Doctors: UK Is Better Prepared For A Second Wave of Coronavirus
Why doctors say UK is better prepared for a second wave of coronavirus
From The Guardian
When a deluge of coronavirus cases threatened to overwhelm the NHS in March, Covid-19 was a brand new and little-understood disease, causing panic as well as deaths. Hospitals under huge pressure did all they could.
Next time round, if, as everyone supposes, there is a next time, it will be different. In a second wave, or even localised spikes across the nation, the health service will know more about what it is dealing with – and will be better able to help people recover and send them home, say doctors.
First, two drugs have been shown to work to some extent, even though neither is a cure. Most exciting is the revelation that a 60-year-old steroid, dexamethasone, reduces deaths among those who are most sick – saving one in eight lives among those on ventilators and one in 25 of those on other oxygen support. Remdesivir is also useful, reducing the length of the illness.
Mervyn Singer, a professor of intensive care medicine at University College London, is delighted with the dexamethasone result. Covid-19 causes inflammation in the lungs and steroids are already used to reduce inflammation, but he said “medicine is conservative with a small ‘c’”, and some clinicians worried that they suppress the immune system, “so they have generally been used later rather than earlier”. However, the Recovery trial, a global trial into possible treatments, showed how well low-dose dexamethasone works in Covid-19 and it will now become standard of care.
One of the big and alarming surprises has been the damage Covid-19 does to the heart and circulatory system. “There is a really increased risk of clotting, probably due to damage to the blood vessels,” said Prof Sir Nilesh Samani, the medical director of the British Heart Foundation.
“The virus attacks the lining of the blood vessels and makes them more likely to clot.”
People who have had heart attacks or strokes are more vulnerable to the virus, which can also cause them in sick patients. “The heart attacks are peculiar,” said Samani. “It is the smaller arteries downstream that are affected, where the inflammation is more acute.”
One small study looking at the lungs of people who died, published in the New England Journal of Medicine, found they had nine times as many blood clots as people who died from swine flu (H1N1).
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