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Interview: US lung-disease expert on coronavirus symptoms, treatment, prevention

Mayo Clinic (lenarc/WikiCommons)

This article was originally published by Radio Free Europe/Radio Liberty and is reprinted with permission.

Ognjen Gajic, a lung expert and critical care specialist at the prestigious Mayo Clinic in the northern U.S. state of Minnesota, was interviewed by Ajla Obradovic, a correspondent with RFE/RL’s Balkan Service, about the coronavirus and the disease’s symptoms and treatment.

RFE/RL: How fast does a person’s health worsen after becoming infected? It seems that patients diagnosed with the coronavirus die rather quickly but recover more slowly compared to other diseases? Or is that an incorrect impression?

Ognjen Gajic: Critical illness [in people with the coronavirus] occurs on average after seven days of mild symptoms. From the moment one starts experiencing shortness of breath, [a patient’s condition can worsen] rapidly, sometimes within a few hours, and then intensive monitoring in a hospital intensive care unit is critical.

RFE/RL: How are COVID-19 patients treated? Is there a standard procedure?

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Gajic: Most patients have mild symptoms and there is no specific treatment thus far other than controlling the symptoms — paracetamol (aka acetaminophen) for fever, weakness, and the like. Untested forms of treatment can be dangerous due to side effects and should not be used until research shows they are efficient.

I deal with the treatment of the critically ill, so I can say more about [those patients]. In many of them, the [COVID-19] disease progresses to severe bilateral pneumonia characterized by shortness of breath and hypoxia (that means oxygen deprivation in body tissue).

These patients should be immediately taken to the hospital for oxygen treatment and their condition should be constantly monitored so it is possible to respond in time [to these problems] with intense respiratory support, including respirators. Sophisticated intensive care with control and support of all organs is successful in about 50 percent of the most severely ill cases, although some patients may be on a respirator for several weeks before recovering or dying.

So far there is no proven specific treatment [for COVID-19] and untested experimental drugs should not be prescribed without the proper research [being conducted]. We are working with colleagues around the world on a day-to-day basis on research projects for new treatments and prevention.

RFE/RL: Is there any data so far on the underlying diseases that are, in some way, more pernicious in combination with the coronavirus?

Gajic: Rather than specific diseases, more important is [someone’s] physiological condition as far as their lungs and [general fitness]; elderly patients who are not fit and those with severe forms of chronic lung or heart disease have little reserve and little chance of successfully enduring intensive respiratory treatment.

RFE/RL: How much more infectious is the coronavirus than other communicable diseases and what is the best way for people to protect themselves? In the Czech Republic, for example, they require everyone to wear masks in public, while the World Health Organization has not cited this as essential for people who are not infected. Can you give some specific tips on protection?

Gajic: Masks should be left to health-care professionals. A thorough hand washing with soap and water is by far the most important tip and, at this point, isolation from all but essential contacts — especially groups — must be respected. Also, before coming to a health-care facility, first make contact by phone, since it is safer to stay home for home treatment if one is showing mild symptoms.

RFE/RL: I understand you worked with your colleagues from Wuhan. What is it that other countries can learn from them and apply in their response to the pandemic?

Gajic: Several colleagues from Wuhan hospitals have been at the Mayo Clinic in recent years and we have been doing joint research. At the beginning of the epidemic in Wuhan, we sent support in terms of treatment guidelines and [medical] staff protection. Now they are helping us. After some initial setbacks, our colleagues in Wuhan, with rigorous isolation measures, adequate equipment, and training, were able to prevent their health-care professionals from becoming sick despite working with critically ill patients.

RFE/RL: The latest information shows that the United States now has the largest number of infected people. Did the U.S. response to the epidemic come too late?

Gajic: I’m not an epidemiologist so I can’t comment on that. When it comes to the critically ill, U.S. hospitals provide fantastic care in these difficult conditions.