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Advances In ICU Care Are Saving More Patients Who Have COVID-19


Now to the pandemic. Despite the grim number in this country of people who have lost their lives to COVID-19, doctors have made big strides in figuring out how to keep people alive in the intensive care unit. NPR science correspondent Richard Harris tells the story of one man's remarkable recovery.

RICHARD HARRIS, BYLINE: In early August, Don Ramsayer was helping his son pack up the car for his freshman year at the Citadel, a military college of South Carolina. Ramsayer wasn't feeling that well, but he tried to play it down.

DON RAMSAYER: We got him ready, got the last box packed. Everything was ready to go in the car. And I finally succumbed to my sister and my kids saying, dad, something's wrong. Go to the hospital.

HARRIS: Ramsayer, who's 59, had been diagnosed in November with a slow-moving form of leukemia. But the doctors at Emory Johns Creek Hospital northeast of Atlanta ran a few tests and concluded that his new symptoms were due to COVID-19. He got sicker and sicker over the weekend, and Ramsayer recalls the doctors called his sister with the sobering news.

RAMSAYER: Because they did not think I was going to make it. During this period of time, they basically started throwing everything in the kitchen sink at me, almost like Sherlock Holmes. What can we try here? What can we try there? Try to, you know, get in front of these things.

HARRIS: Among other measures, Ramsayer was treated with steroids, which have recently been shown to save the lives of some seriously ill COVID-19 patients. He got the antiviral drug remdesivir, as well as an experimental treatment called convalescent plasma. He also ended up on a ventilator for nine days under heavy sedation.

RAMSAYER: Somehow, I got out of the straps. I completely unhooked myself and completely excavated myself and pulled the breathing tube out. And then here's the really funny thing - is I'm really, obviously, pretty doped up. I mean, they had me on all kinds of stuff - how I was even conscious - they're not even sure of that. The first thing I do is I say, can I have a Coke?

HARRIS: Happily, doctors realized that Ramsayer could get along OK without the breathing tube.

RAMSAYER: I continued to improve from that point forward.

HARRIS: Ramsayer's story is remarkable considering his cancer and the many complications of his case. But Dr. Craig Coopersmith, director of Emory's Critical Care Center, says this story is far from unique.

CRAIG COOPERSMITH: We have very much replicated what's been seen worldwide, which is, over time, mortalities in the ICUs have decreased.

HARRIS: The decline in mortality varies month to month, but at Emory's hospitals, it has been in the range of 20 to 50%. Coopersmith says there's lots of reasons for that. A big one is that when the first wave of COVID-19 hit Atlanta's hospitals in April, doctors had no experience with the disease. Medical management of these patients is now, by comparison, routine.

COOPERSMITH: There's certainly nothing routine about the pandemic, but in terms of how we're managing it, once you're taking care of something for the 10th time, it is normal.

HARRIS: Doctors can better manage common and serious complications like blood clots. They realize that patients do better if they aren't lying on their backs all the time. And a series of studies showed that steroids can save lives.

COOPERSMITH: And so that's a tremendous success story. In just a few months, we have a drug which is easily available everywhere and quite cheap that improves survival significantly in the ICU patient population.

HARRIS: Science has rapidly been brought to bear. But Coopersmith says it also helps that for the past six months, the ICU physicians at the five Emory hospitals have shared their personal experiences and ideas with one another in a daily text chat.

COOPERSMITH: And in that we find the art of medicine.

HARRIS: Patient Don Ramsayer adds to the list his own deep faith in God for getting him through the ordeal. After more than six weeks in the hospital, he's finally getting ready to go.

RAMSAYER: I'm walking, sitting. I can get around. My only limitation is just my oxygen requirement.

HARRIS: He's eager to return to his job as a software designer and to keep working with his doctors to figure out the right treatment for his leukemia.

RAMSAYER: That's something we'll tackle once I get back on my feet.

HARRIS: Richard Harris, NPR News.

(SOUNDBITE OF KODOMO'S "CONCEPT 1") Transcript provided by NPR, Copyright NPR.

Award-winning journalist Richard Harris has reported on a wide range of topics in science, medicine and the environment since he joined NPR in 1986. In early 2014, his focus shifted from an emphasis on climate change and the environment to biomedical research.