Virus Treatment Is Changing

But first, here's what happened in virus news today. US President Donald Trump is amping up pressure to send kids back to school, regardless of the safety risks. Today he blasted the Centers for Disease Control and Prevention atter they set guidelines for reopening schools. In a tweet, Trump called the guidelines quote very tough and expensive, and said he would meet with the CDC earlier. Trump said he may cut funding if schools do not open before the November election,

saying keeping them closed benefits the Democrats. The country's largest public school system, New York City, announced today that students would probably return to physical schools part time this fall. Mayor build A Blasio said he anticipates a blended learning program with students in class two to three days a week. New York State Governor Andrew Cuomo said a decision on

schools would be announced the first week of August. Melbourne, Australia's second largest city, goes into lockdown today for the second time in four months. The country's missteps in handling travelers returning from overseas and the complacency of a few neighborhoods tipped the city back into the danger zone. Melbourne is now responsible for the vast majority of Australia's new

COVID nineteen cases in the past month. Even as life in most of the nation returns to normal, Melbourne's five million people will be back under stay at home orders that were first imposed in March, and finally, Brooks Brothers filed for bankruptcy. The company was the latest victim of the pandemics hit to clothing sales. Neiman Marcus Group, Jay Crew Group and John Varvados Enterprises have all filed for bankruptcy since the virus took hold. And now for today's

main story. Almost two hundred days after the first coronavirus cases were reported in Central China, health workers and researchers have raced to learn more about the brand new pathogen. As many as one thousand COVID related research papers are being released daily. Bloomberg Senior editor Jason Gale reports that that research and the experience of frontline healthcare workers is informing better ways to diagnose, prevent, and treat the disease,

and it's helping to save more lives. On April six, in New York, for a personal experience, I think that was the worst day hospital wise. That's Associate Professor Sonya Yellow, an eighteen year veteran critical care doctor currently working at

the Columbia University of a Medical Center. We were really, really very busy, and the hospital was full of patients with with COVID, and I was working in the intermediate care unit or step down unit, which normally has eight to tend patients, and that day we had a more than sixty patient. At some point we had sixty eight patients, so that's approximately eightfold increased. Many patients struggled to breathe.

The most critical we transferred to a pop up intensive care unit, but others also required more invasive respiratory support. Despite all our efforts, we were stuck with the several patients who needed to be incubated, but there was no way Sonia and a colleagues could incubate all of them at once. She had to buy time, so she made the decision to do something unorthodox, something for which there

are no guidelines or protocols. We've been hearing about this technique in the beginning of April from friends and some colleagues about this prawning, which means putting people to lay on their stomach among patients who are not intubated, that means they are not on a respiration or not on a mechanical ventilation, and that's an unconventional treatment. There are no guidelines on such therapy and non intubrated patients. Feeling

she had nothing to lose, Sunny went ahead anyway. Laying on the stomach improves blood circulation in the upper portion of the lung, increasing the volume of oxygen and carbon dioxide that can be exchanged. It also decreases pressure around the lung and can help clear secretions from the airways. So we tried that and the first few patients I remember first three patients really had a dramatic improvement in their oxygen nation, which is measured from a finger by

pulse of symmetry. That's a small clip like device that attaches to the patient finger. But we were very encouraged by that and also the clinical stuff. Nurses and nurse practitioners as well as hospital is they really surprised how well this works. So we said, okay, let's just see who else is needing the most oxygen. So we decided to do this promposition only in those most severe cases

who would otherwise be integrated. Immediately, Sonya got approval to attract these patients and report what happened to them in a study. Her paper was published last month and the Journal of the American Medical Association. She and a colleagues founded if they were able to get patients blood oxygen levels back into the acceptable or normal range, then there was a forty six percent reduction in the probability of

them being intubated. We were hoping that this would be helpful to other health care providers dread and COVID patients. The approach hasn't yet been tested in a large randomized control old trial, but it's a reminder that necessity is the mother of invention in the absence of a cure. Doctors like Sonia are left relying in part on trial and error, but months into the most destructive pandemic in a century, their collective experience is starting to build a

framework of how best to cope with coronavirus patients. In April, Gilead's anti viral Rhamdavia, now approved with the brand name Vecklery, were shown to speed recovery time and COVID patients. Last month, the inexpensive corticosteroid decks of methad zone was found to reduce debts by a third among patients receiving mechanical ventilation. Doctors are also routinely administering heprin, another anti coagulants to prevent dangerous blood clots from forming in the veins of

the critically ill or. COVID nineteen is a respiratory disease. We now know that it has the capacity to cause diverse manifestations um but little by legion, we discovered the new sign new symptoms of the disease. This is Dr Sylvie Bryant, the World Health Organization's Director for Global Infectious Hazard Preparedness. Now we know that there is really a lot, a lot of possibilities for these barns to attact the

human body. The quest is to create a toolbox that will enable doctors to provide better care for the full range of COVID patients aill we says. The w h O is collating data from countries to identify the crucial elements that reduce the proportion of COVID patients who die from their illness. These include how health systems triage COVID patients, how they protect those vulnerable to more serious complications, and the speed with which they provide intensive care. It's not

only what you do. Sometimes at this level there is a little different, but it's really how you do it. What is the particular point that that makes the difference. We are in the midst of our surge now, we are are we have exponential growth in Arizona. The daily case rates are going up, our hospital admissions are going up, So we are in the midst of it right now.

The more COVID patients Dr. Jared Mosey A sees in his hospital's intensive Kegan in Tucson, the more he says he's convinced that saving lives comes down to protecting the lungs of those with acute respiratory distress. Syndrome. It's an inflammatory condition doctors refer to simply as a RDS. Most patients need breathing support, but too little or too much

air pressure and volume can damage the lungs further. And so I look at all of those things and tinker with the ventilator for a good while every day to try to find that balance, and to me, that is the thing that will save the most lives in in this disease is just excellent critical care management of a r d S. Jared is also an associate professor of

emergency medicine at the University of Arizona. When I spoke with him in late June, his hospital had just expanded in intensive care facility to one beds, with plans for more if needed. He says he's laid hands on more than one hundred COVID patients over the past four months or so. I asked him if he thought better treatments we're leading to better survival. How do I hope? So? I think I think that's the case, but it's very hard to answer that question when you're in the thick

of it. I hope. So some days I think we're actually getting pretty good at this and other days. I think this is demoralizing. That's the humbling thing about the pandemic. The more we know, the more we understand that there's so much more we don't yet know well, such as doctors and health authorities are racing to come up with a better waste to find COVID nineteen in the absence of an effected vaccine. The best way to find the pandemic remains avoiding catching the coronavirus in the first place.

That was Jason Gale in Melbourne. And that's it for our show. For coverage of the outbreak from one bureaus around the world, visit bloomberg dot com slash coronavirus and if you like the show, please leave us a review and rating on Apple Podcasts or Spotify or wherever you listen. It's the best way to help more listeners find our global reporting. The Prognosis Daily edition is produced by Topor foreheads Jordan Gospore, Magnus Hendrickson, and Laura Carlson. Today's main

story was reported by Jason Gale. Original all music by Leo Sidran. Our editors are Rick Shine and me Francesco Levi, Bloomberg's head of podcast is me,