Speaker 1: It's Friday, May one. I'm Oscar Ramires from the Daily
Speaker 1: Dive podcast in Los Angeles, and this is your daily
Speaker 1: coronavirus update. As we learned more about COVID nineteen and
Speaker 1: the way it affects people, doctors are seeing a second
Speaker 1: week crash in patients who suffer the most severe reactions
Speaker 1: to the coronavirus. Doctors still don't know why the fifth
Speaker 1: through tenth days seem to be so dangerous for some,
Speaker 1: but they suspect overactive immune responses, blood clotting, or even
Speaker 1: the impact of ventilators. Lenny Bernstein, health and medicine reporter
Speaker 1: for The Washington Post, joins us for more. Thanks for
Speaker 1: joining us, Lenny, Oh, thanks for having me. It's tough
Speaker 1: because we're constantly still learning more about COVID nineteen, how
Speaker 1: the virus affects people. The good news is that we
Speaker 1: just heard about them Deservie and how it is helping
Speaker 1: to reduce recovery time by as much as four days
Speaker 1: and some people, and this kind of fits into exactly
Speaker 1: what we're talking about. Doctors have been reporting this second
Speaker 1: week crash that is a big concern for a lot
Speaker 1: of people. So maybe somebody have some mild symptoms, maybe
Speaker 1: even more severe symptoms. But between the fifth and the
Speaker 1: tenth day, something goes crazy and it gets much much worse.
Speaker 1: So let me tell us a little bit about this
Speaker 1: second week crash and what doctors think about it. This
Speaker 1: really is a novel coronavirus. It's new. We thought we
Speaker 1: knew a good bit about it because it's very much
Speaker 1: like other coronaviruses, like the one that causes cold. But
Speaker 1: it turns out that there are a lot of things
Speaker 1: to this virus that were not apparent when this pandemic
Speaker 1: started four months ago or got to the United States
Speaker 1: two months ago. One of the things that doctors started
Speaker 1: seeing right away and started to tell each other that
Speaker 1: they needed to guard against was that about halfway through
Speaker 1: the course of symptoms, people suddenly went critical. And in
Speaker 1: the beginning you had doctors who had people in the
Speaker 1: I c U or other parts of the hospital, and
Speaker 1: they were saying with themselves, got this person through the
Speaker 1: first week, that's great, because with most diseases, you get
Speaker 1: through the first week, you get more stable, you start
Speaker 1: to earn upwards in your trajectory. This is one of
Speaker 1: those diseases where people can suddenly just start gasping for air,
Speaker 1: start choking, start feeling like they can't breathe, and go
Speaker 1: downhill quite rapidly in that time period that you mentioned.
Speaker 1: And so why do doctors think this is happening? I
Speaker 1: know there's always this big thing of underlying health conditions
Speaker 1: and that can make things worse. We've talked about the
Speaker 1: immune system and how it can go overboard and start
Speaker 1: destroying sealfie hells and make things worse. What are doctors
Speaker 1: thinking that might be the cause for this second week crash?
Speaker 1: So unfortunately nobody knows. There are a number of theories,
Speaker 1: and that's what our story was about. One of the
Speaker 1: big ones is what you just mentioned. The cytokine store
Speaker 1: of virus invades the lungs. The body sends out its
Speaker 1: army of antibodies and other cells to attack this virus,
Speaker 1: and in some people, for reasons we don't really know why,
Speaker 1: their bodies don't turn off that response when they should,
Speaker 1: and they end up with an over response, a hyper
Speaker 1: drive response of their own immune says them, and that
Speaker 1: causes more inflammation and makes the lungs much worse. But
Speaker 1: there's only one theory. Some people think that the virus
Speaker 1: is actually destroying the cells on the insides of the
Speaker 1: little air sacks of your lungs, and it takes three
Speaker 1: or four weeks to regenerate those, but right around five
Speaker 1: or ten days is when you reach a critical point
Speaker 1: and enough of them have gone away that you start
Speaker 1: to be unable to breathe. They're finding micro plots in
Speaker 1: people's lungs and other parts of the body, other parts
Speaker 1: of the party of vascular system, not acent sure whether
Speaker 1: those clots might not have something to do with it.
Speaker 1: And then there's the way we use these ventilators. Traditional
Speaker 1: therapy for someone who comes in and they can't breathe
Speaker 1: and their lungs are full of gunk is if they're
Speaker 1: bad enough, we put them on a ventilator. That's as
Speaker 1: I'm sure everybody's heard by now. They sedate them and
Speaker 1: then they put a ten inch tube down into their
Speaker 1: breathing passages. Well, there are some doctors who are thinking
Speaker 1: that may actually make things worse with certain kinds of
Speaker 1: people who already are hypoxic. Unfortunately, we don't know, and
Speaker 1: one day the research will be done and we will
Speaker 1: have a better grip on this, but right now we don't.
Speaker 1: With the ventilator specifically, there's a few interesting things there.
Speaker 1: They think that it might be because they're putting a
Speaker 1: little too much pressure on the lungs and it can
Speaker 1: produce more of the inflammatory response to the virus. And
Speaker 1: then beyond that, you know, some hospitals are saying, well,
Speaker 1: let's wait a little bit before we put somebody on
Speaker 1: a ventilator, and they're using kind of this technique it's
Speaker 1: called proning, basically just putting patients on their stomachs for
Speaker 1: as much as sixteen hours a day in some cases.
Speaker 1: But all of this kind of helps to maybe not
Speaker 1: use the ventilator so much. And as you mentioned, everybody
Speaker 1: was kind of hearing about ventilators, ventilators, ventilators. We need
Speaker 1: so many of them, and maybe it's not so much
Speaker 1: the case anymore. But this is all kind of developing
Speaker 1: as we're learning more about it. You say, they're kind
Speaker 1: of building the plane while they're flying it at the
Speaker 1: same time. And I do like to talk about proning
Speaker 1: when we can, because it's one of those low tech
Speaker 1: silver linings that doctors are beginning to use more and more.
Speaker 1: Think about watching medical shows on TV, the roles on
Speaker 1: their back because the doctors have to be able to
Speaker 1: get to them and tend to their needs. So you
Speaker 1: want them face up. But doctors and others are turning
Speaker 1: these people on their stomachs, like you said, as much
Speaker 1: as sixteen hours a day and taking pressure off their lungs,
Speaker 1: pressure off their hearts, and they're finding that it does
Speaker 1: improve people. So I like that story. I'd like to
Speaker 1: hear that because it's one of the few silver linings
Speaker 1: that we've found. The VENTI latter. It's a great machine.
Speaker 1: It saves lives, It has saved countless lives. But imagine
Speaker 1: somebody comes in and they're gasping for air and they
Speaker 1: can't breathe it all, and yet they have that look
Speaker 1: of panic in their eyes, and you're gonna turn to
Speaker 1: them and say, you know what, We're not going to
Speaker 1: put you on the vent because we want to see
Speaker 1: if not putting you on the vent works out. First Well,
Speaker 1: that's a tough decision. Who wants to be the doctor
Speaker 1: who has to make that decision. These are people, obviously,
Speaker 1: that are experiencing the most severe symptoms of this. The
Speaker 1: good news is that the majority of people that get
Speaker 1: COVID nineteen don't require this hospitalization. I think they said
Speaker 1: about ten of the one million known cases so far
Speaker 1: require hospitalization, and beyond that, smaller percentages require intensive care
Speaker 1: or the ventilators themselves, or experience really rapid deterioration of
Speaker 1: the health. But this still cause for concern for the
Speaker 1: people that do get ill this second week. You know,
Speaker 1: as you mentioned, you're naturally inclined to think that first
Speaker 1: week you're over it and we're smooth sailing now. But
Speaker 1: that's why it's good news that we are getting some
Speaker 1: good news out of this deserviere and this kind of
Speaker 1: reduces the time to recovery, so we're starting to get
Speaker 1: the hang of it. We're starting to figure this thing out,
Speaker 1: and these are all good things to know. We are
Speaker 1: tossing everything that makes any sense at all at this
Speaker 1: disease because it's a pandemic. People are dying day. So yeah,
Speaker 1: if remdesiviere cuts the time in the hospital from fifteen
Speaker 1: to eleven for some people, that's good news. That you
Speaker 1: want people out of the hospital back home, not lying
Speaker 1: on their back getting pneumonia, So that's great. Anything else
Speaker 1: that we can toss at this thing that actors with
Speaker 1: their sort of ingenuity at this can toss that this
Speaker 1: thing is a blessing, But the problem is that the
Speaker 1: numbers are still very high, and when you get to
Speaker 1: places that individually are overwhelmed with patients. Take some of
Speaker 1: those hospitals in Brooklyn and Queens during the height of
Speaker 1: the pandemic in New York. They're just going as fast
Speaker 1: as they can trying to keep people alive. There wasn't
Speaker 1: a lot of time to sort of work out new
Speaker 1: ways of doing things. Now, Dr guy out there near
Speaker 1: you at u c l A who said, look, we've
Speaker 1: got a manageable flow of patients and that allows us
Speaker 1: to be much more hands on. It's been a lot
Speaker 1: more time with each patient, and that's what we need,
Speaker 1: trying to buy our health system time, as much time
Speaker 1: as possible. So if God forbid you or I find
Speaker 1: ourselves in one of those hospitals, we've got doctors and
Speaker 1: nurses who can spend as much time as they need
Speaker 1: trying to treat us. Lenny Bernstein, health and medicine reporter
Speaker 1: at the Washington Post, thank you very much for joining us.
Speaker 1: Absolutely my pleasure. My Moscar Ramirez, and this has been
Speaker 1: your daily coronavirus update. Don't forget that for today's big news. Stories.
Speaker 1: You can check me out on the Daily Dive podcast
Speaker 1: every Monday through Friday, so follow us on I Heart
Speaker 1: Radio or wherever you get your podcasts.