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88.1% of NYC coronavirus patients put on ventilators died
If a patient requires a ventilator, a new study finds they have a low chance of survival.
The scarcity of ventilators for COVID-19 patients has been one of the frightening problems facing medical professionals during the pandemic. The possibility of having to choose who gets a ventilator and who doesn't has been one of the things keeping them, and us, up at night.
Even so, the scarce data on the device's success rate at resolving COVID-19 infections has been concerning. Now a preliminary study of 5,700 patients hospitalized with COVID-19 in the New York City area finds that 88.1% of patients who go on ventilators don't survive.
There are a few caveats that are important to keep in mind:
- This is preliminary data, and there are many COVID-19 patients currently on ventilators who may yet survive and eventually lower the study's mortality rate.
- It's impossible to know if the study's conclusion reflects the inherent limitations of ventilator treatment for COVID-19, or if it indicates that the medical facilities tracked were so overwhelmed that the quality of care was inescapably compromised.
- This study reflects the facilities of one health network in one area, and we'll know more as other domestic and international locations' statistics become available.
The study was published April 22, 2020 in JAMA.
The data collected for the study
Image source: Vadym Stock/Shutterstock
The study looked at outcomes at hospitals in Northwell Health, the largest academic health system in New York. The system serves roughly 11 million people in Long Island, Westchester, and New York City.
12 acute-care facilities supplied data on 5,700 patients, all of whom had been hospitalized with "confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by positive result on polymerase chain reaction testing of a nasopharyngeal sample."
The period covered in the study ran from March 1, 2020 through April 4, 2020 and includes all patients who had exited hospital care at that point, either by leaving the facilities or by dying there. As noted above, the study doesn't include patients remaining in hospital at the close of April 4.
The data collected includes:
- demographic information (race was self-reported)
- triage (initial diagnostic) vitals
- home medications
- initial and subsequent lab tests, electrocardiogram measurements
- in-patient medications
- treatments, including ventilation and kidney replacement
What the data showed
Image source: Angela Weiss /Getty
- The median age of admitted patients was 63.
- 60.3% of those admitted identified as male and 39.7% as female.
- The most common comorbidities were hypertension (56.6%), obesity (41.7%), and diabetes (33.8%).
- Of those admitted, 21% died.
- More patients in the 18-to-65 age group compared with the older-than-65 years age group were treated in the ICU or received ventilation.
- 14.2% of patents admitted were treated in intensive care.
- 12.2% received invasive mechanical ventilation.
- 81% received kidney replacement therapy.
- The overall mortality rate for patients on ventilators was 88.1%.
- In the 18-to-65 age group, the mortality rate was 76.4%.
- In the older-than-65 age group, the mortality rate was 97.2%.
- No ventilator patients younger than 18 died.
The sad and disturbing truth, from this study and others, is that being put on a ventilator as treatment for COVID-19 constitutes a last-ditch attempt at lifesaving, and not a promising one. We understand that medical care has its limitations, and COVID-19 serves as a heartbreaking reminder of that reality.
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Scientists used CT scanning and 3D-printing technology to re-create the voice of Nesyamun, an ancient Egyptian priest.
- Scientists printed a 3D replica of the vocal tract of Nesyamun, an Egyptian priest whose mummified corpse has been on display in the UK for two centuries.
- With the help of an electronic device, the reproduced voice is able to "speak" a vowel noise.
- The team behind the "Voices of the Past" project suggest reproducing ancient voices could make museum experiences more dynamic.
Howard et al.<p style="margin-left: 20px;">"While this approach has wide implications for heritage management/museum display, its relevance conforms exactly to the ancient Egyptians' fundamental belief that 'to speak the name of the dead is to make them live again'," they wrote in a <a href="https://www.nature.com/articles/s41598-019-56316-y#Fig3" target="_blank">paper</a> published in Nature Scientific Reports. "Given Nesyamun's stated desire to have his voice heard in the afterlife in order to live forever, the fulfilment of his beliefs through the synthesis of his vocal function allows us to make direct contact with ancient Egypt by listening to a sound from a vocal tract that has not been heard for over 3000 years, preserved through mummification and now restored through this new technique."</p>
Connecting modern people with history<p>It's not the first time scientists have "re-created" an ancient human's voice. In 2016, for example, Italian researchers used software to <a href="https://www.smithsonianmag.com/smart-news/hear-recreated-voice-otzi-iceman-180960570/" target="_blank">reconstruct the voice of Ötzi,</a> an iceman who was discovered in 1991 and is thought to have died more than 5,000 years ago. But the "Voices of the Past" project is different, the researchers note, because Nesyamun's mummified corpse is especially well preserved.</p><p style="margin-left: 20px;">"It was particularly suited, given its age and preservation [of its soft tissues], which is unusual," Howard told <em><a href="https://www.livescience.com/amp/ancient-egypt-mummy-voice-reconstructed.html" target="_blank">Live Science</a>.</em></p><p>As to whether Nesyamun's reconstructed voice will ever be able to speak complete sentences, Howard told <em><a href="https://abcnews.go.com/Weird/wireStory/ancient-voice-scientists-recreate-sound-egyptian-mummy-68482015" target="_blank">The Associated Press</a>, </em>that it's "something that is being worked on, so it will be possible one day."</p><p>John Schofield, an archaeologist at the University of York, said that reproducing voices from history can make museum experiences "more multidimensional."</p><p style="margin-left: 20px;">"There is nothing more personal than someone's voice," he told <em>The Associated Press.</em> "So we think that hearing a voice from so long ago will be an unforgettable experience, making heritage places like Karnak, Nesyamun's temple, come alive."</p>
Inequality in wealth, gender, and race grew to unprecedented levels across the world, according to OxFam report.
- A new report by global poverty nonprofit OxFam finds inequality has increased in every country in the world.
- The alarming trend is made worse by the coronavirus pandemic, which strained most systems and governments.
- The gap in wealth, race and gender treatment will increase until governments step in with changes.
People wait in line to receive food at a food bank on April 28, 2020 in Brooklyn.
Photo by Spencer Platt/Getty Images
Credit: Oxfam International
A supernova exploded near Earth about 2.5 million years ago, possibly causing an extinction event.
- Researchers from the University of Munich find evidence of a supernova near Earth.
- A star exploded close to our planet about 2.5 million years ago.
- The scientists deduced this by finding unusual concentrations of isotopes, created by a supernova.
This Manganese crust started to form about 20 million years ago. Growing layer by layer, it resulted in minerals precipitated out of seawater. The presence of elevated concentrations of 60 Fe and 56 Mn in layers from 2.5 million years ago hints at a nearby supernova explosion around that time.
Credit: Dominik Koll/ TUM