Improved methods and medications help doctors battle COVID-19 surge

Posted at 5:08 PM, Dec 09, 2020
and last updated 2020-12-09 22:03:37-05

SAN DIEGO (KGTV) — With hospital beds running short, healthcare workers are trying to care for COVID-19 patients as efficiently as possible, using everything they’ve learned over the last nine months.

Improvements in medications and methods have helped shorten hospital stays, said Sharp Memorial Hospital chief medical officer Dr. Tom Lawrie.

In March, Sharp said COVID-19 patients stayed 12 days in the hospital on average. In November, the average dropped to 5.3 days. Other institutions have reported similar drops in the length of patient stays.

COVID-19 patients now receive a three drug regimen: Remdesivir to fight the virus, a powerful steroid called dexamethasone to prevent the immune system from going haywire, and medications like heparin to reduce blood clotting.

On top of that, hospitals have improved techniques like when to use ventilators.

“Initially, we were in this conundrum where we weren't sure whether we should intubate patients early or whether we should wait a little later,” Dr. Lawrie said. “Over the last several months we've figured out a really good progression.”

The progression now starts with a surprisingly simple technique called proning. Doctors around the country discovered that turning COVID-19 patients onto their stomachs rapidly improved breathing.

Early research suggests proning may keep COVID patients off ventilators.

“By putting people on their stomach in these positions and by proning them, you allow blood to get where the air is and therefore you get better oxygenation,” Dr. Lawrie said. “It makes the oxygen levels better. It makes their work of breathing better. It makes them feel better generally.”

Proning helps move blood from one area of the lung to another where it can receive more oxygen. These regions are called West’s zones of the lung, named after research in the 1960’s by UC San Diego Professor Emeritus John B. West.

Proning has been used as a medical intervention since 1976, when a doctor and a nurse in central Michigan published a study showing it could benefit patients in respiratory distress.

Dr. Lawrie said there are also two outside factors contributing to shorter hospital stays across the country. The patients that are showing up now tend to be younger than early in the pandemic. Younger patients are more likely to respond well to treatment.

There’s also evidence the virus has mutated over time, possibly making it more contagious but slightly less severe, Dr. Lawrie said.

However, patients lately have been showing up faster than hospitals can care for them, threatening to overwhelm already crowded facilities. "If that happens, they won't have access to an ICU bed or to the medications that they need," he said.