1 00:00:05,440 --> 00:00:10,400 Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day forty four 2 00:00:10,560 --> 00:00:14,960 Speaker 1: since coronavirus was declared a global pandemic. Our main story, 3 00:00:15,960 --> 00:00:19,720 Speaker 1: the dire shortage of life saving ventilators that plagued the 4 00:00:19,840 --> 00:00:24,200 Speaker 1: US in March, has been eased in many places. But 5 00:00:24,720 --> 00:00:27,880 Speaker 1: even though these machines are a treatment of last resort 6 00:00:27,920 --> 00:00:32,360 Speaker 1: for the sickest patients, most people on ventilators never recover. 7 00:00:33,080 --> 00:00:38,640 Speaker 1: When they do, their bodies can be changed forever. But first, 8 00:00:39,159 --> 00:00:50,639 Speaker 1: here's what happened today. The death told from the new 9 00:00:50,680 --> 00:00:55,640 Speaker 1: coronavirus reached fifty in the US. The country is the 10 00:00:55,720 --> 00:00:59,240 Speaker 1: epicenter of the global outbreak. According to data compiled by 11 00:00:59,320 --> 00:01:03,920 Speaker 1: John's Hopkins University, New York City has suffered the most, 12 00:01:04,480 --> 00:01:09,200 Speaker 1: with more than sixteen thousand deaths. In the US, some 13 00:01:09,440 --> 00:01:14,160 Speaker 1: eight hundred and seventy thousand people have been infected. Still, 14 00:01:14,880 --> 00:01:18,559 Speaker 1: some states have begun planning rollbacks on social distancing restrictions. 15 00:01:19,720 --> 00:01:23,319 Speaker 1: That creates a challenge of how to restart the economy 16 00:01:23,360 --> 00:01:28,680 Speaker 1: without sparking a second wave of infections. Some European countries, 17 00:01:29,000 --> 00:01:34,559 Speaker 1: including Germany and Austria, are already taking cautious steps towards reopening. 18 00:01:35,840 --> 00:01:40,399 Speaker 1: The u S response to the pandemic remains disjointed, and 19 00:01:40,520 --> 00:01:43,800 Speaker 1: it's not clear how much policy is driven by science. 20 00:01:44,959 --> 00:01:49,000 Speaker 1: In a Thursday evening briefing, President Donald Trump suggested that 21 00:01:49,120 --> 00:01:56,240 Speaker 1: doctor's experiment with injecting disinfectant to treat coronavirus. His comments 22 00:01:56,320 --> 00:02:00,760 Speaker 1: came after a Homeland Security under secretary told reports bleach 23 00:02:00,800 --> 00:02:05,440 Speaker 1: and alcohol killed the virus on surfaces. Disinfect in brands 24 00:02:05,440 --> 00:02:08,400 Speaker 1: and medical experts alike have made statements to the public 25 00:02:08,440 --> 00:02:12,720 Speaker 1: stating in no uncertain terms that bleach is a toxic 26 00:02:12,800 --> 00:02:20,359 Speaker 1: chemical and should never be ingested or inhaled in any way. Separately, today, 27 00:02:20,520 --> 00:02:24,560 Speaker 1: the US Food and Drug Administration warned patients against taking 28 00:02:24,840 --> 00:02:28,440 Speaker 1: two malaria medications that have been talked up by President 29 00:02:28,480 --> 00:02:33,080 Speaker 1: Donald Trump for COVID nineteen unless carefully monitored in a 30 00:02:33,160 --> 00:02:38,720 Speaker 1: hospital or as part of a clinical trial. The FDA 31 00:02:38,880 --> 00:02:41,600 Speaker 1: said it was issuing the warning for the drugs hydroxy 32 00:02:41,680 --> 00:02:46,000 Speaker 1: chloroquine and chloroquin after reports that patients taking them had 33 00:02:46,040 --> 00:02:51,360 Speaker 1: experienced serious heart issues. These heart rhythm problems emerged especially 34 00:02:51,360 --> 00:02:58,160 Speaker 1: when patients were also taking the antibiotic azithromyacin. Finally, Trump 35 00:02:58,200 --> 00:03:01,760 Speaker 1: signed the four hundred and eighty four billion dollar Coronavirus 36 00:03:01,800 --> 00:03:06,520 Speaker 1: Rescue Bill into law today. Congress has pumped out almost 37 00:03:06,560 --> 00:03:10,760 Speaker 1: three trillion dollars to deal with the coronavirus pandemic, mostly 38 00:03:10,800 --> 00:03:15,000 Speaker 1: on a bipartisan basis, But how Speaker and Anti Pelosi 39 00:03:15,200 --> 00:03:19,080 Speaker 1: and Senate Majority Leader Mitch McConnell are poised to spar 40 00:03:19,280 --> 00:03:24,680 Speaker 1: over the next round of government aid. Pelosi wants to 41 00:03:24,720 --> 00:03:27,680 Speaker 1: expand the social safety net as well as provide five 42 00:03:28,080 --> 00:03:32,919 Speaker 1: billion dollars to struggling state and local governments. McConnell hasn't 43 00:03:33,000 --> 00:03:36,440 Speaker 1: yet committed to another big aid package and has indicated 44 00:03:36,600 --> 00:03:41,440 Speaker 1: he will resist issuing aid to states. The next phase 45 00:03:41,440 --> 00:03:46,480 Speaker 1: of economic stimulus likely will be the last before the elections. 46 00:03:48,880 --> 00:03:53,400 Speaker 1: And now our main story, we've heard a lot about 47 00:03:53,480 --> 00:03:58,000 Speaker 1: ventilators over the past few weeks. These once obscure pieces 48 00:03:58,040 --> 00:04:02,200 Speaker 1: of medical equipment have become you biquitous in everyday conversation 49 00:04:03,680 --> 00:04:06,520 Speaker 1: because the machines are so often used to treat very 50 00:04:06,560 --> 00:04:10,720 Speaker 1: ill COVID nineteen patients. They are prized in hospitals across 51 00:04:10,800 --> 00:04:15,280 Speaker 1: the US and beyond, but they are also feared for 52 00:04:15,320 --> 00:04:18,360 Speaker 1: the damage they can inflict and for the slim odds 53 00:04:18,360 --> 00:04:24,760 Speaker 1: of survival they offer. Ventilators are the last line of defense. 54 00:04:25,520 --> 00:04:28,080 Speaker 1: They can completely take over for the lungs in the 55 00:04:28,200 --> 00:04:32,680 Speaker 1: sickest patients, those with no other options, and give their 56 00:04:32,720 --> 00:04:36,760 Speaker 1: bodies time to fight off an infection. There's a reason 57 00:04:37,240 --> 00:04:43,600 Speaker 1: it's called life support. But the machines are invasive. Doctors 58 00:04:43,640 --> 00:04:45,560 Speaker 1: have to insert a tube all the way down into 59 00:04:45,560 --> 00:04:50,599 Speaker 1: the trachea to just above the lungs. Studies show most 60 00:04:50,640 --> 00:04:56,000 Speaker 1: patients with COVID nineteen on ventilators don't survive, and that 61 00:04:56,120 --> 00:05:01,800 Speaker 1: invasive process isn't without consequences. Michelle fake Cortes reports that 62 00:05:01,920 --> 00:05:05,359 Speaker 1: we don't know exactly what ventilators due to our bodies. 63 00:05:06,480 --> 00:05:09,600 Speaker 1: It's not yet clear what the long term consequences are 64 00:05:09,920 --> 00:05:13,159 Speaker 1: for those lucky enough to recover after having been on one. 65 00:05:14,279 --> 00:05:29,600 Speaker 1: Olivia Carville also reported this segment that round of applause 66 00:05:29,640 --> 00:05:32,279 Speaker 1: you Here is a group of healthcare workers at Somerset 67 00:05:32,320 --> 00:05:36,039 Speaker 1: Hospital in New Jersey. They're lining the halls, clapping and 68 00:05:36,080 --> 00:05:39,520 Speaker 1: playing joyful music for Carlos Aguilar, a sixty four year 69 00:05:39,560 --> 00:05:42,800 Speaker 1: old father from New Jersey who was just excavated after 70 00:05:42,839 --> 00:05:46,200 Speaker 1: spending three days hooked up to a ventilator in intensive 71 00:05:46,200 --> 00:05:49,920 Speaker 1: care units around the country. There are similar celebrations whenever 72 00:05:49,960 --> 00:05:53,360 Speaker 1: a COVID nineteen patient gets off a ventilator. That's because 73 00:05:53,360 --> 00:05:57,440 Speaker 1: it's rare. About seventy of patients who are put on 74 00:05:57,480 --> 00:06:02,760 Speaker 1: a ventilator don't survive. Luckily, Carlos was eventually able to 75 00:06:02,800 --> 00:06:05,679 Speaker 1: breathe on his own again. What makes his story even 76 00:06:05,760 --> 00:06:09,960 Speaker 1: more remarkable is the fact that he wasn't alone. His 77 00:06:10,000 --> 00:06:13,479 Speaker 1: wife of thirty five years, Diana, was treated for COVID 78 00:06:13,560 --> 00:06:17,679 Speaker 1: nineteen in the same hospital. She was intubated for ten days. 79 00:06:18,440 --> 00:06:20,800 Speaker 1: When she was taken off the ventilator, she got a 80 00:06:20,839 --> 00:06:24,679 Speaker 1: cheering section and a song of her own. Diana remembers 81 00:06:24,680 --> 00:06:27,520 Speaker 1: that fear she felt when she couldn't breathe before the 82 00:06:27,600 --> 00:06:30,719 Speaker 1: ventilator was hooked up to breathe for her. She says 83 00:06:30,760 --> 00:06:33,040 Speaker 1: she knew she was going to die. I gave up. 84 00:06:33,839 --> 00:06:38,640 Speaker 1: I gave up. I called my husband, I stay bye 85 00:06:38,640 --> 00:06:43,120 Speaker 1: to him. I can him more, I can breathe. The 86 00:06:43,320 --> 00:06:46,400 Speaker 1: doctor came and said you need that vent to it. 87 00:06:47,760 --> 00:06:51,440 Speaker 1: He said, don't, my god, And now they exclaiming what 88 00:06:51,520 --> 00:06:54,960 Speaker 1: was going to happen to me? A lot of Stepida. 89 00:06:55,040 --> 00:06:58,839 Speaker 1: I don't on the spin, but in the same time 90 00:06:59,520 --> 00:07:02,440 Speaker 1: I want to they put it right away because I 91 00:07:02,480 --> 00:07:06,599 Speaker 1: cannot drink. Diana, who worked as a janitor and has 92 00:07:06,680 --> 00:07:10,920 Speaker 1: underlying health problems, including two bouts of colon cancer, had 93 00:07:10,960 --> 00:07:14,800 Speaker 1: spent a week suffering from dizziness, body aches, shortness of breath, 94 00:07:15,080 --> 00:07:17,240 Speaker 1: and a fever as high as a hundred and five 95 00:07:17,320 --> 00:07:21,239 Speaker 1: point three before being admitted to Somerset with COVID nineteen. 96 00:07:21,880 --> 00:07:25,640 Speaker 1: The infection warped her reality. She thought the nurses and 97 00:07:25,720 --> 00:07:30,239 Speaker 1: doctors wearing masks and gowns were angels or something else. 98 00:07:30,840 --> 00:07:33,480 Speaker 1: We spoke to Diana a week after she was discharged. 99 00:07:34,000 --> 00:07:38,160 Speaker 1: Her son, Carlos Aguilar Jr. Helped with the translation, It's 100 00:07:38,240 --> 00:07:48,280 Speaker 1: so scary. It's like um, like space because the favor, 101 00:07:48,440 --> 00:07:52,280 Speaker 1: the high favor, you know, it makes you see paints. 102 00:07:52,880 --> 00:08:01,840 Speaker 1: I say, okay, oh my god, espras Alien doctors explained 103 00:08:01,920 --> 00:08:04,480 Speaker 1: that she was about to be intibated and connected to 104 00:08:04,520 --> 00:08:09,360 Speaker 1: a ventilator, but Diana was saying her goodbyes. I was 105 00:08:09,440 --> 00:08:16,520 Speaker 1: so scared and everybody trying to slay me. What's going 106 00:08:16,600 --> 00:08:20,920 Speaker 1: to happen to me? And they asked me, do you understand? 107 00:08:21,960 --> 00:08:28,160 Speaker 1: Said yes, I understand. Only that I want is they 108 00:08:28,160 --> 00:08:35,240 Speaker 1: helmet to bread you just wanted to hurry up. Diana 109 00:08:35,320 --> 00:08:38,680 Speaker 1: was struggling to breathe because the infection and inflammation was 110 00:08:38,720 --> 00:08:41,960 Speaker 1: taking hold in her lungs. Together, they caused to build 111 00:08:42,000 --> 00:08:44,760 Speaker 1: up a fluid and thick mucus in the tiny air 112 00:08:44,840 --> 00:08:48,920 Speaker 1: sacks that are critical for the lungs to work. After 113 00:08:48,960 --> 00:08:52,360 Speaker 1: you take a breath, delicate sacks known as aviola, take 114 00:08:52,440 --> 00:08:55,440 Speaker 1: oxygen from the air and transfer it into your blood. 115 00:08:56,280 --> 00:08:59,640 Speaker 1: From there it fuels every part of your body. For 116 00:08:59,720 --> 00:09:03,840 Speaker 1: Diane Anna, the system wasn't functioning. Not enough oxygen was 117 00:09:03,840 --> 00:09:07,440 Speaker 1: getting into her blood. After she was sedated, doctor slid 118 00:09:07,440 --> 00:09:10,040 Speaker 1: a tube down her throat that was connected to the ventilator. 119 00:09:10,440 --> 00:09:13,720 Speaker 1: They adjusted the machine to deliver higher levels of oxygen 120 00:09:14,000 --> 00:09:17,320 Speaker 1: than what's normally found in ambient air and raise the 121 00:09:17,320 --> 00:09:24,800 Speaker 1: pressure to get it through her clogged lungs. Where you 122 00:09:24,840 --> 00:09:27,280 Speaker 1: have a problem with ventilators who are working very hard 123 00:09:27,320 --> 00:09:30,600 Speaker 1: trying to find Nobody in their wildest dreams would have 124 00:09:30,640 --> 00:09:33,720 Speaker 1: ever thought that we need tens of thousands of ventilators. 125 00:09:33,720 --> 00:09:36,520 Speaker 1: This is something that's very unique to this to what happened. 126 00:09:36,679 --> 00:09:39,200 Speaker 1: There was a near panic early in the pandemic about 127 00:09:39,240 --> 00:09:42,880 Speaker 1: the number of ventilators available in the US hospitals have 128 00:09:42,920 --> 00:09:46,320 Speaker 1: about sixty three thousand of them across the country. New 129 00:09:46,360 --> 00:09:48,920 Speaker 1: York Governor Andrew Cuomo said at one point that New 130 00:09:49,000 --> 00:09:52,280 Speaker 1: York alone might need forty thou of them. All The 131 00:09:52,400 --> 00:09:55,679 Speaker 1: projections say you could have an eight packs needing a 132 00:09:55,760 --> 00:10:00,320 Speaker 1: hundred and forty thou beds and about forty ventilators. Those 133 00:10:00,360 --> 00:10:05,040 Speaker 1: are numbers. Device makers ramped up production, and even car 134 00:10:05,080 --> 00:10:10,679 Speaker 1: companies started making them. Hospitals we're seeing unprecedented demand. Only 135 00:10:10,679 --> 00:10:14,439 Speaker 1: the most severe patients like Diana and Carlos need intubation, 136 00:10:15,080 --> 00:10:18,000 Speaker 1: even with the help of a ventilator, many don't make it. 137 00:10:20,240 --> 00:10:23,120 Speaker 1: For those who do survive extabation, that's not the end, 138 00:10:23,600 --> 00:10:27,080 Speaker 1: far from it. After being weaned off life support, both 139 00:10:27,080 --> 00:10:30,640 Speaker 1: Diana and Carlos have a long road to recovery. Part 140 00:10:30,640 --> 00:10:34,720 Speaker 1: of its stems from the ventilator itself. Many patients are 141 00:10:34,760 --> 00:10:37,520 Speaker 1: given sedatives so they don't fight against the machine that's 142 00:10:37,559 --> 00:10:40,480 Speaker 1: trying to breathe for them, but muscles that are used 143 00:10:40,480 --> 00:10:44,319 Speaker 1: to working every day quickly start to atrophy. A condition 144 00:10:44,559 --> 00:10:47,439 Speaker 1: known as post i c U syndrome can develop in 145 00:10:47,640 --> 00:10:51,400 Speaker 1: up to half of patients, a widespread weakness that never 146 00:10:51,440 --> 00:10:56,280 Speaker 1: fully resolves. For some it's as if they're paralyzed. For others, 147 00:10:56,679 --> 00:11:01,240 Speaker 1: regular activities are exhausting. Duct or Michael Roderick's is the 148 00:11:01,280 --> 00:11:04,760 Speaker 1: medical director of Intensive Care at Somerset. He says some 149 00:11:04,800 --> 00:11:08,800 Speaker 1: patients never regain their full strength. Sometimes when you're on 150 00:11:08,840 --> 00:11:11,760 Speaker 1: the ventilator for two weeks, you're you're not able to 151 00:11:11,840 --> 00:11:15,040 Speaker 1: go back to how you were prior to getting sick, 152 00:11:15,160 --> 00:11:17,440 Speaker 1: and you need to go to rehab for some period 153 00:11:17,440 --> 00:11:19,920 Speaker 1: of time to be able to do your activities of 154 00:11:20,080 --> 00:11:24,120 Speaker 1: daily living. And it's not just physical activity. Sometimes memory 155 00:11:24,120 --> 00:11:28,000 Speaker 1: and thinking clearly are also a challenge. You may have 156 00:11:28,080 --> 00:11:32,360 Speaker 1: some mild cognitive impairments after being on the ventilator. So, 157 00:11:32,559 --> 00:11:35,600 Speaker 1: for instance, someone that worked as an accountant prior to 158 00:11:35,720 --> 00:11:37,520 Speaker 1: being on the ventilator and being in the i c U, 159 00:11:37,920 --> 00:11:40,360 Speaker 1: they may have a tough time going back to work. 160 00:11:41,000 --> 00:11:44,360 Speaker 1: Someone uh an older person who was maybe independent and 161 00:11:44,480 --> 00:11:46,840 Speaker 1: drove and took care of all their own activities, while 162 00:11:46,880 --> 00:11:48,920 Speaker 1: they may not be able to go back to that 163 00:11:49,040 --> 00:11:51,600 Speaker 1: same lifestyle and they might need help. They might not 164 00:11:51,679 --> 00:11:54,400 Speaker 1: be able to drive, they may not be able to 165 00:11:54,520 --> 00:11:58,160 Speaker 1: shop and walk around the supermarket and carry out their 166 00:11:58,200 --> 00:12:02,440 Speaker 1: own activities of daily living. Your overall condition may take 167 00:12:02,520 --> 00:12:07,120 Speaker 1: some time to get back to its pre COVID pre 168 00:12:07,320 --> 00:12:09,920 Speaker 1: I c U state, if if it even gets back 169 00:12:10,000 --> 00:12:13,240 Speaker 1: to that free I c U state. That's why it's 170 00:12:13,280 --> 00:12:15,600 Speaker 1: more important than ever to celebrate the winds right now. 171 00:12:16,120 --> 00:12:19,840 Speaker 1: Diana and Carlos Aguilar have been together for thirty five years. 172 00:12:20,600 --> 00:12:24,000 Speaker 1: They both got COVID nineteen, they were both on ventilators, 173 00:12:24,520 --> 00:12:28,200 Speaker 1: and they both beat the odds. Here comes the sun. Indeed, 174 00:12:30,160 --> 00:12:34,439 Speaker 1: I feel like a god give me, give us another opportunity. 175 00:12:35,600 --> 00:12:42,000 Speaker 1: I give thanks to God to to live again. And 176 00:12:42,160 --> 00:12:48,480 Speaker 1: I feel lucky. I feel lucky. It's some miracle. I 177 00:12:48,640 --> 00:12:52,880 Speaker 1: feel though they am here and I can't say my 178 00:12:53,200 --> 00:13:07,800 Speaker 1: story that was Michelle Fake Cortes. Olivia Carville also helped 179 00:13:07,840 --> 00:13:11,160 Speaker 1: with reporting on this story. And that's it for our 180 00:13:11,160 --> 00:13:14,319 Speaker 1: show today. For coverage of the outbreak from our bureaus 181 00:13:14,360 --> 00:13:19,000 Speaker 1: around the world, please visit Bloomberg dot com, slash Coronavirus 182 00:13:19,840 --> 00:13:23,760 Speaker 1: and as usual a favor. If you appreciate the show, 183 00:13:24,000 --> 00:13:26,880 Speaker 1: please leave us a review and a rating on Apple 184 00:13:26,920 --> 00:13:30,360 Speaker 1: Podcasts or Spotify. It's the best way to help more 185 00:13:30,400 --> 00:13:35,640 Speaker 1: listeners find our global reporting. The Prognosis Daily edition is 186 00:13:35,679 --> 00:13:39,280 Speaker 1: hosted by Me Laura Carlson. The show was produced by 187 00:13:39,320 --> 00:13:44,920 Speaker 1: Me Tophor Forehaz, Jordan Gospoure, and Magnus Hendrickson. Today's main 188 00:13:45,000 --> 00:13:49,120 Speaker 1: story was reported by Michelle fay Cortes and Olivia Carville. 189 00:13:50,080 --> 00:13:54,439 Speaker 1: Original music by Leo sidrin Our. Editors are Francesca Levi 190 00:13:54,800 --> 00:13:59,560 Speaker 1: and Rick Shine. Francesca Levi is Bloomberg's head of podcasts. 191 00:14:00,160 --> 00:14:01,040 Speaker 1: Thanks for listening.