Dr. Sean Hollingworth, anesthesiologist st Medicine Hat Regional Hospital and interim associate medical director for the AHS South zone.--SUBMITTED PHOTO
There is still no specific medication to treat COVID-19 but at Medicine Hat Regional Hospital a range of treatments are used and the province has a team looking at research from around the world.
Dr. Sean Hollingworth, MHRH anesthesiologist and interim associate South zone medical director, says oxygen is still used consistently, and also a steroid – dexamethasone – that prevents the release of substances in the body that cause inflammation. Antibiotics are given to address possible bacterial pneumonia.
There is nothing yet that has been shown to work specifically for COVID. Studies take a long time to do and need a large number of participants to get anything of statistical relevance, said Hollingworth. Early studies were observational with physicians reporting back on the results they’d observed from treating a few patients.
Hollingworth says Alberta Health has an advisory group that is constantly studying information.
“They search the world for credible resources to try and see what’s working, what’s not working, what’s the evidence behind it … It’s been very challenging to come up with treatments that are working consistently.”
At MHRH they are waiting longer now before intubating – inserting a tube through the mouth and into the airway so the patient can be placed on a ventilator. Some on ventilators are now also turned on to their stomachs to relieve the pressure on their chest
“To turn them onto their stomach is risky; of course, the tube can come out,” he said.
It takes the co-ordinated efforts of a team. The more it’s being done the more efficient it is and almost routine.
Not only is oxygen being administered in hospital, some patients are able to go home with a supply of oxygen, said Hollingworth. Physiotherapy is also being used to help them take deep breaths and to get moving and avoid secondary bacterial pneumonia.
There is also a process to determine which patients would benefit from monoclonal antibodies. This is what former U.S. president Donald Trump was given when he was admitted to hospital with COVID.
There have been discussions about when to give some patients anticoagulants to prevent the micro blood clots.
Discussion is also taking place about whether to treat someone who is positive for COVID but asymptomatic, and how bad symptoms need to be before treatment.
“If I was at home I would be taking … vitamin D and zinc to boost your immune system. I don’t think these can harm you. Try to keep moving and try to get deep breaths in,” said Hollingworth, noting that the best course of action is to limit interaction with others and avoid getting sick to start with. He also encourages people to wear masks correctly and wash their hands.
