The 7 Stages of Covid

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Old 09-20-2021, 07:48 PM
Boomer Boomer is offline
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Default The 7 Stages of Covid

I have never done a cut-and-paste from a published article, but that's the only way I could do this. Unlike other cut-and-pastes I have seen that often do not cite the source, I will do so. . .

This is what is known to research as a primary source. Primary sources are defined as first-hand accounts of a topic by people who had a connection with it.

The following article was published in the Op-Ed section of the LA Times, August 26, 2021. The writer is Karen Gallardo, a respiratory therapist at Community Memorial Hospital in Ventura.

(In spite of the disagreements we Villagers can have sometimes on TOTV, I think most of us have sense enough to have been vaccinated. We duly vaccinated, older and (sometimes) wiser, people do not seem to be the age-group that welcomed Covid back to another rampant run.

I have boomer friends who cannot get their adult children to be vaccinated -- not to protect their own children, not to protect themselves, and not to protect their "old" parents. Family dynamics for some are getting downright weird. . .but. . .I digress.)

Here's the article. Read it and weep.

Boomer



Op-Ed: On the front lines, here’s what the seven stages of severe COVID-19 look like


I’m a respiratory therapist. With the fourth wave of the pandemic in full swing, fueled by the highly contagious Delta variant, the trajectory of the patients I see, from admission to critical care, is all too familiar. When they’re vaccinated, their COVID-19 infections most likely end after Stage 1. If only that were the case for everyone.

Get vaccinated. If you choose not to, here’s what to expect if you are hospitalized for a serious case of COVID-19.


Stage 1. You’ve had debilitating symptoms for a few days, but now it is so hard to breathe that you come to the emergency room. Your oxygen saturation level tells us you need help, a supplemental flow of 1 to 4 liters of oxygen per minute. We admit you and start you on antivirals, steroids, anticoagulants or monoclonal antibodies. You’ll spend several days in the hospital feeling run-down, but if we can wean you off the oxygen, you’ll get discharged. You survive.

Stage 2. It becomes harder and harder for you to breathe. “Like drowning,” many patients describe the feeling. The bronchodilator treatments we give you provide little relief. Your oxygen requirements increase significantly, from 4 liters to 15 liters to 40 liters per minute. Little things, like relieving yourself or sitting up in bed, become too difficult for you to do on your own. Your oxygen saturation rapidly declines when you move about. We transfer you to the intensive care unit.

Stage 3. You’re exhausted from hyperventilating to satisfy your body’s demand for air. We put you on noninvasive, “positive pressure” ventilation — a big, bulky face mask that must be Velcro’d tightly around your face so the machine can efficiently push pressure into your lungs to pop them open so you get enough of the oxygen it delivers.

Stage 4. Your breathing becomes even more labored. We can tell you’re severely fatigued. An arterial blood draw confirms that the oxygen content in your blood is critically low. We prepare to intubate you. If you’re able to and if there’s time, we will suggest that you call your loved ones. This might be the last time they’ll hear your voice.
We connect you to a ventilator. You are sedated and paralyzed, fed through a feeding tube, hooked to a Foley catheter and a rectal tube. We turn your limp body regularly, so you don’t develop pressure ulcers — bed sores. We bathe you and keep you clean. We flip you onto your stomach to allow for better oxygenation. We will try experimental therapeutics.

Stage 5. Some patients survive Stage 4. Unfortunately, your oxygen levels and overall condition have not improved after several days on the ventilator. Your COVID-infested lungs need assistance and time to heal, something that an ECMO machine, which bypasses your lungs and oxygenates your blood, can provide. But alas, our community hospital doesn’t have that capability.

If you’re stable enough, you will get transferred to another hospital for that therapy. Otherwise, we’ll continue treating you as best we can. We’re understaffed and overwhelmed, but we’ll always give you the best care we can.

Stage 6. The pressure required to open your lungs is so high that air can leak into your chest cavity, so we insert tubes to clear it out. Your kidneys fail to filter the byproducts from the drugs we continuously give you. Despite diuretics, your entire body swells from fluid retention, and you require dialysis to help with your renal function.

The long hospital stay and your depressed immune system make you susceptible to infections. A chest X-ray shows fluid accumulating in your lung sacs. A blood clot may show up, too. We can’t prevent these complications at this point; we treat them as they present.

If your blood pressure drops critically, we will administer vasopressors to bring it up, but your heart may stop anyway. After several rounds of CPR, we’ll get your pulse and circulation back. But soon, your family will need to make a difficult decision.

Stage 7: After several meetings with the palliative care team, your family decides to withdraw care. We extubate you, turning off the breathing machinery. We set up a final FaceTime call with your loved ones. As we work in your room, we hear crying and loving goodbyes. We cry, too, and we hold your hand until your last natural breath.

I’ve been at this for 17 months now. It doesn’t get easier. My pandemic stories rarely end well.

Karen Gallardo is a respiratory therapist at Community Memorial Hospital in Ventura.
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Last edited by Boomer; 09-20-2021 at 08:04 PM. Reason: typo
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Old 09-20-2021, 08:21 PM
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Boomer, my daughter considers the vaccine a “medical procedure”. She would rather leave the country if mandatory vaccinations, than get vaccinated. Both of her parents taught at university and she also attended. Both of her parents are even ready for the booster so it is not our example. I have learned to respect her choice … with a broken heart. I pray and hope I never have to face the day when she will say to me, “Mom, I’ve tested positive”. If you have any words of wisdom for me, I am really listening.

Last edited by Velvet; 09-20-2021 at 08:32 PM.
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Old 09-20-2021, 08:31 PM
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Originally Posted by Velvet View Post
Boomer, my daughter considers the vaccine a “medical procedure”. She would rather leave the country if mandatory vaccinations, than get vaccinated. Both of her parents taught university and she also attended. Both of her parents are even ready for the booster so it is not our example. I have learned to respect her choice … with a broken heart. I pray and hope I never have to face the day when she will say to me, “Mom, I’ve tested positive”. If you have any words of wisdom for me, I am really listening.
Only my opinion…..you should respect her choice, (as I’m sure you would), the same as in other decisions she may make regarding her body.
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Old 09-20-2021, 09:34 PM
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Originally Posted by Velvet View Post
Boomer, my daughter considers the vaccine a “medical procedure”. She would rather leave the country if mandatory vaccinations, than get vaccinated. Both of her parents taught at university and she also attended. Both of her parents are even ready for the booster so it is not our example. I have learned to respect her choice … with a broken heart. I pray and hope I never have to face the day when she will say to me, “Mom, I’ve tested positive”. If you have any words of wisdom for me, I am really listening.
We have friends that have one child with a brand new baby and she witnessed firsthand the struggles that people experienced in the hospital and still no dice. Once they are of age what can you do?

We decided to be supportive. In this case, it's like fighting city hall. We've seen others try to convince her. Hoping for the best for those who can't see the other path....who knows, they may be correct, but I doubt it.
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Old 09-20-2021, 09:40 PM
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One of my long time close friends has a daughter who is a physician at UCLA treating Covid cases. Her daughter is furious at the unvaccinated who are overwhelming the hospital. Today I got my Pfizer booster shot!
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Old 09-20-2021, 09:46 PM
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Originally Posted by manaboutown View Post
One of my long time close friends has a daughter who is a physician at UCLA treating Covid cases. Her daughter is furious at the unvaccinated who are overwhelming the hospital. Today I got my Pfizer booster shot!
Good for you manaboutown. Say it loud and proud. I got my Moderna Booster about two weeks ago.

We still mask up when we feel it's appropriate. I don't give a rats NOTHING about what anyone thinks about it either.

I don't judge them for their decisions. I just judge my immediate family but only with my wife.

Last edited by Nucky; 09-21-2021 at 08:02 AM. Reason: speallink
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Old 09-20-2021, 09:51 PM
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Good for you manaboutown. Say it loud and proud. I goy my Moderna Booster about two weeks ago.

We still mask up when we feel it's appropriate. I don't give a rats NOTHING about what anyone thinks about it either.

I don't judge them for their decisions. I just judge my immediate family but only with my wife.
VA called and told me to come in last week for my booster. Needless to say, I did.
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Old 09-20-2021, 10:11 PM
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Another longtime friend has a daughter who is an MD professor at Harvard. She performs surgeries at Mass General. I have heard so many Covid horror stories from her, including amputations. Brrr. My barber is down to 1/2 a kidney due to Covid. Two people I knew, 29 and 30 years of age, unvaccinated, died over the last week, probably from the delta variant. The 30 year old was a woman with three children under five years of age. Tragic...
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Old 09-20-2021, 11:14 PM
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Quote:
Originally Posted by Boomer View Post
I have never done a cut-and-paste from a published article, but that's the only way I could do this. Unlike other cut-and-pastes I have seen that often do not cite the source, I will do so. . .

This is what is known to research as a primary source. Primary sources are defined as first-hand accounts of a topic by people who had a connection with it.

The following article was published in the Op-Ed section of the LA Times, August 26, 2021. The writer is Karen Gallardo, a respiratory therapist at Community Memorial Hospital in Ventura.

(In spite of the disagreements we Villagers can have sometimes on TOTV, I think most of us have sense enough to have been vaccinated. We duly vaccinated, older and (sometimes) wiser, people do not seem to be the age-group that welcomed Covid back to another rampant run.

I have boomer friends who cannot get their adult children to be vaccinated -- not to protect their own children, not to protect themselves, and not to protect their "old" parents. Family dynamics for some are getting downright weird. . .but. . .I digress.)

Here's the article. Read it and weep.

Boomer



Op-Ed: On the front lines, here’s what the seven stages of severe COVID-19 look like


I’m a respiratory therapist. With the fourth wave of the pandemic in full swing, fueled by the highly contagious Delta variant, the trajectory of the patients I see, from admission to critical care, is all too familiar. When they’re vaccinated, their COVID-19 infections most likely end after Stage 1. If only that were the case for everyone.

Get vaccinated. If you choose not to, here’s what to expect if you are hospitalized for a serious case of COVID-19.


Stage 1. You’ve had debilitating symptoms for a few days, but now it is so hard to breathe that you come to the emergency room. Your oxygen saturation level tells us you need help, a supplemental flow of 1 to 4 liters of oxygen per minute. We admit you and start you on antivirals, steroids, anticoagulants or monoclonal antibodies. You’ll spend several days in the hospital feeling run-down, but if we can wean you off the oxygen, you’ll get discharged. You survive.

Stage 2. It becomes harder and harder for you to breathe. “Like drowning,” many patients describe the feeling. The bronchodilator treatments we give you provide little relief. Your oxygen requirements increase significantly, from 4 liters to 15 liters to 40 liters per minute. Little things, like relieving yourself or sitting up in bed, become too difficult for you to do on your own. Your oxygen saturation rapidly declines when you move about. We transfer you to the intensive care unit.

Stage 3. You’re exhausted from hyperventilating to satisfy your body’s demand for air. We put you on noninvasive, “positive pressure” ventilation — a big, bulky face mask that must be Velcro’d tightly around your face so the machine can efficiently push pressure into your lungs to pop them open so you get enough of the oxygen it delivers.

Stage 4. Your breathing becomes even more labored. We can tell you’re severely fatigued. An arterial blood draw confirms that the oxygen content in your blood is critically low. We prepare to intubate you. If you’re able to and if there’s time, we will suggest that you call your loved ones. This might be the last time they’ll hear your voice.
We connect you to a ventilator. You are sedated and paralyzed, fed through a feeding tube, hooked to a Foley catheter and a rectal tube. We turn your limp body regularly, so you don’t develop pressure ulcers — bed sores. We bathe you and keep you clean. We flip you onto your stomach to allow for better oxygenation. We will try experimental therapeutics.

Stage 5. Some patients survive Stage 4. Unfortunately, your oxygen levels and overall condition have not improved after several days on the ventilator. Your COVID-infested lungs need assistance and time to heal, something that an ECMO machine, which bypasses your lungs and oxygenates your blood, can provide. But alas, our community hospital doesn’t have that capability.

If you’re stable enough, you will get transferred to another hospital for that therapy. Otherwise, we’ll continue treating you as best we can. We’re understaffed and overwhelmed, but we’ll always give you the best care we can.

Stage 6. The pressure required to open your lungs is so high that air can leak into your chest cavity, so we insert tubes to clear it out. Your kidneys fail to filter the byproducts from the drugs we continuously give you. Despite diuretics, your entire body swells from fluid retention, and you require dialysis to help with your renal function.

The long hospital stay and your depressed immune system make you susceptible to infections. A chest X-ray shows fluid accumulating in your lung sacs. A blood clot may show up, too. We can’t prevent these complications at this point; we treat them as they present.

If your blood pressure drops critically, we will administer vasopressors to bring it up, but your heart may stop anyway. After several rounds of CPR, we’ll get your pulse and circulation back. But soon, your family will need to make a difficult decision.

Stage 7: After several meetings with the palliative care team, your family decides to withdraw care. We extubate you, turning off the breathing machinery. We set up a final FaceTime call with your loved ones. As we work in your room, we hear crying and loving goodbyes. We cry, too, and we hold your hand until your last natural breath.

I’ve been at this for 17 months now. It doesn’t get easier. My pandemic stories rarely end well.

Karen Gallardo is a respiratory therapist at Community Memorial Hospital in Ventura.
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I applaud you for this post. It needs to be said and heard.

It is the truth and worse I have known a husband and wife, married for almost sixty years that died like this and without each other or their beloved children present. They were from Cincinnati and I taught their granddaughter and knew their daughter well too. They died just about a year ago, a week apart.

I can only think of someone that we love dearly going though this and we are unable to be present.
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Old 09-21-2021, 04:56 AM
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If that article isn’t enough to get the vaccine, I don’t know what is. Scary stuff.
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Old 09-21-2021, 04:58 AM
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Absolutely fabulous post! Thank you, Boomer.
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Old 09-21-2021, 05:08 AM
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Wife and I are booked for our boosters next week.
I cannot understand how anyone who is able, and has no medical reason not to, does not get vaccinated if the OP is the alternative.
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Old 09-21-2021, 05:16 AM
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Default A Story That Needs To Be Told

Thanks Boomer!
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Old 09-21-2021, 05:20 AM
thevillages2013 thevillages2013 is offline
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Most unvaccinated people who get Covid do not go to the hospital and recover just fine. No one wants to hear that though
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Old 09-21-2021, 05:34 AM
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Default Booster Shot.?

Being as a Booster shot has only been recommended just last week and not Approved by either FDA or CDC, response from both coming sometime this week, just what is this "Booster" shot you've taken?

Interesting.

Carl
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