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SciCheck Digest
Ventilators can be lifesaving for critically ill COVID-19 patients. A social media claim that a new study shows ventilators killed nearly all COVID-19 patients is quite wrong, according to the studys co-author. Ventilator-associated complications can contribute to deaths, but patients are typically put on ventilators when they would otherwise die.
COVID-19 cancauselung damage and respiratory failure. In patients who are unable to breathe well enough to supply oxygen to their bodies, mechanical ventilatorscan be lifesavingand give them time to recover. Ventilators help people breathe by pushing air into their lungs via a tube inserted down their windpipe.
Yet, social mediapostshave sharedanarticlefrom the Peoples Voice with a false headline: Official Report: Ventilators Killed Nearly ALL COVID Patients. The Peoples Voice, formerly News Punch, frequentlypublishesarticleswith false and inflammatoryheadlines.
The posts misrepresent the conclusions of astudypublished in April in the Journal of Clinical Investigation. The idea that ventilators and not COVID-19 killed nearly all COVID-19 patients is quite wrong, study co-authorDr. Benjamin Singer, a pulmonary and critical care physician at Northwestern Medicine, told us.
Rep. Thomas Massie, a Republican from Kentucky, also misrepresented the conclusions of the study,tweeting, How many COVID patients died due to the use of ventilators? A recent examination of the data suggests quite a few.
The idea that ventilators are dangerous, and not COVID-19, is a misinterpretation of his data, Singer said. Its not the ventilator that was the cause of death, he said. The ventilator was very much life support for these patients. It was ultimately COVID-19 that caused the deaths.
Singers study looked at 585 people put on ventilators due to respiratory failure between 2018 and 2022 at Northwestern Memorial Hospital. These people primarily had COVID-19 or some other infectious disease, such as another viral or bacterial illness.
Around half of these very sick patients who required mechanical ventilation people who likely would have died without the intervention went on to survive their illness. The survival rate was similar whether they had COVID-19 or another disease and was consistent with the survival rate for COVID-19 patients on ventilators found in another, larger study.
Singers study explored the degree to which a known ventilator-related complication called ventilator-associated pneumonia contributes to death, finding that the complication is more common in people with COVID-19 and, when unresolved, is linked to death. VAP is usually treated with antibiotics.
People with COVID-19 likely have an elevated risk of VAP because they stay on ventilators for longer-than-average periods. COVID-19 also affects the immune system and damages the surface of the lungs in unique ways, Singer said, which could potentially make the lungs more susceptible to secondary infections.
VAP contributes to death in some COVID-19 and other infectious disease patients, explainedDr. Mark Metersky, a pulmonary and critical care physician and professor at the University of Connecticut School of Medicine who was not involved in the study.
However, virtually all of these patients would have died if they had not been put on a ventilator, he said. Its not that the ventilator killed them, the ones who died. Its that the ventilator failed to save them.
A related claim in a popularpost that medical professionals put patients on ventilators due to financial incentives is also unsupported by evidence, asweand otherfact-checkerspreviously explained. Its standard for hospitals to get more money for patients, such as those on ventilators, who require more care.
VAP typically occurs as a form of secondary pneumonia, which means it shows up in patients who already have another pneumonia diagnosis, such as pneumonia resulting from COVID-19, the flu or a bacterial infection.
People are diagnosed with pneumonia when their lungs become swollen with fluid from a respiratory infection. VAP typically arises frombacteriaintroduced to the lungs via the patients breathing tube.
Singers newpaper finds that once very sick COVID-19 patients are on ventilators, they are at greater risk of VAP compared with other similarly ill pneumonia patients, he said.
Further, the paper found that whether that ventilator-associated pneumonia was cured or not was a major determinant of whether patients went on to live or die in the ICU, he said. However, just being diagnosed with VAP was not associated with a higher risk of death.
Based on these conclusions, the Peoples Voice article makes a false claim, which was shared widely: Nearly all COVID-19 patients who died in hospital during the early phase of the pandemic were killed as a direct result of being put on a ventilator, a disturbing new report has concluded.
First, many hospitalized COVID-19 patients have died who never went on ventilators. And Singers study was not limited to the early phase of the pandemic but rather went through March 2022.
As weve said, this line of thinking is also misleading because it does not make it clear that the patients on ventilators would have typically died without them. It is also untrue that Singers study showed that ventilator-related complications killed nearly all ventilated patients who died.
The Peoples Voice article explains its reasoning by saying that most patients put on ventilators because of COVID-19 developed VAP. So while COVID-19 may have put these patients in the hospital, it was actually a secondary infection brought on by the use of a mechanical ventilator that caused their deaths, the article says.
In reality, 57% of COVID-19 patients on ventilators in the study developed VAP and a quarter of other ventilated pneumonia patients did. Around half of all patients with VAP died, which was not significantly different from the death rate in patients on ventilators who didnt have VAP, according to the study.
Singer and his colleagues did find that patients whose VAP was not successfully treated were more likely to die than patients whose VAP resolved, indicating a connection between VAP and poor outcomes. The study was not randomized, and the researchers write that they cannot definitively determine that unresolved VAP and not some other factor associated with it leads to poor outcomes.
Metersky was skeptical that VAP is that much of a contributor to mortality,pointing to other studies that show a lower rate of VAP in pneumonia patients than was found in Singers study.
Yes, some patients who are put on a ventilator will develop a fatal complication, Metersky said. Probably 1 in 100 patients put on a ventilator develop fatal VAP, he said, based on data from before the pandemic. Since about twice as many COVID-19 patients develop VAP compared with other pneumonia patients on ventilators, he said that would indicate that around 2% of people with COVID-19 who go on a ventilator die of VAP.
But there are other complications, Metersky said. These can include damage to the lungs from high oxygen and the air pressure from the ventilator or side effects from drugs used to sedate people on ventilators, for instance. Thats why we dont put a patient on a ventilator unless they absolutely need it, he said.
Regardless, its ridiculous to go from that study to say that the ventilators are killing all these people, Metersky said, referring to the claim that nearly all COVID-19 deaths were caused by ventilators.
Other false claims, reviewed previously by others, state that overuse of ventilators played a major role in the first wave of COVID-19 deaths.
There were some suggestions very early in the pandemic that doctors should put COVID-19 patients on ventilators earlier than other pneumonia patients, Singer and Metersky both said, out of concern that respiratory failure might progress very quickly.
This was soon followed bycallsfor caution in ventilating patients early, and these practices quickly stopped, Singer said. The standard indications for initiation of mechanical ventilation are really the same as they always have been for patients with pneumonia, he said, regardless of whether they have COVID-19.
Multiple facts about the early ventilation recommendations are unclear. First, there was no standard definition of what experts meant when recommending early ventilation. Decisions on when patients require mechanical ventilation are based on the best judgment of their doctors as they monitor multiple indicators. Doctors want to be sure the ventilator is truly necessary that the patient is headed toward death from respiratory failure without it. But they also dont want to wait until the patient has organ damage from lack of oxygen.
Second, its unclear how widespread early ventilation was. Singer mentioned that his own recent paper showed that Northwestern Medicine put patients with COVID-19 on ventilators after a similar amount of time in the ICU as other pneumonia patients. Others have pointed out that some doctors at the beginning of the pandemic took measures to avoid putting patients on ventilators due to shortages.
Finally, its uncertain what impact early ventilation had on patients. The available research, recently reviewed in ablog postby epidemiologist Gideon Meyerowitz-Katz, a Ph.D. candidate at the University of Wollongong in Australia, indicates that early versus later ventilation did not appreciably affect COVID-19 deaths. For instance, a review study that pooled and analyzed data from multiple studies found that going on a ventilator within a day of entering the ICU versus later had no impact on mortality.
It is possible that people occasionally were put on ventilators who could have avoided them, but this is difficult to quantify.
There were probably a small number of patients who got put on a ventilator who ultimately might not have needed it, Metersky said. As we learned more about the disease, we learned to recognize that some patients may not need the ventilator. But it wasnt this big conspiracy that we put everyone on the ventilator even though they could have gone home instead.
Editors note: SciChecks articles providing accurate health information and correcting health misinformation are made possible by a grant from the Robert Wood Johnson Foundation. The foundation has no control over FactCheck.orgs editorial decisions, and the views expressed in our articles do not necessarily reflect the views of the foundation.
Pulmonary Manifestations. COVID-19 Real-Time Learning Network. Updated 22 Feb 2022.
Tobin, Martin and Manthous, Constantine. Mechanical Ventilation. American Journal of Respiratory and Critical Care Medicine. Published 15 Jul 2017. Updated April 2020.
Adl-Tabatabai, Sean. Official Report: Ventilators Killed Nearly ALL COVID Patients. The Peoples Voice. 13 May 2023.
Jones, Brea. Posts Fabricate Charge Against Bill Gates in Philippines. FactCheck.org. 10 Mar 2023.
Spencer, Saranac Hale. Hate Crimes Hotline Headline Is Wrong. FactCheck.org. 30 Nov 2018.
Yandell, Kate. Posts Share Fake Chelsea Clinton Quote About Global Childhood Vaccination Effort. FactCheck.org. 10 May 2023.
Gao, Catherine A. et al. Machine Learning Links Unresolving Secondary Pneumonia to Mortality in Patients with Severe Pneumonia, Including COVID-19. The Journal of Clinical Investigation. 27 Apr 2023.
Massie, Thomas (@RepThomasMassie). How many COVID patients died due to the use of ventilators? A recent examination of the data suggests quite a few. The investigators found nearly half of patients with COVID-19 develop a secondary ventilator-associated bacterial pneumonia. Twitter. 15 May 2023.
Nolan, Margaret B. et al. Mortality Rates by Age Group and Intubation Status in Hospitalized Adult Patients From 21 United States Hospital Systems During Three Surges of the COVID-19 Pandemic. Chest. 29 Jan 2023.
Frequently Asked Questions about Ventilator-Associated Pneumonia. CDC website. Updated 9 May 2019.
Adele Conspiracy Queen(@truth.bomb.mom). Such a bummer that this happened. Instagram. 21 May 2023.
Fichera, Angelo. Hospital Payments and the COVID-19 Death Count. FactCheck.org. 21 Apr 2020.
Kertscher, Tom. Fact-Check: Hospitals and COVID-19 Payments. PolitiFact. 21 Apr 2020.
Pneumonia Causes and Risk Factors. NIH website. Updated 24 March 2022.
Pneumonia What Is Pneumonia? NIH website. Updated 24 Mar 2022.
Kohbodi, GoleNaz A. et al. Ventilator-Associated Pneumonia. Updated 10 Sep 2022.
Metersky, Mark L. et al. Trend in Ventilator-Associated Pneumonia Rates Between 2005 and 2013. JAMA. 13 Dec 2016.
Melsen, Wilhelmina G., et al. Attributable Mortality of Ventilator-Associated Pneumonia: A Meta-Analysis of Individual Patient Data from Randomised Prevention Studies. Lancet Infectious Diseases. 25 Apr 2013.
Metersky, Mark L. et al. Temporal Trends in Postoperative and Ventilator-Associated Pneumonia in the United States. Infection Control and Hospital Epidemiology. 3 Nov 2022.
Meyerowitz-Katz, Gideon. Did Ventilators Kill People During COVID-19? Medium. 25 May 2023.
Howard, Jonathan. Intubations and Accusations: Doctors Were Just Going Crazy, and Intubating People Who Did Not Have to Be Intubated.' Science-Based Medicine. 19 Sep 2021.
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Marino, Ryan (@RyanMarino). And -anecdotally- I was treating COVID patients in 2020. It was bleak and terrifying. They were incredibly sick and we actually did not have enough ventilators as we needed for this disease. I still remember the panicky feeling of using every possible attempt to avoid intubation. Twitter. 15 May 2023.
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Ventilators Save Lives, Did Not Cause Nearly All COVID-19 Deaths
JAMA Network Open published a study yesterday on the safety of donors with COVID-19 donating a kidney, showing that the use of kidneys from donors with either active or resolved COVID-19 infections yields excellent outcomes.
Now that the COVID-19 pandemic has entered a phase wherein many Americans have experienced infections, questions about the medium-term prognosis of organ donation remain to be answered.
The study was based on national US transplant registry data from 35,851 deceased donors (71,334 kidneys) and 45,912 adult patients who received kidney transplants from March 1, 2020, to March 30, 2023.
At the beginning of the pandemic, COVID-19positive organs from deceased donors were not recommended for use, and overall, the number of organs transplanted in the United States fell, alongside a 15% reduction in global transplant rates. From August 8, 2020, to September 29, 2021, only 150 SARS-CoV-2positive deceased donors were assessed for organ donation, the authors said.
All kidneys in the study were subjected to nucleic acid amplification tests (NAT) to determine if the organ donor had an active infection (within 7 days of kidney procurement) or a resolved infection (at least 1 week prior). The primary outcomes studied were kidney nonuse, all-cause kidney graft failure, and all-cause recipient death. Secondary outcomes included acute rejection (within 6 months of the transplant), transplant hospitalization length of stay, and delayed graft function.
The deceased donors had an average age of 42.5, 62.3% were men, and 66.9% were white. Recipients had an average age of 54.3, 60.9% were men, and 33.4% were Black.
Though kidneys from deceased donors with an active or resolved infection were less likely to be used than those without COVID-19, that trend decreased overtime, and by 2023, kidneys from donors with active infections or resolved infections were being used.
From 2020 to 2022, kidneys from active COVID-19positive donors (2020: adjusted odds ratio [AOR], 11.26; 95% confidence interval [CI], 2.29 to 55.38; 2021: AOR, 2.09 [95% CI, 1.58 to 2.79]; 2022: AOR, 1.47 [95% CI, 1.28 to 1.70]) had a higher likelihood of nonuse compared with kidneys from donors without COVID-19. That means kidneys from active COVID-19positive donors had 56% higher odds of nonuse, and donors with resolved COVID-19 had 31% higher odds of nonuse.
According to the authors, patients receiving kidneys from active COVID-19positive donors had no greater risk for graft failure (adjusted hazard ratio [AHR], 1.03; 95% CI, 0.78 to 1.37), patient death (AHR, 1.17; 95% CI, 0.84 to 1.66). And results were similar with resolved COVID-19positive donors (graft failure: AHR, 1.10; 95% CI, 0.88 to 1.39; patient death: AHR, 0.95; 95% CI, 0.70 to 1.28).
Receiving a kidney from a COVID-19positive donor was not associated with any longer hospital stay nor with a higher risk of acute rejection.
Our findings support the use of these valuable organs.
In January of 2023, the American Society of Transplantation updated guidance stating that donors who are SARS-CoV-2positive on NAT and who died of COVD-19attributable complications should be considered for non-lung transplant acceptance.
"Our findings support the use of these valuable organs and may encourage organ procurement organizations to consider recovering more kidneys from COVID-19positive donors and promote further acceptance among transplant professionals," the authors concluded.
"Given that more than 40% of individuals in the US had evidence of a past COVID-19 diagnosis as of May 2022, excluding potential kidney donors based on past or current COVID-19 diagnosis would substantially limit opportunities for organ use and [kidney transplant], which is not a benign consequence."
Originally posted here:
Kidney transplants from COVID-19-positive donors appear safe
Much is left to learn about the coronavirus that is changing life as we know it, but our journey has already yielded many lessons. In late December 2019, reports emerged of a novel coronavirus outbreak connected with pneumonia cases at a wildlife market in Wuhan, China. COVID-19 spread across the nation within weeksand then stormed its way across the world. By March 11, the World Health Organization labeled COVID-19 a pandemic.
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What is COVID-19 and how can I protect myself? Answer From Daniel C. DeSimone, M.D.
A new virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the cause of a disease outbreak that began in China in 2019. The disease is called coronavirus disease 2019 (COVID-19).
In March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. Public health groups, including the U.S. Centers for Disease Control and Prevention (CDC) and WHO, are monitoring the pandemic and posting updates on their websites. These groups have also issued recommendations for preventing the spread of the virus that causes COVID-19.
Data has shown that the COVID-19 virus mainly spreads from person to person among those in close contact. The virus spreads by respiratory droplets released when someone infected with the virus coughs, sneezes, breathes, sings or talks. These droplets can be inhaled or land in the mouth, nose or eyes of a person nearby.
Sometimes the COVID-19 virus can spread when a person is exposed to small droplets or aerosols that stay in the air for several minutes or hours called airborne transmission.
The virus can also spread if you touch a surface with the virus on it and then touch your mouth, nose or eyes. But the risk is low.
The COVID-19 virus can spread from someone who is infected but has no symptoms. This is called asymptomatic transmission. The COVID-19 virus can also spread from someone who is infected but hasn't developed symptoms yet. This is called presymptomatic transmission.
It's possible to get COVID-19 twice or more.
COVID-19 symptoms can be very mild to severe. Some people have no symptoms. The most common signs and symptoms are fever, cough, tiredness, and loss of taste or smell.
Other signs and symptoms may include shortness of breath, muscle aches, chills, sore throat, headache, chest pain, diarrhea, vomiting and nausea. This list is not complete. Other less common symptoms have also been reported. Symptoms may appear 2 to 14 days after exposure.
A vaccine might prevent you from getting COVID-19 or prevent you from becoming seriously ill from COVID-19 if you get the COVID-19 virus.
The U.S. Food and Drug Administration (FDA) has approved the Pfizer-BioNTech COVID-19 vaccine, now called Comirnaty, to prevent COVID-19 in people age 12 and older. The FDA has given emergency use authorization to the Pfizer-BioNTech COVID-19 vaccine for children age 6 months to 11 years old.
The FDA has approved the Moderna vaccine, now called Spikevax, to prevent COVID-19 in people age 18 and older. And the FDA has given emergency use authorization to the Moderna COVID-19 vaccine for age 6 months to age 17. The FDA has also authorized the Novavax COVID-19, adjuvanted vaccine for people age 12 and older.
An additional primary shot of a COVID-19 vaccine is recommended for people who are vaccinated and might not have had a strong enough immune response.
In contrast, a booster dose is recommended for people who are vaccinated and whose immune response weakened over time. Research suggests that getting a booster dose can decrease your risk of infection and severe illness with COVID-19.
There are many steps you can take to reduce your risk of infection from the COVID-19 virus and reduce the risk of spreading it to others. WHO and CDC recommend following these precautions:
If you have a chronic medical condition, you may have a higher risk of serious illness. Check with your health care provider about other ways to protect yourself.
If you're in an area with a high number of people with COVID-19 in the hospital and new COVID-19 cases, the CDC recommends wearing a well-fitted mask indoors in public.
Using masks in public may help reduce the spread from people who don't have symptoms. The CDC says that you should wear the most protective mask possible that you'll wear regularly, fits well and is comfortable. Respirators such as nonsurgical N95s give the most protection. KN95s and medical masks provide the next highest level of protection. Cloth masks provide less protection. The CDC says that surgical N95 masks should be reserved for health care providers.
You're considered fully vaccinated two weeks after you get a second dose of an mRNA COVID-19 vaccine, or Novavax COVID-19 vaccine. You are considered fully vaccinated two weeks after you get a single dose of the Janssen/Johnson & Johnson COVID-19 vaccine. You are considered up to date with your vaccines if you have gotten all recommended COVID-19 vaccines, including booster doses, when you become eligible.
The CDC recommends that you wear a mask while on planes, buses, trains and other forms of public transportation.
If you're planning to travel, check for travel advisories and use appropriate precautions when in public. You may want to talk with your health care provider if you have health conditions that make you more susceptible to respiratory infections and complications.
If you develop symptoms or you've been exposed to the virus that causes COVID-19, contact your health care provider for medical advice. Your health care provider will likely recommend that you get tested for COVID-19. If you have emergency COVID-19 symptoms, such as trouble breathing, seek care immediately. If you need to go to a hospital, call ahead so that health care providers can take steps to ensure that others aren't exposed.
Take the following precautions to avoid spreading the virus that causes COVID-19:
With
Daniel C. DeSimone, M.D.
.
Read more from the original source:
Coronavirus: What is it and how can I protect myself? - Mayo Clinic
The facilities listed below are not operated by Harris County Public Health (HCPH) or Houston Health Department (HHD) - and may not be a comprehensive list of COVID-19 vaccine providers in the county. Contact providers in advance to confirm vaccination location and hours, that they have COVID-19 vaccines on hand, and that you are eligible for vaccination at that site. Not all providers are vaccinating the public or people in all priority groups. Vaccine is available atno charge, regardless of insurance states.
See the original post:
Local COVID-19 Vaccine Providers | Harris County Public Health
The DSHS Immunization Unit aims to eliminate the spread of vaccine-preventable diseases by increasing vaccine coverage for Texans, raising awareness of the diseases that vaccines prevent and educating the public about vaccine safety. We do this through the administration of the Texas Immunization Registry (ImmTrac2), which provides access to immunization records, the establishment of school immunization rules, and the administration of the Texas Vaccines for Children and Adult Safety Net programs, which provide low-cost vaccines to eligible children and adults.
To request COVID-19 vaccine administration data, please visit the Immunization Unit Data Request Form page.
Learn about immunization requirements for all students and childcare facilities in Texas.
SCHOOL REQUIREMENTS
Need immunization records for a child or adult? Learn how to obtain them from ImmTrac2, the state registry.
REGISTRY INFO
Being fully immunized against vaccine-preventable diseases is part of being mission-ready. Are you and your team up to date?
FIRST RESPONDERS
Learn about which vaccines are recommended for children and adults and download schedules for reference offline.
IMMUNIZATION SCHEDULES
Texas Vaccines for Children provides vaccines to children who might not otherwise be vaccinated because of their inability to pay.
LOW-COST VACCINES
VIS are informational documents produced by the CDC that explain both the benefits and risks of vaccine-to-vaccine recipients.
VIS DOWNLOADS
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NextCare and its family of brands has announced it will begin using the new Abbott ID-NOW technology to test for COVID-19. This new test is groundbreaking in both its design and efficiency and allows patients to receive their results in under 15 minutes. If a patient is positive for COVID-19, a result will be known in as little as 5 minutes and if a patient is negative for COVID-19, a result will be known in as little as 13 minutes. The efficiency of ID-NOW COVID-19 is helpful in not only allowing the patient to know their specific result, but the speed of the test allows healthcare professionals to make appropriate and more efficient treatment and infection control decisions.
Due to limited supplies, at this time we are reserving these tests for patients who have met provider-determined criteria.
Patients who MAY be eligible for a Rapid COVID-19 Test:
*Non-rapid patients would be eligible for a specimen collection send-out COVID-19 Test.
The above criteria is a generalization of patients who should expect to receive rapid COVID-19 testing and patients who should expect to receive specimen collection send-out COVID-19 testing at locations that offer both options. The final determination will be made at the time of visit by the provider treating the patient.
The locations below with the RAPID COVID-19 TESTING icon (pictured below) have the ability to offer rapid test results.
Follow this link:
Rapid COVID-19 Testing, Curbside & Alt Entrance Options - Nextcare
China abandoned 'zero covid.' But some don't want to leave it behind. The Washington Post
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China abandoned 'zero covid.' But some don't want to leave it behind. - The Washington Post
The Covid deaths that did not get counted The Guardian
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