By Guy Page
As Vermonters become more interested in and informed about Covid-19 treatment options, many have been asking how people admitted to Vermont hospitals are being treated for the disease. The Chronicle put the question to Vermont Dept. of Health Commissioner Dr. Mark Levine yesterday at the weekly press briefing.
Vermont Daily Chronicle: “Could you describe the treatment protocol for patients who are admitted to the hospital for Covid 19?”
Health Commissioner Dr. Mark Levine: Usually you don’t get into the hospital unless there’s a problem with your ability to maintain a good oxygen level in your blood. So there are criteria for that from the get-go. And you usually have to have some element of illness beyond Covid that would probably get you there because you’re in a compromised state.
“But probably the primary modality of treatment I would list is oxygen, given in a variety of ways. The least common way is because you’re ventilated by a machine, because so many of the ways we can administer oxygen now help prevent you from having to get on a ventilator.
“Medication-wise, most people who are getting hospitalized aren’t on their first or second day of illness; they’ve had the Covid for a while, at least five, seven days, and that’s the point in time when they’re starting to deteriorate, not necessarily related to the virus but related to the inflammatory response that the illness has produced in them, their bodies trying to fight off the virus. All kinds of inflammatory chemicals are being released within their bloodstream to try to do that, so some of the therapies are actually to reign in control of some of that overzealous response on the part of the body. That’s why things like corticosteroids are used in that setting.
“There are also antiviral medications – not the one that Merck is trying to get approved now [molnupiravir, a chemical cousin of ivermectin], that’s a different one – but some older ones that are used to work on the virus part itself.
“So it’s a whole host of interventions to support people’s ability to breathe and have a good oxygen level without being on a ventilator, hopefully to rein in the inflammatory response and to address the virus itself.”
Chronicle: “Is remdesiver one of those antivirals?”
Levine: “Remdesivir is one of those antivirals. Okay it is the one of those antivirals in terms of the one that would be chosen for the appropriate patient who meets the criteria.”
Chronicle: “Are you using the monoclonal antibodies too?”
Levine: “So, most of the time someone would have gotten into the hospital either too late to use the monoclonal antibodies. The cat’s out of the bag, so to speak. This therapy is used early in the course to prevent you from getting in the hospital so it would be the less common person who’s actually admitted to the hospital who would still qualify for it because they may have passed that point in time when it would be useful.”