A
Another heartbreaking day in the ER.
A healthy 40-something dx w/ COVID a week ago.
So was their spouse.
Both unvaccinated.
My patient came in today with an oxygen sat of 64%.
Their spouse has a mild cough.
We can predict who will more likely than others get very sick from COVID19.
The elderly.
The immunocompromised.
Those with underlying lung disease.
Others.
It's not a guarantee, but those folks are more "at risk."
Those are the people we were told to protect last year.
Those are the people who have mostly been vaccinated.
Those people are able to be easily identified.
But how do I know who among all of the other people I see every shift will end up on a ventilator?
I don't.
My experience in the ICU last month reminded me of the reality that some of the "low risk" people do end up on ventilators for months. They end up with tracheostomies and feeding tubes and need to learn to walk again.
My patient today reminded me that 2 people in the same house with the same likely exposure and the same basic risks can have 2 very different courses of their illness.
One with a mild cough, and one breathing 44 times/minute and only oxygenating at 64%
I don't yet know the path my patient will take in (hopefully) their recovery. By the time I left the ER, they were on a high flow nasal cannula at 80 L/min and 85%. (That's alot!) They're getting everything available to manage their infection. I fear that they will end up on a ventilator before morning. The ventilator doesn't damage the patient so much as the virus damages the patient and the vent is our last ditch effort to pull them through. And while death is a horrible outcome from this disease, long term survival for months on a ventilator and learning how to eat and walk again is pure misery for patients and their loved ones.
So if your'e wondering:
Why am I so passionate about getting people vaccinated?
Why do I support vaccine mandates?
Why do I support masks in schools?
Why do I try to follow the science?
It's my patient today.
They do not get a second chance at getting vaccinated.
They cannot prevent their current fate.
Their family must wait and hope and pray.
And it's my next patient who with a safe and effective vaccine can avoid all of this misery.