Treating Coronavirus: A day inside Houston Methodist’s Highly Infectious Disease Unit
Many COVID-19 patients are being treated at Houston Methodist’s Highly Infectious Disease Unit. What does a day inside look like? Follow the staff's journey and see how the community's most vulnerable are being cared for.
What do you say to a patient who is clearly getting sicker?
Our Chief Medical Officer, Dr. Josh Landy, is sharing his experiences in the ICU: I’ve admitted a handful of patients with COVID-19 to the ICU as they deteriorate, as so far the most common clinical presentation is progressive hypoxemia (e.g. SpO2 90% on a non-rebreather mask) with a modestly elevated respiratory rate (20-30), and very little distress. Unlike most of the typical admissions to the ICU, the patients are awake and lucid. They ask normal questions about their illness, like “Am I going to be okay?” and “Do I need a ventilator?” Unsurprisingly, I rarely know the answers and I’d like to say something helpful. I’ve been using the phrase, “We’re going to take good care of you.” I’d like to hear how others have been approaching these conversations during the pandemic. What do you say to your patients? Join the discussion
UPDATED APRIL 16, 2020
Thanks to an anonymous friend for sharing how she and her team are protecting their ears while wearing masks for an extended period of time.
UPDATED APRIL 14, 2020
After the storm
Our Chief Medical Officer, Dr. Josh Landy, is sharing his experiences in the ICU: "Today I met a patient who is a COVID-19 survivor. He was in the ICU for a month, requiring mechanical ventilation for almost four weeks. That’s much longer than a typical patient with bacterial pneumonia. This patient required a lengthy infusion of neuromuscular blockade which, along with his profound shock, contributed to profound weakness. This complication, also called critical illness polyneuropathy, is one that I suspect we’re going to see a lot of this summer, as the patients who are sick in April are discharged from an ICU in May and June. I’d love to hear others’ reflections on this and if you have any tips for preparation."
Our Chief Medical Officer, Dr. Josh Landy, is sharing his experiences in the ICU: "I’ve been struck lately at how all my routines have been upset. Everything’s been more difficult because all of my trusty routines for work and play have to be re-written. That chaos alone is hard to manage, and then there’s the part of my job where I help look after a patient who dies.
Last night I looked after a patient who died from septic shock. He was in his 50's and had multiple comorbidities, but it was startling to see someone that young be so ill. Yes, he did have COVID-19, but that part faded into the background pretty quickly when I noticed something that made me feel reassured. No one at work (doctors or nurses) are talking about who’s got the virus and who doesn’t. We mostly talk about who’s sick and who’s not. Our patient wasn’t treated differently because he was struck with the pandemic strain..." Read his full experience
UPDATED APRIL 6, 2020
“My first shift back in the ICU since the pandemic began”
Our Chief Medical Officer, Dr. Josh Landy, is sharing his experiences in the ICU: “The whole atrium is now a screening centre. When you arrive, they ask you a few questions, watch you wash your hands, and give you 2 masks in a paper bag to wear for the day. When I arrived in the ICU office, I was greeted by the daytime doctor, who had shaved his beard and suggested I wear a face shield and a head cover all the time. I rounded on the ICU patients. Only a few intubated patients have COVID pneumonia, and as usual, there were lots of other people with non-COVID disease. The COVID-19 patients are harder than a typical patient with pneumonia or even ARDS (severe lung inflammation), and it shows. They don’t respond to the same types of ventilator adjustments as other patients, so the usual strategies don’t work." Read his full experience
UPDATED APRIL 3, 2020
How to make a no-sew mask
Thanks to Steven Hutchins (@drnhutch), a compounding pharmacy technician, for sharing this video on how to make a no-sew mask with easily found items in your home.
“Do not underestimate the impact of coronavirus”: A message from Spain
Hi everyone, My name is Federico del Castillo. I am a general surgeon from one of the most important hospitals in Madrid and in Spain. I have a message to all the healthcare workers and to all that may be reading this: Do not underestimate the impact of the coronavirus on your health, your patients, your family, and your health system. People are dying in hundreds and hundreds per day in a city like Madrid, where we have one of the best health systems in the entire world. We, healthcare workers, are dying with them. Keep safe, keep your families and communities safe, and be ready for the impact of this pandemic in your lives.
Thanks to Federico del Castillo-Díez for sharing his personal experience. Want to share your own perspective?
Liz, a registered nurse working in a burn unit in Maryland, U.S., describes how the COVID-19 pandemic is affecting her and her patients. Watch the video
UPDATED MARCH 24, 2020
COVID-19: A conversation with colleagues in Italy
Listen to the experiences of two physicians working in Italy during the pandemic. Marco Ripa, a researcher and infectious disease physician and Giacomo Monti, a consultant in anesthesia and intensive care, share their perspectives with Mike Rose of Clinical Problem Solvers.