Patients discharged after COVID are so sick they return to hospital
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On Monday morning, Des Moines writer Andie Dominick met again with Dr Tom Benzoni, a local emergency physician, to talk about the coronavirus pandemic. He has been interviewed for the Register several times since the coronavirus pandemic hit Iowa.
Here are the previous installments for 2020 on March 31, April 28, May 12, May 26, June 8, June 21, July 1, July 18, August 10, August 24, September 11, October 30, November 16, December 16 and 2021 January 7, January 26, February 22, March 22, April 15, May 11, June 1, June 23, July 24, August 15, Sept. 13, Oct. 22 and Dec. 4.
Here are edited excerpts from the conversation on December 27:
You have worked two shifts at two different hospitals in the past 21 hours. Tell me about some COVID patients.
An unvaccinated middle-aged man was recently released from the hospital and returned because he could not breathe. He was weak, needed oxygen, and had pain in his legs.
In the emergency room, her legs suddenly turned white and cold. This is what you see in people with atrial fibrillation who have clots in their arteries. As it turned out, this guy had a clot in the aorta and was throwing clots in his legs.
That means blood thinners and surgery, and I don’t know his prognosis.
Put a thumbtack in there, because I think we’re going to have a bunch of people who have survived this virus in their 30s to 50s and have lifelong pulmonary vascular disease. Some may be on oxygen for the rest of their lives. Some may need a lung transplant, and you don’t get a lung transplant unless someone else dies.
Just across the hall was a young man with little oxygen. His skin was gray and he had chest pain so we had to check if he had blood clots. There was a 70-plus-year-old vaccine denier with lungs full of COVID.
All three unvaccinated?
All three were not vaccinated, had been hospitalized in the past and were so ill they had to be readmitted.
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I hadn’t thought about the numbers of COVID hospitalizations reflecting repeat patients. Explain again why infected people develop blood clots.
In the wall of all blood vessels there are receptors. COVID’s famous spike protein slips in like a key in a lock. The virus can bind to anywhere you have blood vessels – that is, anywhere except your hair and fingernails.
So we shouldn’t be surprised that people infected with COVID have everything from altered mental status to swelling to blood clots.
Do you admit people who have been vaccinated?
I have admitted a few elderly people who are vaccinated, but they are admitted for everything. Usually, people who are sick enough to need to stay in hospital are not vaccinated.
I’m finally realizing something about anti-vaccines and all their “sheep” stuff. They call the vaccinated people sheep, but they themselves are the sheep – the ones led by bad shepherds.
Do any of these patients say they regret not having been vaccinated?
The vast majority of them know what I call an involvement bias. Once you’ve mapped out a path, it’s much easier to continue that path than it is to examine it. If you ask “am I right? Then a possible answer is “no”. Who wants to live the life of a jerk?
I have spoken to a few people who report swollen lymph nodes after booster shots.
First, let’s be clear about correlation and causation. We connect things that are not connected in order to create consistency. The person with the swollen lymph nodes may have flipped a switch, but the switch did not cause the swelling.
Again, it makes perfect sense for the vaccine to cause the glands to swell, partly in the area where the vaccine has drained, such as your left armpit if you get the vaccine in your left arm. The vaccine travels through your lymphatic system and the factory that makes the antibodies is in the lymphatic tissue.
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Can you explain how the new antiviral pill from Pfizer works?
Simply put, it slows down the replication of the virus. It erases the production line.
But the Merck pill works in a different way. Suppose the assembly line manufactures and packages # 2 pencils. Merck throws in a giant pencil every now and then to mess up the process.
Any thoughts on the accuracy of COVID home testing?
In fact, they’re pretty good. You are more likely to get a false negative than a false positive. When you test positive, you are positive.
I have heard people say that COVID is now “endemic”. What’s your response to that?
Endemic occurs after the virus has been passed from generation to generation and virtually everyone has been exposed to it. It becomes predictable as what we call the “common cold”. No, COVID is not yet endemic.
What did you do for Christmas?
We see a lot of really sick patients in hospitals. I worked. But at least I was able to get home after my shift.
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This article originally appeared on Des Moines Register: Opinion: COVID-19 is changing, not yet endemic, says Iowa emergency doctor
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