Okay so, if you're watching
the news and all that,
you have still no clue
what actually happens
when you get Coronavirus,
because it's all interspersed 
with fear.
Here's what happens if you
get infected with Coronavirus,
in the instance of the
people who aren't that sick,
and the people who get 
really sick.
So the people who aren't 
that sick,
they may have a fever,
they may have a cough,
and it's often a dry cough,
although sometimes there can
be the productions of snot,
and mucus, and that
kind of thing.
And then some people 
have a little mild
shortness of breath initially,
but a lot of people don't.
So it really feels 
like an early flu,
or a cold, you can have muscle
aches, that kind of thing.
And the majority of people
in the series that 
they've looked at
get better in one to two weeks.
So the symptoms get better,
maybe they barely have
any symptoms at all.
But, you know what, it's weird,
when they actually scan
the lungs of these patients
that are barely 
having symptoms,
they actually have 
some abnormalities
even then on their lung scans
that they're really not
feeling a lot of symptoms of.
So, it starts to 
make you think,
people are spreading this thing
without a ton of symptoms,
and they looked even 
at the cruise ship,
people were testing positive
not having a lot of symptoms.
So that's how this thing
is probably spreading,
we don't even know it,
because we're not testing
everybody around, okay?
So mild symptoms, 
not much going on.
Well, what happens in the
people who get really sick?
And these tend to 
be older people,
they tend to be people
with other comorbidities,
meaning they have a lung
disease, or diabetes,
or high blood pressure, 
or heart disease,
or they have immunocompromise.
And it doesn't, 
it's not always the case,
but it seems that 
the older people
are hit very hard by this,
and young kids are
particularly spared by it.
So, in those older patients
what may happen is,
somewhere after the
initial symptoms start,
maybe even up to eight
days on average after,
you suddenly get worse.
And the way that manifests is,
a lot of shortness of breath.
So people really feel like, oh
I'm having trouble breathing.
And that's what often leads then
to the presentation 
to the hospital.
They end up in the hospital.
And at that point it's
a rapid decompensation.
Where if you do a scan then,
the lungs show these
very distinctive patterns
of pneumonia.
It's often on both 
sides of the lungs,
it's often in the 
periphery of the lungs
on the outside part 
of the lungs,
and it often leads to people,
up to 15% of the patients, 
or higher,
that show up to the hospital,
end up going to the ICU.
And at that point, they
need help with breathing.
Whether it's a high 
pressure mask,
a lot of oxygen, or an
actual breathing tube
placed in the lung.
Now, why?
The reason is, the pneumonia
which is a kind of inflammation
caused by the infection
and the immune response
to the infection of the lungs
causes a barrier 
between the ability
to exchange oxygen and 
carbon dioxide,
and your blood, and the air.
And so as a result, people
feel like they can't breathe,
their blood oxygen levels drop,
they may have a white 
blood cell count
that's either too low 
or too high,
and their liver function
tests are a little abnormal.
Those are some of the 
lab tests you see.
But really, you see 
they're just
having trouble breathing, 
right,
and oxygenating and 
exchanging gas.
So at that point, 
you may have to put in
a ventilatory assistance
tube, an endotracheal tube.
Now, what we see then is,
in patients who get really sick,
they develop something called,
and this is why this
disease can be so fatal
in people who it does 
affect that way,
which by the way, are again,
a minority of the patients
that are infected.
So all the fear mongering 
and everything
you're hearing on the news,
I mean, this can happen
with influenza, guys,
and it does, it does, all right.
So, they get something called
acute respiratory 
distress syndrome.
That's when the lungs 
really take a hit.
They get damaged.
And if you take biopsies, 
you just see the
little alveoli sacks 
that exchange air
are just jacked up for lack
of a medical word, right?
And in those settings,
it takes a lot of assistance
to ventilate those patients.
It's often associated 
with other problems
due to the immune reaction 
to the virus.
And that includes sepsis,
sometimes due to secondary
infections that happen.
So 'cause your lungs 
are all gummed up,
and you're on a
ventilator, and it's moist,
and it's a perfect environment
for bacteria and other viruses,
you can often get a secondary
infection like a pneumonia,
and those sort of things.
And that can cause
things to get even worse.
At that point if you have sepsis,
you can get multi-organ failure,
your blood pressure can plummet,
you can go into shock, you
can have trouble ventilating,
you may need the assistance
of dialysis for your kidneys,
or ECMO, which is like kind of
external oxygenation device,
like a bypass machine.
And when it gets that serious,
your chances of dying are very, 
very high.
If you actually survive that,
your chances of having
some permanent disability
in your lungs due to scarring,
or other responses from 
the inflammation
are not very low either.
And this happened with 
SARS as well, so,
we're seeing this pattern with
this family of Coronaviruses.
So, this is how people 
tend to get sick.
So, the bottom line is, if
you're having mild symptoms,
fever, cough, you're not having
a lot of shortness of breath,
you don't need necessarily
to show up at the doctor,
right, you can call and
we can talk about that
in a separate video.
But, the people who get 
very sick,
those warning signs are
real shortness of breath,
dizziness, lightheadedness,
changes in your mental status,
and your ability to think,
inability to keep food down.
Those are signs that 
you really need
to seek emergency care.
So, I hope this was helpful.
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