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The breath of life

September 28, 2021

Man_dressed_in_Black_by_Calcar_(Hermitage)Though doctors have discovered some drugs that are useful in treating Covid-19, and large randomized trials are starting for three more prospects, the core technology for those infected and in respiratory distress are aids to respiration: mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Neither of those were available a few decades past. It is a bit sobering to realize that most every Covid-19 patient who enters ICU would have died, if similarly struck in 1950. That also is a reminder that the mortality rate for a disease is as much a function of the larger culture as it is of the underlying biology. The history of mechanical ventilation makes interesting reading. Alas, the ability of modern ICUs to keep a body alive is not matched by the ability to make sure that body heals fully.

The media has taken some notice that US deaths from Covid-19 surpass the number from the Spanish flu a century past. There are two major qualifiers to that statistic. First, that the US population now is more than three times as large. Second, that our death toll has been much less than it would have been without advances in medical practice, including those mentioned above. Those caveats work in opposite direction, in how one might view this disease. The first might cause one to think that the Spanish flu was much worse, that so many more died per capita. The second makes one realize we have not suffered the worst case scenario, but a scenario where modern medicine has been able to save a large fraction of those who would have died in times past.

Modern aids to respiration won’t save someone who refuses them, because their politically misinformed friends persuade them to leave ICU.

One Comment leave one →
  1. Michael Grossberg permalink
    September 28, 2021 10:02 am

    How true… It’s especially sobering to realize that 1) this wasn’t the “big” one, not by a long stretch. (Imagine something as deadly as the 1918-1919 flu that killed people of all ages, and especially healthy adults 20 to 40 or so with very strong immune systems, who paradoxically died from their immune system’s overreaction to the flu, or even a worldwide pandemic of Ebola), and 2) if the same percent of the U.S. population had died today from COVID as died from the 1918-1919 “super flu” (my name, since it wasn’t Spanish at all), we’d likely end up with roughly 2.5 million deaths – and how would the media and the population have reacted to that dismal reality?

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