels of evidence”. Some evidence is better than others. No study is worth a lot before it has been replicated by someone else. Did you believe one person who runs counter to the mainstream because they say they are a doctor?

If you’re against vaccines (or at least this one) because they’re “unnatural”, are you against soap and water or antibiotic ointment if you get a cut? Why not just let your body’s natural defenses go to work? Maybe you’ll live, maybe you’ll die. Maybe that cut finger will result in being faced with the choice of death or amputating the arm. Amputation is unnatural. Death is completely natural. Decision made.

After all, life is 100% fatal. Why wait?

[Editor’s note: Sorry, it has been a rough week at the hospital. The writer apologizes to those who do take care of themselves and others and is not wishing an early and painful death on anyone. He is tired of reading about people refusing help until it is too late and then demanding their own particular choice of help. He is tired of reading about people looking for lawyers to sue hospitals for employing the standard of care instead of listening to their half-baked theories. He is tired of reading about people who refuse to take action to protect themselves and others, then beg for your prayers and money for funerals and to raise the children of stupid people who refuse the vaccine, refuse to wear masks, and think they are standing up for freedom. He is sick and tired in general this week – and he hasn’t even finished the first week of this rotation.]

Author: halffastcyclingclub

We are a group of friends who ride bikes. Some of us are fast, some of us are slow, all of us are half-fast. In 2018, one of us is riding coast to coast across the US. If we meet Sal Paradise, we'll let you know.

14 thoughts on “COVID ICU”

  1. Great post! I hate that you have to do this rotation. It’s so scary. Wishing you well in the weeks ahead. I wish more people would listen to someone like you who is living through this nightmare that healthcare workers deal with on a daily basis. Thanks for what you’re doing, Steve. Be safe.

    Liked by 2 people

    1. Thanks, Vikki! When I’m seeing COVID patients, I’m probably safer than you would be if you ate in a restaurant (especially outside of this county). Worse is that I won’t see my grandchild for a month. But you’re right – it is still a nightmare.

      Liked by 1 person

  2. I no longer care about the intentionally unvaccinated. If they get sick, it was their choice to join a cult. Their choice not to think for themselves and instead allow demagogues to do their thinking for them. Their fault for being science deniers. If they die I am sad for all the harm they did and all the precious resources they consumed while they were dying.

    I am amazed at how gullible supposedly intelligent people can be. The need to belong to their little social/internet bubble completely overwhelms their logical faculties. (Equally true of a lot of things other than vaccinations.) This ain’t rocket science and the data is easily to get at – but if it isn’t from their own guru, they can’t believe and won’t try to understand. The denial of the efficacy of vaccination is a kind of religious faith, not a rational decision.

    The population we have today would never have obliterated smallpox. We’d still be having massive polio outbreaks. We’d still be using bloodletting and exorcisms as standard medical practice.

    Liked by 3 people

    1. I’m afraid you’re right. The massive undertaking to get the Sabin oral polio vaccine into all of us would probably be greeted by armed protesters if it happened today. We’d have people insisting that folks were faking paralysis. Bloodletting is actually a current practice – though only in very limited use. I once did a presentation called “Medieval Medicine in the 21st Century: What is the current science?” My review for that presentation found that the cause of George Washington’s death was likely acute anemia secondary to repeated bloodlettings to “cure” a cold. (How did I get to be this old and not know that?) He had three doctors, each of whom bled him when the others’ bloodletting failed to bring about a cure. It worked. He was no longer coughing.

      Liked by 2 people

      1. Not sure where you’re going with this. It appears that you are calling the vaccine the “COVID clotshot”, while also claiming (in your next comment) to “follow the science”. If you can show us science that shows risk of death from the vaccine to be greater than the risk of death from the virus (even if you limit it to the relative risk of death from clotting disorders) I would be more inclined to take you seriously.

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      2. if you could show good science that the risk of death from the virus is greater than the risk of death from the clotshot, I might stop needling you. 😉

        Of course, then you’d have to actually have some autopsy sampling of VAERS covid vaccine death reports by the CDC, but they don’t seem very interested in doing actual science that might question their narrative that vaccines are “safe and effective.”

        Hence, we don’t know much about the actual risk of clotshots. It looks like VAERS reports are the best science we have. Accordingly, we should use it.

        It looks like adverse event underreporting runs about 30x actual reports (1). Let’s use the CDC figure of 9,367 covid vaccine VAERS death reports. So it looks like there have been about 270,000 covid vaccine deaths, which is a small fraction of total vaccinations.

        As of now, the risk of death from covid is tiny for two reasons. First, it looks like we may have achieved herd immunity in the US. Second, the risk of death is small when antiviral treatment is used–20% of baseline. So my plan requires that early antiviral be given to high risk patients. Maybe 1% of the US population is actually at high risk from covid. But probably 90% of that group has some sort of immunity to covid. So we are talking 0.1% of the US population being seriously at risk. But antiviral cocktails given early–yes, I am assuming early treatment–will reduce covid mortality by 80%. So that looks like maybe 25,000 deaths from covid per year, which is in the range of flu. The clotshot so far this year has racked up 270,000 deaths, based on our estimates.

        It looks like continual boosters would be required if we followed your plan–with the undiminished risk for each booster–resulting in continual, straight-line vaccine deaths in all age groups.

        So, now, the risk from vaccination looks to be far higher than the risk from covid–especially for younger cohorts.

        (1) https://academic.oup.com/cid/article/61/6/864/451758?login=true

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      3. To thecovidpilot:

        Your “science” is lacking. First, the VAERS system is notoriously unreliable. In their own words: “Reports may include incomplete, inaccurate, coincidental and unverified information. The number of reports alone cannot be interpreted or used to reach conclusions about the existence, severity, frequency, or rates of problems associated with vaccines.”

        Second, the citation you offer does not support your conclusion of underreporting by a factor of 30, nor do the underlying articles cited in that source.

        Third, even the data you cite are not specific to your assertion that the risk of death from clotting disorder is greater from the vaccine than from the disease.

        Fourth, correlation does not equal causation. In randomized, double-blind, placebo-controlled trials, adverse reactions to the placebo are reported routinely.

        Fifth, the article you cite is from before the COVID vaccine. There are clearly political factors at play here that were not at play during the period studied. There is a large and vocal anti-vaccine group, much more so than with any single prior vaccine. That group has a vested interest in reporting adverse effects. One could assert that there are those with an interest in falsifying reports of adverse effects for political gain. One cannot ignore that public health officials have received death threats for their work.

        Sixth, as Stephen Wright told us, “42.7% of all statistics are made up on the spot.” I have seen no evidence to support your dual assertions that only 1% of the US population is at high risk and that 90% of that group has “some sort of immunity” to COVID. This leads to your next false assertion.

        Seventh, you assert (due to your “calculation” above) that 0.1% of the US population is “seriously at risk” from COVID-19, though the death rate to date is already 2.5 times that.

        Eighth, Johns Hopkins has confirmed 762,972 deaths from COVID-19 in the US as of 11/13/2021. They have confirmed 47,050,502 cases of COVID, for a death rate of 1.62% The reported (unconfirmed, and subject to the biases VAERS cites) deaths attributed to the vaccine total 7793, while 439,034,461 doses of the vaccine have been administered. This yields a death rate of 0.002%. Even if you limit the count to those fully vaccinated (which would eliminate anyone allegedly killed by the first dose and anyone who chose not to get the second dose due to an alleged adverse reaction to the first dose), the death rate is 0.004%. Thus the risk of dying from the virus is at least 400 times greater than that of dying from the vaccine, and probably considerably higher than that.

        Ninth, since this is my blog, this is the end of this discussion. If you would like to continue to spread misinformation, disinformation, or misleading conclusions from incomplete information, you are free to do so on your own site.

        Liked by 1 person

    1. Thanks. This week, I could use a hug. To be honest, much of my frustration was about other work-related but not COVID-related stuff; though nearly two years into this pandemic and working in a hospital, there isn’t much that isn’t in some way COVID-related. As an example, they cut back the hours during which patients can get food due to lack of food service staff, which is due to COVID-related staffing losses and difficulty finding replacements.

      Liked by 1 person

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