Like all of you, I have this underlying hum of anxiety every day that wasn’t there before. So far, no one in my immediate circle of family and friends has contracted COVID-19. All of them (and me!) are practicing physical distancing – we only go out for exercise and groceries, and even then we wear (non-medical) masks and gloves when appropriate. Sometimes that’s not enough.
I know my chances. From last June to this January, I had three colds severe enough to work from home, and it is not unusual for me to pick up every sniffle from younger relatives, only ten times worse. My immune system will not be able to handle the serious challenge of our current pandemic. As such, I have been thirsty for information about what the actual cause of death is in COVID-19 patients. I want to know exactly what I am facing and what, if anything, I can do to help myself.
This is what I have learned in the last week:
1. It doesn’t matter whether you have your condition is under control. I think my diabetes and kidney disease are under pretty good control -- at least, better than they were a few months ago (I have to do my labs at the end of this week.). My asthma has always been mild with symptoms only caused by vigorous exercise or heavy weather (you know, when the air is dense but it isn’t quite raining yet). But they are still sources of vulnerability. Dr. Calvin Sun, an NYC ER doctor said on MSNBC this week that even young patients with no underlying conditions are having strokes or viral myocarditis due to COVID-19, and that he has seen well-controlled diabetics and asthmatics come in critically ill.
2. The biggest issue is the body’s ability to get oxygen. We have all heard about the issues hospitals are facing with getting enough ventilators. That’s because the most serious cases are the ones in which patients can’t get enough oxygen into their bodies and can’t get the carbon dioxide out, a condition called acute respiratory distress syndrome (ARDS). That’s what has been causing the shortness of breath, rapid breathing, dizziness, and rapid heart rate, all indications that your body is panicking because it isn’t getting enough oxygen. ARDS damages the mechanisms that get oxygen into the blood. There’s not a lot that can be done about this outside of a hospital, but there has been some evidence that lying prone (on your stomach) may help improve your blood oxygenation.
3. Hypercoagulation is happening even in previously healthy patients. In that same MSNBC segment I referenced above, Dr. Sun said that hospital staff is seeing an unusually high rate of hypercoagulation, to the point where it is causing IV lines to clog. Blood clots are extremely dangerous under any circumstances. If a blood clot doesn’t dissolve in its own, it can travel to your heart, lungs, or brain, and block blood flow to those organs. There is not a lot of information on why COVID-19 causes hypercoagulation or whether it can be viewed the same way as non-COVID-19-related blood clotting but, generally, drinking a lot of water and getting exercise (hard to do in lockdown, I know) or at least a decent amount of movement can help lower the risk for blood clots.
I know that what I’ve learned this week isn’t a lot, and one of the scariest aspects of this whole situation is the newness of it. I feel like I am flying blind here. Which makes every bit of new information feel important, even if there is nothing I can do about it. Knowing more about what I could be facing both shores up my willpower to physically isolate myself for the long haul (I suspect that my state’s lockdown is going to be another six to eight weeks), and gives me an ever-so-slightly increased feeling of control over this uncontrolled environment.
I’ll take what I can get.