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If you think all coronavirus news is bad, think about Don Ramsayer’s uplifting story.
The 59-year-old man from Cumming, Georgia is living proof that intensive care unit doctors quickly figured out how to help more patients survive.
In early August, Ramsayer helped his son pack the car for his freshman year at the Citadel, South Carolina’s military college. Ramsayer had sweats in the night and wasn’t feeling well, but he tried to downplay it.
“We packed the last box and she was ready to go in the car, and I ended up succumbing to my sister and kids who said, ‘Dad, something is wrong. Go to the hospital.'”
Ramsayer, a software designer and self-described exercise rat, was diagnosed with a slow form of leukemia in November. However, doctors at Emory Johns Creek Hospital, northeast of Atlanta, ran some tests and concluded that his new symptoms were indeed from COVID-19.
He was hospitalized and got sick and sick over the weekend. Ramsayer recalls that the doctors called his sister and told her to prepare for the worst “because they didn’t think I would make it”.
When his health deteriorated, the doctors “basically threw everything in the sink at me,” he says. “Almost like Sherlock Holmes. ‘What can we try here? What can we try there to face these things?’ “”
Doctors gave him a newly available antiviral drug, remdesivir, as well as an experimental treatment called convalescent plasma. This includes transfusions of blood plasma from people who have recovered from COVID-19 and who carry antibodies that could help fight the virus.
He landed on a ventilator for nine days while being very sedated.
Ramsayer himself ended this phase of his treatment quite unexpectedly.
“Somehow I got off the belt,” he says in an interview from his hospital bed. “I completely unhooked myself … and pulled the air tubing out. And here’s the really fun thing. I’m obviously pretty worn out. They’ve got me doing all sorts of things and as I was even conscious, they’re not even the first what i do is say “can i have a cola?” “”
He says the doctors initially considered putting the air tubing back in, but saw that he could breathe well enough on his own.
“From that point on, I’ve continued to improve,” he says.
Ramsayer’s story is remarkable when you consider his cancer and the complications of his case. But this story is far from unique.
“We have recreated a lot of what has been seen around the world. Over time, the mortality rate in intensive care units has decreased,” says Dr. Craig Coopersmith, director of the Emory Critical Care Center. He oversees intensive care units in five Emory System hospitals, including Johns Creek.
The decline in mortality related to COVID-19 varies from month to month. For Emory it ranged from 20% to 50%. Coopersmith says there are many reasons for this.
When the first wave of Covid-19 hit Atlanta hospitals in April, doctors had no experience with the disease. The medical management of these patients is now relative to routine.
“The pandemic certainly has nothing to do with routine,” says Coopersmith, “but as far as the way we deal with it, it’s normal when you’ve taken care of something for the tenth time.”
Doctors are better able to deal with common and serious complications such as blood clots. They realized that patients are better off if they don’t lie on their back all the time. Patients at Emory hospitals are encouraged to lie on their stomachs for some time. That simple exertion is sometimes enough to keep her off the ICU.
Ramsayer found it uncomfortable sleeping on his stomach – he says he had a few burned windows from his days as a powerlifter – but he slept on his side when he could.
And while no drug can cure COVID-19, a number of studies have shown that steroids can benefit the sickest patients.
Like many medical centers, Emory had not routinely used steroids like dexamethasone to treat COVID-19 until a large study from the UK showed these drugs reduced the risk of death in critically ill patients.
“So that’s a huge success story,” says Coopersmith. “In just a few months we will have a drug that is readily available everywhere, is reasonably priced and that greatly improves survival in the ICU patient population.”
In fact, steroids were part of Ramsayer’s treatment.
The trend towards improving survival has been documented in intensive care units around the world. Even so, people treated for COVID-19 in intensive care units are at higher risk of death than other viral lung diseases. Hundreds of people are still dying from COVID-19 every day in the United States.
Coopersmith attributes some of the improvements in treatment to scientific advances, as has been the case with steroids. He says it also helped that, for the past six months, all attending physicians shared their observations and ideas in a daily text chat, “and that’s where we find the art of medicine.”
Ramsayer also credits his own deep faith in God for getting him through the ordeal. As we talked, he was preparing to be released after being in the hospital for more than five weeks.
“I walk, sit, I can move around. My only limitation is my need for oxygen,” he says. He thinks this is a mere inconvenience.
He is keen to get back to his job as a software designer and continue to work with his doctors to find the right treatment for his leukemia.
“We’ll tackle that as soon as I’m back on my feet.”
You can contact NPR science correspondent Richard Harris at [email protected]