LULU GARCIA-NAVARRO, HOST:
There are at least 2,900 confirmed cases of COVID-19 in the United States right now and at least 57 people have died of the disease. Those numbers will rise, but we should stress that most patients who do contract the virus will recover. As the United States grapples with the pandemic, we wanted to check in with a doctor who has treated critically ill COVID-19 patients. James Towne is medical director of the medical intensive care unit at Harborview Medical Center in Seattle, and he joins us now.
Doctor, welcome.
JAMES TOWN: Thank you very much.
GARCIA-NAVARRO: How many COVID-19 patients have you treated?
TOWN: Well, we have had about six in our medical ICU to this point, and a few have passed away. One or two others have been able to leave our ICU, and there's still a couple that remain.
GARCIA-NAVARRO: Can you tell me a little bit about their ages? Did they have anything in common?
TOWN: You know, we are a few miles away from the Life Care Center in Kirkland where there was a large outbreak in a skilled nursing facility. And so we've had a couple in that age bracket being elderly. And then we've also had a handful of people who are middle aged. And then other intensive, this I know in the region have patients who are younger. So really it's all-age spectrums right now.
GARCIA-NAVARRO: And when they get to the hospital, what are you seeing in terms of what they're dealing with?
TOWN: The vast majority of people have, you know, what we would say is a viral syndrome, which is that they have body aches and fevers and a cough. And then there's varying degrees of respiratory issues which can range from a little bit of shortness of breath to full on respiratory failure and needing to be intubated and put onto a mechanical ventilator. A few of the patients we've had have also developed pretty profound cardio genetic shock, and those are the ones who have passed away so far.
GARCIA-NAVARRO: Cardiac shock, you mean that's when they have heart failure essentially.
TOWN: Yeah, essentially that's a little bit more dramatic than just the respiratory failure that we kind of expected to see.
GARCIA-NAVARRO: What are you doing to help treat them? You've mentioned ventilators. What does that look like in practice?
TOWN: You know, in practice treating a critically ill patient for viral pneumonia is largely just supportive care, which means we use a ventilator when people are unable to breathe on their own. We give them fluids if they need them. We give them artificial nutrition through temporary feeding tubes. And we try to help their bodies survive, you know, the effects of the virus.
GARCIA-NAVARRO: In China, they use something called ECMO, which is a type of artificial lung that oxygenate the blood. Have you done that here?
TOWN: We have not personally tried a case here, and that is a therapy that we have and lots of other centers around us have. You know, one of the things that concerned us about this disease is that patients who require mechanical ventilation right now it looks like quite a lot of them don't do very well. And patients who need ECMO are, you know, even sicker than those usually. And the ones who are on the ventilator often take quite a long time to get off the ventilator. And so that means potentially a really protracted course on ECMO machine. So it's a little bit of a difficult situation to figure out who the right candidate is right now.
GARCIA-NAVARRO: I'd also like to talk about some drugs that might be able to help although we don't know yet. There's one called remdesivir. We know that in China and here in the U.S. they are testing it. We should say this is very early data, but there is some suggestion that it may be promising.
TOWN: Yeah. We are actually going to likely be a clinical site for one of the trials. And so when we had our first patients come through, we applied to Gilead for compassionate use, which means...
GARCIA-NAVARRO: Gilead, the company that's manufacturing the drug.
TOWN: Yes. And unfortunately a few of the patients that we applied for, their kidney function got so bad that they weren't going to be candidates for the drug anymore.
GARCIA-NAVARRO: Doctor, how is the hospital coping right now?
TOWN: You know, we're all preparing for the worst so that we can make sure that we still retain the ability to offer services that we normally offer as well as services for an expected influx of patients. There's a strong esprit de corps at Harborview and at a lot of hospitals like ours where we know that this is our job and we're here to help. But at the same time, you know, people are scared. People are not sure what's going to happen next.
GARCIA-NAVARRO: Have you ever seen anything like this?
TOWN: No. A friend of mine said it best. This could be one of the defining, you know, moments in our careers or in our lives. So it really is a unique situation right now.
GARCIA-NAVARRO: That was Dr. James Town, medical director of the medical intensive care unit at Harborview Medical Center in Seattle.
Thank you very much and best of luck.
TOWN: Thank you for having me.
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