Last Saturday we were unlucky that the Sahara dust required the minor in the house to be taken to the emergency room of a local hospital to treat respiratory problems. What I explain below is the story of a therapist so that those who still refuse to be vaccinated have the opportunity to read in great detail the consequences that are being addressed.
As the therapist told me, with the fourth wave of the pandemic in full swing, driven by the highly contagious Delta variant, the trajectory of the patients he sees, from admission to critical care, is consistent and ends very badly. When vaccinated, however, their COVID-19 infections most likely end in Stage 1.
After all, their recommendation is to get vaccinated because if you choose not to, this is what you can expect if you are hospitalized for a serious case of COVID-19.
- Stage 1. You have had debilitating symptoms for a few days, but you find it so hard to breathe that you go to the emergency room. Your oxygen saturation level indicates that you need help, an additional flow of 1 to 4 liters of oxygen per minute. You are admitted to the hospital and start with antivirals, steroids, anticoagulants, or monoclonal antibodies. You will spend several days in the hospital feeling exhausted, but if they can miraculously get oxygen out of you, they will discharge you. You survived.
- Stage 2. It gets harder and harder to breathe. “How to drown,” many patients describe the sensation. The bronchodilator treatments that apply to you provide little relief. Your oxygen needs increase significantly, from 4 liters to 15 liters to 40 liters per minute. Little things, like doing your needs or sitting in bed, become too difficult to do on your own. Your oxygen saturation decreases rapidly as you move. You are transferred to the intensive care unit.
- Stage 3. You get exhausted from hyperventilating to meet your body’s demand for air. They apply non-invasive “positive pressure” ventilation: a large, bulky mask that should be placed with velcro around your face so that the machine can efficiently press your lungs to open them and get enough oxygen.
- Step 4. Your breathing becomes even harder. An arterial blood draw confirms that the oxygen content in the blood is critically low. They prepare you for intubation. If you can and if there is time they suggest you call your loved ones. This might be the last time they hear your voice.
You are connected to a fan. You are sedated and paralyzed, fed through a feeding tube, connected to a Foley catheter and a rectal tube. They mobilize your flaccid body regularly, so that you do not develop ulcers. They bathe you and try to keep you clean. They put you upside down to allow for better oxygenation. In some cases, they try experimental therapies. - Step 5. Only a few patients survive Stage 4. Unfortunately, your oxygen levels and general condition do not improve after several days in the ventilator. Your COVID-infested lungs need help and time to heal, which can provide an ECMO machine, which oxygenates your blood without using your lungs. But unfortunately, not all hospitals have this capacity.
- Step 6. The pressure needed to open the lungs is so high that air can seep into the chest cavity, so tubes are inserted to clean it. Your kidneys do not filter the by-products of the medications you are given continuously. Despite diuretics, your whole body is swollen from fluid retention and you need dialysis to help with your kidney function.
The long stay in the hospital and your depressed immune system make you susceptible to infections. A chest x-ray shows fluid buildup in the lung sacs. A blood clot may also appear. They cannot prevent these complications at this time; they treat you as best they can.
If your blood pressure drops critically, you are given vasopressors to increase it, but your heart can stop anyway. After several rounds of CPR, they may regain your pulse and circulation. But soon your family will have to make a difficult decision. - Step 7: After several meetings with the palliative care team, your family decides to withdraw medical attention. They extubate you by turning off the respiratory machinery. Coordinate one last call with your loved ones. As they work in your room, they hear tears and loving goodbyes.
The staff that will take care of you throughout this journey also suffers, cries and even holds your hand until your last natural breath. They have been in this for 17 months and, from personal experience, warns you that living with a COVID-19 infected patient who has not received the vaccine rarely ends well.