
The Infection That’s Silently Killing Coronavirus Patients - vo2maxer
https://www.nytimes.com/2020/04/20/opinion/coronavirus-testing-pneumonia.html
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shalmanese
This was already reported in China since the very early days of the infection.
People would come in with critically low spO2 that seemed to have no problems
breathing but would then rapidly collapse.

China switched to a system of centralized quarantine where people were put
under medical supervision no matter how mild their case was and their spO2 was
checked twice a day[1]. Anyone with spO2 < 93% was put on supplemental oxygen
immediately rather than waiting for clinical signs.

The American practice of allowing people to recover at home and make a self-
determination of when they require hospitalization is likely causing many more
excess deaths.

Here's a Rachel Maddow video from March 12th explaining all of this:
[https://www.msnbc.com/rachel-maddow/watch/how-a-country-
seri...](https://www.msnbc.com/rachel-maddow/watch/how-a-country-serious-
about-coronavirus-does-testing-and-quarantine-80595013902)

[1] Page 72 of [https://gmcc.alibabadoctor.com/prevention-
manual/reader?pdf=...](https://gmcc.alibabadoctor.com/prevention-
manual/reader?pdf=Construction%20and%20Operation%20Manual%20of%20Fangcang%20Shelter%20Hospitals%20for%20COVID-19%20Summary\(Compressed\).pdf&no_handbook=true&opt=read&version=compressed&language=en&content_id=2&entry=aliyungmcc_re_20200420__)

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infinite_beam
The President should use the Defense Production Act to get pulse oximeters to
everyone. In our household we have been following Dr. John Campbell's videos
on youtube for sometime now. Dr. Campbell suggested in February that everyone
should have a pulse oximeter at home and we got one. My friends who have been
looking to get one now can't seem to find them (the affordable ones)anywhere.

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taneq
There's something weird going on with COVID-19 and oxygen levels. I've seen
lots of doctors posting that they're seeing patients with crazy low oxygen
levels - like in the 30s which is usually fatal but these patients were
conscious and responsive.

Whether it's messing with the way we read blood oxygen levels, or there's
something else funky going on, I don't know. But it's weird.

~~~
oxymoran
They said that they can function with the oxygen levels that low because the
lungs are still compliant at expelling the carbon dioxide which is not
typically the case with respiratory disease. I read in a different article
that it’s perhaps because the virus is actually striking the vascular system
causing restriction of blood vessels in the lungs which restrict air supply
while the lungs themselves function.

~~~
taneq
That would make sense of the "all OK" -> "suddenly just about dead"
transition. And it wouldn't need to lower O2 absorption by much to get this
effect because if CO2 is being expelled normally, the body won't engage its
normal can't-breathe responses so the O2 level drops virtually unchecked.

I've read about successful treatment just with hyperbaric oxygen which would
also make sense here.

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Jaruzel
[http://archive.is/QSBfc](http://archive.is/QSBfc)

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fxtentacle
TLDR: silent hypoxia - meaning that their blood oxygen level is low.

But people don't notice it yet, because CO2 levels are not building up as they
would with "normal" breathing problems.

I like that they included saturation numbers so that those of us who have
oxymeters (e.g. from skydiving) can self-check.

~~~
Loughla
Any advice on an oxymeter to purchase, or components/features to look for?
They all seem to be the same, but vary in price from $20-$300. Reviews on
websites are just garbage.

~~~
exhilaration
Search Reddit, lots of doctors and med students discussing which of the cheap
ones work. Nearly all are sold out though. I bought this one last night based
on Reddit feedback for $35 but it's already sold out:
[https://www.amazon.com/gp/product/B01HSAG8BE/ref=ppx_yo_dt_b...](https://www.amazon.com/gp/product/B01HSAG8BE/ref=ppx_yo_dt_b_asin_title_o00_s00)

If you've got $300 to spare, this one is _allegedly_ FDA approved:
[https://www.masimopersonalhealth.com/products/mightysat-
fing...](https://www.masimopersonalhealth.com/products/mightysat-fingertip-
pulse-oximeter-with-bluetooth-le-rrp-pvi)

~~~
Loughla
Thanks! A place called Medkioskinc.com apparently still has stock of those (at
least they did ten minutes ago when I looked), for anyone reading this thread.

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sp332
Interesting article, but I'm not sure about the headline. The infection that's
killing patients _is_ the coronavirus.

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thebzax
I don't know if you're being pedantic, or what exactly.

The definition of infection on wikipedia is "An infection is the invasion of
an organism's body tissues by disease-causing agents, their multiplication,
and the reaction of host tissues to the infectious agents and the toxins they
produce."

The infection killing patients is not "the coronavirus". The coronavirus is a
particular kind of virus, specifically known as SARS-CoV-2. COVID-19 is, by
definition "an infectious disease caused by severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2)". So to be pendantic, COVID-19 is the infection
that is killing patients. The question of, by what mechanism the particular
disease causing agents are producing the deadly reaction, is in fact is
perfectly described by the headline.

~~~
sp332
I guess I wasn't being pedantic enough. SARS-CoV-2 causing COVID-19 lung
infections doesn't seem to be headline-worthy, let alone "silent".

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service_bus
It's "silent" because people weren't getting diagnosed properly before.

Why would you check for pneumonia in a guy that comes in presenting stab
wounds and reports no difficulty breathing?

Only now because with increased testing and experience are doctors realizing
that many people have a pneumonia that doesn't present like pneumonia.

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viburnum
If you diagnose the pneumonia early, what’s the treatment? The article doesn’t
say what they do for people that can prevent needing to go on a ventilator.

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gambiting
A really stupid question - is oxygenating the blood externally a thing that is
possible at all? Just like a dialysis machine filters the blood, is there a
machine that can oxygenate the blood outside of the body?

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stmfreak
Yes, but much more expensive and problematic than putting someone on a
ventilator. The machine itself gets clogged with clotted blood so thinners are
required to delay that breakdown.

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vanniv
And you thought the delirium caused by extended vent usage was exciting, wait
till you read about pumphead syndrome!

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aussiegreenie
Pneumonia was called "The old mans' friend" as it killed people in their sleep
without any pain.

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Ciantic
Fitbit has sp02 sensor in it's watches. Could they detect Covid patients
earlier?

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palisade
[https://www.youtube.com/watch?v=YRfwZcLeOm4](https://www.youtube.com/watch?v=YRfwZcLeOm4)

~~~
telesilla
Not sure why this is downvoted, I founded it highly informative. Is there
something I don't know about the channel?

