The term interstitial lung disease (ILD), also known as Diffuse Parenchymal Lung Disease (DPLD) comprises more than 200 separate disease entities  that cause progressive scarring of lung tissue. Scarring caused by interstitial lung disease eventually impairs one’s capacity to breathe and absorb adequate oxygen into the bloodstream.. The crude annual incidence of ILDs in India is 10.1–20.2 per 100,000 population.

The pathogenetic sequence involves a series of inflammation and fibrosis that extends beyond disrupting the interstitial bed to changing the parenchyma (alveoli, alveolar ducts, and bronchioles).

Interstitial lung disease is much more likely to affect adults, although infants and children sometimes develop the disorder.

Some of the known cause of ILD include : 

  • Long-term exposure to occupational or environmental agents like mineral dust, organic dust, and toxic gases. Most common are silica, asbestos, coal mine dust. 
  • Allergic reaction to inhaled molds, fungi, bacteria and bits of bird feathers or droppings.
  • Auto immune diseases and connective tissue diseases like rheumatoid arthritis, lupus, systemic sclerosis.
  • Granulomatous diseases like sarcoidosis.
  • Drug induced ILDs.
  • Smoking. Some forms of interstitial lung disease are more common in smokers, and active smoking may aggravate the condition, especially if there is accompanying emphysema.

When the cause of ILD is unidentified, it is labelled as Idiopathic Iinterstitial Pneumonia of which, Idiopathic pulmonary fibrosis is the most common and with a bad prognosis.

In contrast to developed countries, sarcoidosis and Hypersensitivity pneumonitis are the ILDs with the highest burden in India.

The most frequently reported symptom is gradual onset of shortness of breath which is usually progressive, but sometimes it may simply be a persistent cough. Fatigue, chest discomfort, weight loss are other symptoms associated with ILDs. Some patients may be asymptomatic and are incidentally diagnosed on ct scan of the lungs.

ILDs are diagnosed based on history, clinical examination, relevant blood investigations that include auto immune workup, pulmonary function tests, HRCT chest and a lung biopsy as and when required.

Most of the ILDs cause irreversible lung damage and are progressive. Early diagnosis and treatment play a vital role in slowing down the progression of the disease and improving the quality of life.

Treatment for ILD usually focuses on treating underlying disease and improving symptoms.  General supportive measures include smoking cessation, pulmonary rehabilitation which can help improve functionality, and good pulmonary hygiene.

Gastroesophageal reflux disease (GERD) can make ILD worse, hence requires adequate treatment. The mainstay therapy for treatment of ILD is corticosteroids and immunosuppressive therapies to intercept the inflammatory process within the lungs.

Antifibrotic drugs have proven benefits in IPF and other progressive fibrotic ILDs not responding to corticosteroids and other immunosuppressive therapy.

Supplemental oxygen is necessary for those who demonstrate hypoxemia (sao2 less than 88). Pulmonary rehabilitation plays an important role in the management of ILDs.

Unfortunately, despite all the efforts most of the ILDs progress and significantly impair the quality of life.

Vaccination against common pulmonary pathogens is recommended for all patients with ILD irrespective of their age. This will help reducing infectious ecxacerbations and hospitalisations.

When left untreated, idiopathic pulmonary fibrosis (IPF), the prototype of fibrotic ILDs, has a prognosis of 3-5 years survival following diagnosis. Predicting prognosis for individual ILD patients is still difficult. Signs of pulmonary hypertension and right ventricular failure, as well as the presence of a pneumothorax, have been linked to poorer outcomes in ILD.

Lung transplant is the sole treatment modality that can reinstate physiological function in patients with ILD, who worsen despite maximum medical therapy.

No biomarker or clinical prediction algorithm has been identified as a reliable predictor of disease outcome or response to therapy in ILD at this time. As a result, early referral to a lung transplant programme is still suggested to minimise the possibility that a potentially eligible patient would miss out on a lung transplant.



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COVID-19 may no longer be a global threat, as announced by the World Health Organisation, but cases of the human metapneumovirus or HMPV, a respiratory disease, seem to be peaking in the United States presently. According to the Centers for Disease Control and Prevention (CDC), there was a major uptick in the number of cases in the country, and at its peak in mid-March, nearly 11 percent of tested specimens were positive for HMPV, a number that’s about 36 per cent higher than the average pre-pandemic levels.

Most people who caught the virus probably didn’t know they had it and sick people are not usually tested for it outside of a hospital or ER, according to CNN. Unlike COVID-19 and the flu, currently, there are no vaccines or anti-viral drugs available to administer to patients and people. There is only one step that the doctors can take, which is to tend to the symptoms faced by the patients.

What is HMPV?

Dr Sabine Kapasi, Public Health Leader, United Nations Disaster Assessment and Coordination and Geneva told indianexpress.com, “Human metapneumovirus (HMPV) is a respiratory virus that can cause respiratory tract infections in humans. It belongs to the Paramyxoviridae family, which also includes other respiratory viruses such as respiratory syncytial virus (RSV). According to The Lancet, “There were an estimated 14.2 million cases of HPMV globally in children younger than 5 years old.”

It can affect people of all age groups, however, the United States Food and Drug Administration (FDA) notes that the risk is higher for small children, older adults, and those with immunocompromised systems.

hmpv According to the American Lung Association (ALA), people infected with it usually experience mild symptoms akin to a cold. (Source: Freepik)

As far as its origins are concerned, Dr Kapisi mentioned that HMPV was first discovered by Dutch virus hunters in 2001. According to the expert, people infected with it usually experience mild symptoms akin to a cold, which usually last for about two to five days, and resolve on their own in healthy individuals. Other symptoms include cough, fever, nasal congestion and shortness of breath.

Additionally, she noted that in most cases, HMPV infections are mild and resolve on their own without specific treatment. “However, severe infections can occur, especially in individuals with pre-existing respiratory conditions or compromised immune systems. Complications may include pneumonia or bronchiolitis, particularly in young children. Severity and outcome of HMPV infection can vary from person to person, and the risk of fatality is generally low.”

How is it transmitted?

CDC reported that HMPV spreads similarly to other viruses through airborne particles produced by coughing and sneezing, physical contact with an infected person or handling objects contaminated with the virus before touching the nose, eyes or mouth. Further, the virus is more likely to circulate during the winter and spring months.

The primary approach to prevention, as pointed out by Dr Kapisi, is regular handwashing with soap and water or using alcohol-based hand sanitisers, covering the mouth and nose with a tissue or the elbow when coughing or sneezing, avoiding close contact with individuals who have respiratory symptoms, cleaning and disinfecting frequently touched surfaces and promoting good respiratory hygiene practices in community settings.

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aerosol: (adj. aerosolized) A tiny solid or liquid particle suspended in air or as a gas. Aerosols can be natural, such as fog or gas from volcanic eruptions, or artificial, such as smoke from burning fossil fuels.

asthma: A disease affecting the body’s airways, which are the tubes through which animals breathe. Asthma obstructs these airways through swelling, the production of too much mucus or a tightening of the tubes. As a result, the body can expand to breathe in air, but loses the ability to exhale appropriately. The most common cause of asthma is an allergy. Asthma is a leading cause of hospitalization and the top chronic disease responsible for kids missing school.

average: (in science) A term for the arithmetic mean, which is the sum of a group of numbers that is then divided by the size of the group.

colleague: Someone who works with another; a co-worker or team member.

diesel fuel: Heavier and oilier than gasoline, this is another type of fuel made from crude oil. It’s used to power many engines — not only in cars and trucks but also to power some industrial motors — that don’t rely on spark plugs to ignite the fuel.

economist: Someone who works in the field of economics: how a society's resources relate to the things it produces or achieves. Often this is measured in the goods people make, the money they earn or the costs they encounter (such as pollution or sickness). Economists might calculate this for something as small as a village or as large as a nation — even for workers living across the globe.

epidemiologist: Like health detectives, these researchers look to link a particular illness to what might have caused it and/or allowed it to spread.

fossil fuel: Any fuel — such as coal, petroleum (crude oil) or natural gas — that has developed within the Earth over millions of years from the decayed remains of bacteria, plants or animals.

global warming: The gradual increase in the overall temperature of Earth’s atmosphere due to the greenhouse effect. This effect is caused by increased levels of carbon dioxide, chlorofluorocarbons and other gases in the air, many of them released by human activity.

link: A connection between two people or things.

natural gas: A mix of gases that developed underground over millions of years (often in association with crude oil). Most natural gas starts out as 50 to 90 percent methane, along with small amounts of heavier hydrocarbons, such as propane and butane.

nitrogen oxides: Pollutants made up of nitrogen and oxygen that form when fossil fuels are burned. The scientific symbol for these chemicals is NOx (pronounced “knocks”). The principle ones are nitric oxide (NO) and nitrous oxide (NO 2 ).

pneumonia: A lung disease in which infection by a virus or bacterium causes inflammation and tissue damage. Sometimes the lungs fill with fluid or mucus. Symptoms include fever, chills, cough and trouble breathing.

policy: A plan, stated guidelines or agreed-upon rules of action to apply in certain specific circumstances. For instance, a school could have a policy on when to permit snow days or how many excused absences it would allow a student in a given year.

random: Something that occurs haphazardly or without reason, based on no intention or purpose. Or an adjective that describes some thing that found itself selected for no particular reason, or even chaotically.

renewable energy: Energy from a source that is not depleted by use, such as hydropower (water), wind power or solar power.

sustainability: (adj: sustainable) To use resources in a way that they will continue to be available in the future.

threshold: A lower limit; or the lowest level at which something occurs.

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In a recent article published in The Lancet, researchers described the heterogeneous nature of long coronavirus disease (Long-COVID), focusing on its pulmonary and extrapulmonary sequelae. They reviewed pre-existing respiratory issues [e.g., lung fibrosis, asthma, and chronic obstructive pulmonary disease (COPD)] that possibly aggravate pulmonary sequelae of COVID-19 or affect its outcomes. Additionally, the discussed clinical care, rehabilitation, and non-pharmacological strategies for people affected by post-COVID-19 dyspnea, a type of persistent disabling breathlessness.

Study: Respiratory sequelae of COVID-19: pulmonary and extrapulmonary origins, and approaches to clinical care and rehabilitation. Image Credit: Lightspring / ShutterstockStudy: Respiratory sequelae of COVID-19: pulmonary and extrapulmonary origins, and approaches to clinical care and rehabilitation. Image Credit: Lightspring / Shutterstock

Background

The post-acute sequelae of COVID 2019 (COVID-19), or PASC, systematically affects multiple organs, especially people with chronic lung diseases like thromboembolic disease.

Multiple previous studies have described worsening of respiratory systems during PASC due to destabilizing of pre-existing symptoms or COVID-19-related effects, independent of the severity of acute illness; however, the exact mechanisms governing these changes remain unclear. 

Several published studies have also described, using a large dataset, the cluster of respiratory symptoms constituting PASC, for instance, erratic breathing, hyperventilation, and persistent cough. Perhaps, mechanisms like viral persistence, autoimmunity, and systemic inflammation, including activation of interferon (IFN) I and III and interleukin 6, contribute to the worsening of respiratory systems during PASC.

By March 2023, worldwide COVID-19 mortality had reduced from 101,600 deaths to 6,500 deaths per week. Also, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related hospital admissions have reduced drastically. Researchers have attributed these improvements, in part, to the increased availability of vaccines and treatments, such as IL-6 therapies. However, it remains critical to understand the long-term effects of COVID-19 on the respiratory system for studies focused on the post-COVID-19 landscape.

About the study

To this end, in the present study, researchers extensively searched databases, such as PubMed and CINAHL, using keywords like dysfunctional breathing, post-COVID fibrosis, fibrosis, and rehabilitation, to name a few.

Regarding post-COVID-19 conditions, they uncovered that the most prevalent symptoms were independent of the severity of acute illness. For instance, understanding the precise mechanisms that underlie symptoms of acute lung injury, the dominant insult in severe acute COVID-19 patients requiring mechanical ventilation, in contrast to any post-COVID-19 sequelae, requires proper assessments and targeted interventions.

The team identified a meta-analysis that covered 54 studies and two medical records that discussed respiratory symptoms as an important cluster alongside fatigue and cognitive problems post-long COVID. In contrast, another study defined a positive correlation between the burden of symptoms and their severity with all the symptoms combined.

Extrapulmonary and pulmonary sequelae of COVID-19

In this study, researchers discussed the incidence and mechanisms of pulmonary fibrosis, pulmonary emboli, and microvascular thrombi, COPD, reduced exercise tolerance, and frailty after COVID-19. In addition, they highlighted studies discussing all these features of long COVID to bring attention to the fact that these contribute to breathlessness and breathing pattern disorders, hence, need attention when devising therapeutic and rehabilitative strategies.

Here it is noteworthy that conventional measures of lung function cannot consistently predict breathlessness. It is a complex condition, which, if pathologically triggered, does not necessarily improve after treatment with bronchodilators. Thus, treatment approaches for breathlessness should be guided by an extensive assessment that covers routine spirometry.

The largest cohort study conducted among 1,733 people discharged from the hospital after COVID-19 recovery performed lung function tests in 349 participants six months post-discharge. It was biased toward adults with clinical symptoms of pulmonary issues. In addition, it should cover Dyspnoea Profile questionnaires that explore the multidimensional components of breathlessness. Clinicians must also consider cardiopulmonary exercise testing and more complex investigations, such as magnetic resonance imaging (MRI) in cases of diagnostic uncertainties related to breathlessness

In post-COVID-19 conditions, cardiopulmonary exercise testing identified dysfunctional breathing or an erratic breathing pattern in the absence of a respiratory limitation or impaired oxygen delivery and reported a lower peak oxygen uptake in individuals with persistent breathlessness compared with those who had a full recovery after COVID-19.

Small cohort studies documented altered breathing patterns in ~20% of people admitted to hospitals with acute COVID-19, and those not admitted to hospital were referred to specialist follow-up clinics. They attributed aberrant breathing patterns to changes in lung function and effects of sedation and mechanical ventilation on respiratory centers, etc.

The Nijmegen Questionnaire specifically accessed hyperventilation syndrome, and the Breathing Pattern Assessment Tool (BPAT) accessed all breathing pattern disorders with high sensitivity and specificity.

Likewise, mechanistic similarities between COVID-19-related pneumonia and idiopathic pulmonary fibrosis (IPF), raise the possibility of a potential global burden of long-term fibrosis arising post-COVID-19.

At present, rehabilitation programs for people with post-COVID-19 conditions are highly heterogeneous, but they should cover aerobic and resistance exercises and spread awareness on symptom management. A recent systematic review showed they improved dyspnoea, physical function, and QoL. However, patients should be selected per symptom profiles, and further research should focus on high-quality evidence, particularly for people not admitted to hospital for COVID-19.

Research evaluating the effectiveness of non-pharmacological interventions is ongoing. However, respiratory and rehabilitation specialists should be at the core of integrated multidisciplinary teams offering support to patients with post-COVID-19 conditions. Most importantly, these teams should use therapeutic and rehabilitative strategies tailored to each patient's symptom profiles and specific needs to ensure they give culturally appropriate, equitable access to the diverse set of affected populations.

Conclusions

Like other critical illnesses, severe COVID-19 leaves patients with long-term morbidity that affects their quality of life (QoL) and physical and mental well-being. As well-recognized, symptoms-like brain fog and cognitive deficits are common in patients with long COVID. These manifestations might be related to the disease, its treatment, or both; notably, doctors administer such treatments in the intensive care unit (ICU) to complement life-support therapies.

In the future, studies should target characterizing the long-term complications of pulmonary and extrapulmonary sequelae of COVID-19 in-depth, e.g., its mechanisms of causing insult. Further, these studies should determine optimal diagnostic and management approaches for this debilitating condition to improve outcomes in this population.

Other future research priorities should be as follows:

i) identifying mechanisms governing reduced asthma and COPD control after COVID-19

ii) extrapulmonary complications that give rise to or worsen breathlessness after COVID-19

iii) diagnostic modality for detection of post-COVID-19 pulmonary vascular disease

iv) strategies to prevent, mitigate, and treat pulmonary fibrosis

v) mechanisms driving symptoms of breathlessness post-COVID-19 and rehabilitation or breathing exercises that effectively reduce it.

Journal reference:

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Monday, June 5th, 2023 04:20 | By

air-pollution

As the World marks its 50th World Environment Day today, the ambitious goal to end environmental pollution appears to be a far-fetched dream with close to zero chances of being realised.

Despite efforts to get rid of  environmental menace, 90 per cent of the world’s population breathes air that is polluted beyond World Health Organisation’s (WHO)targets.

While some people know the clear effects of environmental pollution, it is impossible for them to separate themselves from such surroundings.

For Amos Wasike, his relocation to Nairobi was an attempt to escape from a polluted working environment, only to land in a more polluted environment.

In 2019, Wasike moved from Kericho where he had been working in a flower farm to Nairobi, with a hope of landing himself a safer working place.

“Working in a flower farm had its challenges such as chemicals, which then made me always wear a mask for protection. I got tired of that environment and realised I needed a new environment where all this was not necessary,” he says.

But his moving was more like jumping straight into the fire since he landed a job within a more polluted area.

Air Pollution

Wasike is a street vendor along Mombasa Road, one of the major highways in Kenya. He sells soft drinks, sweets, and snacks at a bus stop where the air is fully polluted with exhaust fumes from passing vehicles. Next to him are food kiosks, which use firewood and charcoal to prepare their food, adding more pollution to the air he breathes. The area also experiences noise pollution from the honking of horns from vehicles and constant traffic, which makes it difficult to communicate effectively even with his customers.

But despite all these challenges, Wasike cannot afford to move away from this place again in search of a cleaner environment because this is where he gets his daily bread.

“Sometimes I am forced to wear a face mask to protect myself, but most of the time I am without a mask. Though I would like to stop working in such a polluted environment,  I cannot because this business is where I earn a living. Apart from that, getting a less polluted area where a business can thrive is challenging,” he says.

Alice Mutuku,another roadside vendor says she has been experiencing some health issues but it has never crossed her mind that they might have been caused by her working conditions. “Day in and day out, I have been experiencing severe colds, and chest infections, but I cannot say that it is because of working in a polluted environment. I think it is due to being exposed to the morning cold for  long and also prolonged exposure to biomass fuel,” she says.

While millions of Kenyans, especially street vendors face one or more forms of pollution every day, many have  limited understanding on air pollution and its impact especially on their health.

Glaring dangers

According to Maurice Kavai, Deputy Director, Air Quality and Climate Change Nairobi County Government, most of these health complications vendors are experiencing are due to continuous exposure to polluted air from several sources, which include traffic or automotive emissions, dust from unpaved roads, construction sites, industrial processes, and biomass fuel.

“Though outdoor air pollution affects everyone, women are the most affected because they dominate the informal trading sector. Available research shows that using biomass fuels often and being exposed to air pollution from traffic increases the chance of negative reproductive challenges on women,” he says.

According to WHO, the health effects of air pollution are so serious that a third of deaths from stroke, lung cancer, and heart disease are due to air pollution. Its effects are equivalent to those of smoking tobacco.

WHO’s recent research  shows that breathing air is becoming dangerously polluted with nine out of 10 people breathing polluted air. Exposure to polluted air in both the ambient environment and in the household causes about seven million premature deaths each year.

“Pollutants can be physical, chemical, or biological, but the pollutants of concern are particulate matter also known as PM2.5 and PM10, ozone, carbon monoxide, sulfur dioxide, nitrogen dioxide, lead, and greenhouse gases. Particulate matter is the main pollutant. These tiny particles come from many sources, including burning fossil fuels for lighting and transportation, chemicals in mines, burning garbage in open areas, burning forests and fields, using indoor stoves as well as heating oil,” says Kavai.

Despite its effects, WHO says no one is safe from the polluted environment including those residing in wealthy neighborhoods, which ideally, are considered to have a clean environment. Microscopic pollutants in the air can slip past our body’s defenses, penetrating deep into our respiratory and circulatory system, and damaging our lungs, heart, and brain.

“Air pollution is a major environmental health threat globally. It is because of it that in Kenya we are losing about 27,000 people annually. Another health effect of air pollution is that it has reduced life expectancy by 1.6 years,” says George Mwaniki, Head of air quality at the World Resources Institute Africa.

According to Mwaniki, despite these horrifying statistics, there is little focus on this public health crisis by both the governments and other health players. The reason is, unlike other sources of pollution, which are visible and kill fast, this one is not visible and kills slowly. Apart from that, polluted air has no smell and most people think that bad odour is what can be considered as air pollution.

“In Nairobi for example concentration of particulate matter in the air is five times higher than the recommended levels by WHO, which is five microgrammes per cubic metre. Though data is there to show how bad the situation is, nothing has been done,” adds Mwaniki. 

According to Dr Paul Njogu, Nairobi Air Research and Data Committee Chair, Kenya’s ambient air pollution (air pollution in outdoor environments) continues to worsen even though there are various air pollution standards such as Air Quality Regulation 2014, Nairobi City County Air Quality Act among others that exist to enhance the quality of ambient air for the sake of securing an environment that is not harmful to the health and well-being of people.

Respiratory infections

“What is happening in Kenya is happening because of investment gaps and not policy gaps. Technologies to measure air quality are there, but limited resources hinder the country from buying these technologies. That is why this country continues to suffer from lack of data and thus fewer interventions,” reveals Njogu. 

Sammy Simiyu from Vital Strategies and a Public Health Specialist at Nairobi Metropolitan Services says poor air quality has doubled up cases of upper respiratory tract infections in Nairobi County for the last four years; from 379,250 in 2017 to 768,415 in 2021.

Apart from the higher rates of infections, air pollution is also among the top five risk factors for death.

According to Simiyu about 124 deaths in every 100,000 are due to air pollution. Also, about 22 per cent of neonatal deaths are caused by air pollution.  The menace has long term effects on human health such as cancer risks, central nervous system diseases, cardiovascular diseases as well as some impacts on one’s liver. Pollution further has effects on  the human’s reproductive system  as it is likely to cause fertility problems, miscarriage among pregnant women, slow foetal growth, premature birth and also low birth weight. According to the expert, short term effects include frequent headaches, coughing, pneumonia, bronchitis and even skin irritation.

“This is why we need to prioritize clean air action for health. We need to identify and address leading air pollution sources. This will be possible if we invest in prevention rather than cure,” said Simiyu.

He says people need to know  that air pollution affects all other body organs and not only the respiratory system. Air pollution also affects health throughout life.

Purity Munyambu, Gender Specialist at World Resources Institute, Africa says that government policies and effective enforcement are critical. However, air pollution mitigation measures will be more sustainable, equitable, and likely to achieve better results if gender considerations are included throughout the planning and implementation stages.



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Karl and Jasmine Stefanovic have opened up about their three-year-old daughter Harper's health battle after they rushed her to hospital last year when she struggled to breathe.

Harper was treated for respiratory syncytial virus (RSV), with Jasmine and Karl teaming up with the Immunisation Foundation of Australia to spread awareness of the virus.

Karl Stefanovic and his wife Jasmine have revealed their daughter Harper's health battle and how terrifying it has been for them. Photo: Instagram/Jasmine Stefanovic

Karl Stefanovic and his wife Jasmine have revealed their daughter Harper's health battle and how terrifying it has been for them. Photo: Instagram/Jasmine Stefanovic

"RSV – the first time Jas and I heard these three letters was in the hospital with our daughter Harper struggling to breathe," Karl said in a video for the Immunisation Foundation of Australia. "Little did we know that so many other families were living the same frightening experience with this common yet unpredictable respiratory virus."

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"It was last winter, and Harper had the sniffles and a cough. Karl and I assumed she just had a bit of a cold. But within hours, she became very sick," Jasmine wrote on the foundation's website. "It was alarming to see how hard she was working to breathe, with her little ribs sucking in and tummy pulling up into her chest."

Jasmine revealed that she knew Harper needed medical help, but wasn't sure if she was overreacting, however, her "gut instinct" took over and they went to see the GP.

Jasmine wrote of the terrifying moment her daughter was taken to hospital after a GP visit. Photo: Immunisation Foundation of Australia

Jasmine wrote of the terrifying moment her daughter was taken to hospital after a GP visit. Photo: Immunisation Foundation of Australia

"Right there in the doctor’s office, Harper’s condition worsened," she added. "Her temperature skyrocketed and her heart rate was close to 200 beats per minute. Our doctor administered oxygen and called an ambulance. Within minutes, we were on our way to hospital.

"It was a long night as we sat in the hospital ward with Harper, trying to comfort her as a medical team worked to help her breathe. We were so relieved the next day when Harper responded well and was able to breathe unassisted."

Jasmine adds that despite it being a year since Harper's hospital visit, she still has a "lingering wheeze".

"Doctors have explained that RSV can have a range of long-term health effects. We’ll be keeping a close eye on her this winter," she concluded, adding she hopes that by sharing their story other parents will understand when to seek medical help.

The couple shared their story in a bid to raise awareness for RSV. Photo: Immunisation Foundation of Australia

The couple shared their story in a bid to raise awareness for RSV. Photo: Immunisation Foundation of Australia

RSV is a major cause of lung infections in children and can lead to pneumonia and bronchiolitis, which is very dangerous in young children.

Jasmine and Karl's followers shared messages of thanks to the couple for spreading awareness of RSV, with one user writing, "Thank you for using your platform to raise awareness for this! So glad Harper has recovered well. My littlest one got it at 11 weeks old and it’s so hard seeing them struggle to breathe."

"So scary when they can’t breathe. My son got RSV, terrifying," another added.

"Thank you so much for your involvement in the #RSVandMe campaign. I hope Harper is doing much better now," a third said.

"Thank you for sharing, this will start a conversation and raise awareness," someone else added.

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Or if you have a story idea, email us at [email protected].

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Parents have been urged to learn the symptoms of Respiratory Syncytial Virus (RSV), with a major report fearing more than 12,000 babies could be hospitalised with the “unpredictable” virus in 2023.

Infants less than six months of age were found to be the most at-risk group.

A major report from health advisory firm, Evohealth found the respiratory illness – which can quickly progress to bronchiolitis or pneumonia – was the leading reason for hospitalisation of children under five.

RSV caused 15,864 hospitalisation children under five every, with one-in-four causes requiring intensive care.

Sick baby boy applying inhale medication by inhalation mask to cure Respiratory Syncytial Virus (RSV) on patient bed at hospital.
Camera IconA recent report found RSV to be the leading cause of hospitalisations in children under the age of five. Credit: istock

Immunisation Foundation of Australia founder Catherine Hughes said the virus was “unpredictable and can be very serious”. There is also no vaccine to prevent RSV, or reduce its effects.

“It’s important that caregivers know the signs that may indicate severe disease, trust their gut, and seek medical attention when it’s needed,” she said.

“We are all hoping to avoid a repeat of last year’s record number of hospital admissions due to RSV.”

Initial symptoms include a runny nose, coughing, sneezing, wheezing, loss of appetite, lethargy and irritability, however it can progress to bronchiolitis or pneumonia.

Parents are warned to seek medical care if severe symptoms like a high fever, shortness of breath, or increased effort to breathe appear.

Signs that the virus has progressed to bronchiolitis or pneumonia can also include wheezing, fared nostrils, grunting while breathing, rapid breathing (more than 40 breaths per minute), a blue tint to the child’s skin around their mouth and eyes, or laboured breathing.

Today host, Karl Stefanovic and his fashion designer wife, Jasmine Stanovic recently shared their scare with RSV, when their daughter Harper was two.

Ms Stefanovic, who has partnered with Evohealth to share their experiences, says what started as a cold, quickly turned into breathing issues.

“Initially, Harper had the sniffles and a cough, and we assumed she just had a bit of a cold. But within hours, she deteriorated,” she said.

“It was alarming to see how hard she was working to breathe, with her little ribs sucking in and tummy pulling up into her chest”.

Supplied Editorial
Camera IconKarl and Jasmine Stefanovic rushed baby Harper to hospital after her condition quickly deteriorated. Instagram Credit: Supplied

After seeing advice from a GP, Harper was rushed to hospital.

“It was a long night as we sat in the hospital ward beside Harper, trying to comfort her as a medical team worked to help her breathe,” she said.

“It’s been almost a year since our awful experience with RSV, and Harper still has a lingering wheeze. Doctors have explained that RSV can have a range of long-term health effects.

“We’ll be keeping a close eye on her this winter.”

The Evohealth report found the virus to be a nearly $200m on Australia’s healthcare system, with each infant hospitalisation costing $12,000.

The report called on a national awareness campaign and surveillance program to measure the spread of the virus.

Evohealth’s managing director, Renae Beardmore said the burden of RSV was huge.

“This is a virus that often went undiagnosed due to lack of awareness, monitoring and reporting, which has recently changed,” she said.

“Now that we are starting to understand the scale of the RSV in Australia, it’s time to act to reduce the burden of the virus on children, parents and hospitals.”

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Parents are advised to look out for signs of breathing problems in young children over winter, with a report highlighting the deadly risks from a mostly unknown seasonal virus.

The report found RSV, or respiratory syncytial virus, is responsible for the hospitalisation of about 12,000 babies under 12 months each year.

That number climbs to over 15,000 for children under five, which is eight times higher than the numbers hospitalised for the flu.

The virus is relatively unknown within the community, with Australia's first RSV Awareness week launched on June 4.

Children who contract the virus can suffer long term health complications including allergies and asthma.

In infants, symptoms include a runny nose, coughing, sneezing, wheezing, loss of appetite, lethargy and irritability.

The report, funded by pharmaceutical giant Sanofi, found low levels of awareness of the virus within the community, despite the dangers.

Healthcare advisory company Evohealth was involved in the report, with managing director Renae Beardmore saying growing awareness of the virus is showing the scale of its impact on Australian children.

She said while most children will contract the virus by the age of two, some will suffer complications such as bronchiolitis and pneumonia.

"This is a virus that often went undiagnosed due to lack of awareness, monitoring and reporting, which has recently changed," she said.

"Now that we are starting to understand the scale of the RSV in Australia, it's time to act to reduce the burden of the virus on children, parents and hospitals."

The report found the common and unpredictable virus is costing the healthcare system about $200 million a year.

Last month, the Therapeutic Goods Administration gave the green light to a newly approved nasal swab able to diagnose COVID-19, influenza and RSV within 15 minutes.

Channel Nine broadcaster Karl Stefanovic and his wife Jasmine are involved in the RSV awareness week campaign, after their young daughter Harper suffered complications from the virus last winter.

Stefanovic became emotional on air last year when he described their fear as their two-year old daughter was hospitalised.

The Immunisation Foundation Australia is hopeful RSV will soon become a vaccine-preventable illness, with founder Catherine Hughes's daughter also impacted by the virus.

"It's important that caregivers know the signs that may indicate severe disease, trust their gut, and seek medical attention when it's needed," she said.

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Karl Stefanovic and his wife Jasmine reveal their daughter Harper's health battle after rushing her to hospital as she 'struggled to breathe'

Karl Stefanovic and his wife Jasmine have revealed their three-year-old daughter Harper's health battle.

The couple rushed Harper to hospital last year as she struggled to breathe and she was treated for respiratory syncytial virus (RSV).

Jasmine admitted in a press release this week: 'The first time Karl and I heard the letters RSV was when Harper was in hospital struggling to breathe.'

'Initially, Harper had the sniffles and a cough, and we assumed she just had a bit of a cold.'

'But within hours, she deteriorated; it was alarming to see how hard she was working to breathe, with her little ribs sucking in and tummy pulling up into her chest.'

Karl Stefanovic and his wife Jasmine have revealed their three-year-old daughter Harper's health battle after rushing her to hospital as she 'struggled to breathe'. (All pictured)

Karl Stefanovic and his wife Jasmine have revealed their three-year-old daughter Harper's health battle after rushing her to hospital as she 'struggled to breathe'. (All pictured) 

Karl added: 'While Harper fought off the infection, we do worry about the impact of RSV on her long-term health.' 

Karl previously spoke about the terrifying experience on the Today show last year, revealing how Harper had 'the sniffles and a small cough', which led to him and Jasmine taking her to the GP.

But her condition soon deteriorated, with her temperature reaching a dangerous 40C and her heart rate racing to 200bpm.

The couple rushed Harper to hospital last year as she struggled to breathe and she was treated for respiratory syncytial virus (RSV)

The couple rushed Harper to hospital last year as she struggled to breathe and she was treated for respiratory syncytial virus (RSV)

She was then rushed to hospital in an ambulance and diagnosed with RSV, which is common in children in the winter months.

'Two days ago, my daughter Harper had what's she had so many times this year, a sniffle and a small cough,' Karl told viewers at the time.

'Within a few hours we gave her Nurofen and Panadol like advised and put her down for a sleep.

'Initially, Harper had the sniffles and a cough, and we assumed she just had a bit of a cold. But within hours, she deteriorated; it was alarming to see how hard she was working to breathe, with her little ribs sucking in and tummy pulling up into her chest,' Jasmine explained

'Initially, Harper had the sniffles and a cough, and we assumed she just had a bit of a cold. But within hours, she deteriorated; it was alarming to see how hard she was working to breathe, with her little ribs sucking in and tummy pulling up into her chest,' Jasmine explained

'When she woke up she was breathing really quickly, wheezing, and her heart rate and temperature were through the roof.'

RSV - respiratory syncytial virus - is a major cause of lung infections in children and can lead to pneumonia or bronchiolitis, which is particularly dangerous in young infants.

Severe cases can kill babies and toddlers, whose tiny airways have not yet fully formed and who struggle to cope with the infection.

Globally, almost 120,000 children under five die from the disease every year.

Karl previously spoke about the terrifying experience on the Today show last year, revealing how Harper had 'the sniffles and a small cough', which led to him and Jasmine taking her to the GP

Karl previously spoke about the terrifying experience on the Today show last year, revealing how Harper had 'the sniffles and a small cough', which led to him and Jasmine taking her to the GP

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3. Cigars and Pipes: Often romanticized or seen as a symbol of sophistication, cigars and pipes hold no exemption from the perils of tobacco.

4. Jajeer, the traditional hookah of Kashmir, may hold cultural significance, but it harbors significant health risks, particularly for senior citizens. The smoke produced by Jajeer contains toxic chemicals, such as carbon monoxide and cancer-causing substances, which can damage the respiratory system and vital organs.

5. Hookah, also known as shisha or waterpipe, is a deceptive allure of this seemingly harmless pastime. Hookah tobacco poses significant health risks and can have devastating effects on individuals, particularly senior citizens.

6. E-cigarettes, or e-cigs, have gained popularity as an alternative to traditional tobacco smoking. E-cigs contain harmful chemicals that, when heated, produce aerosol or vapor that is inhaled into the lungs. Nicotine, present in most e-cigs, is addictive and can have adverse effects on cardiovascular health.

7. Cigarette filters, commonly made of cellulose acetate, are intended to reduce the intake of harmful substances. However, they can pose health risks. Filters may create a false sense of safety, as they don’t filter out all harmful chemicals.

Quitting smoking entirely is the best way to reduce tobacco-related harm.

 

Harms of Tobacco on Senior Citizens:

1. Compromised Respiratory Health: Senior citizens, with their aging lungs and weakened immune systems, are particularly susceptible to the detrimental effects of tobacco smoke. The inhalation of toxic substances exacerbates respiratory conditions such as asthma and bronchitis, while increasing the likelihood of respiratory infections and pneumonia. The already diminished lung capacity of seniors is further hampered, limiting their ability to engage in physical activities and enjoy a fulfilling quality of life. In most cases, COPD is due to smoking.

2. Cardiovascular Complications: Tobacco consumption significantly heightens the risk of cardiovascular diseases in seniors. Nicotine constricts blood vessels, raising blood pressure and burdening the heart. This, coupled with the detrimental effects of tobacco on cholesterol levels and blood clotting, paves the way for heart attacks, strokes, and other cardiovascular disorders. The toll on the cardiovascular system can be catastrophic for elderly individuals who are already grappling with age-related cardiovascular challenges.

3. Increased Cancer Vulnerability: The link between tobacco and cancer is undeniable, with smoking being the leading cause of preventable cancer deaths worldwide. Senior citizens, with a lifetime of exposure to tobacco toxins, face an elevated risk of developing various types of cancer, including lung, oral, throat, bladder, and pancreatic cancer. For a generation that has already weathered the storms of time, the burden of cancer poses an additional layer of emotional and physical anguish.

4. Impaired Oral Health: Tobacco use takes a toll on the oral health of senior citizens, leading to gum diseases, tooth decay, and tooth loss. The chemicals in tobacco products irritate the gums, making them more susceptible to infection and inflammation. The compromised oral health not only hampers their ability to eat and speak comfortably but also diminishes their overall quality of life and self-esteem.

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CONNECTICUT — Cases of a little-known respiratory illness that is especially dangerous for young children — human metapneumovirus, or HMPV — and mimics the symptoms of other common respiratory diseases spiked this spring in the Northeast, according to Centers for Disease Control and Prevention health data.

A regional breakdown of HMPV cases shows nearly a 50 percent positivity rate among those antigen tested in Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont around the second and third weeks in April. That's up about 25 percent from similar testing done a month earlier.

The symptoms of the lower lung infection include a deep cough, fever, runny nose, sore throat and shortness of breath, which are also symptoms of RSV, influenza and COVID-19. As cases of those illnesses began to subside, HMPV was just getting started in many parts of the country, according to the CDC data.

At the mid-March peak of HMPV, nearly 11 percent of specimen tests nationwide were positive. That’s about 36 percent higher than the average, pre-pandemic seasonal peak of 7 percent HMPV test positivity.

Viruses are responsible for a range of respiratory infections, from the common cold to severe bronchitis and pneumonia. With improvements in molecular testing, more viruses have been detected, including pneumovirus isolated two decades ago by Dutch scientists in children with respiratory illnesses.

Medical experts don’t know the full burden of HMPV because testing is rarely done until the patient has to be hospitalized. Dr. John Williams, a pediatrician at the University of Pittsburgh, told CNN that HMPV cases are at least equal to RSV and influenza.

The CDC recommends that physicians and clinics test for it regularly.

Respiratory infections are the leading cause of death in children under 5 worldwide and a major reason for hospitalizations of young children in developed countries. According to the CDC, HMPV also poses risks for older adults and people with weakened immune systems.

According to a 2020 study in The Lancet Global Health journal, an estimated 14 million children under 5 worldwide had HMPV infections in 2018, resulting in 600,000 hospitalizations and more than 16,000 deaths.

Several pharmaceutical companies are working on vaccines, including COVID-19 vaccine maker Moderna, which just completed a clinical trial testing an mRNA vaccine against HMPV.

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Therapeutic oxygen is an essential component of healthcare systems worldwide. It plays a vital role in ensuring patient safety and saving lives, from emergency rooms to intensive care units. It primarily supports patients who struggle to breathe or have low saturation levels. This article explores the vital role of medical oxygen in healthcare, highlighting its applications and impact on patient outcomes.

Applications in Healthcare

Emergency Medicine:

In emergency medicine, medical-grade oxygen is a critical intervention for patients experiencing life-threatening situations. Medical professionals utilise various delivery devices such as masks or nasal cannulas to provide a high gas concentration and stabilise patients. This helps restore oxygen saturation levels, prevent further organ damage, and improve the chances of survival.

Respiratory Care:

Respiratory conditions such as pneumonia, acute respiratory distress syndrome (ARDS), asthma, or chronic obstructive pulmonary disease (COPD), often require continuous oxygen therapy to manage and alleviate symptoms. Oxygen is administered to these patients through various delivery systems, including concentrators, compressed gas cylinders, or liquid gas systems. Oxygen therapy improves oxygenation levels, reduces respiratory distress, eases breathing difficulties, and enhances the overall quality of life for individuals with chronic respiratory conditions.

Intensive Care Units (ICUs):

In intensive care units, therapeutic oxygen is a cornerstone of patient care. Critically ill patients often have compromised respiratory function and struggle to maintain adequate levels of life-giving gas. Oxygen therapy in ICUs is delivered through advanced systems such as ventilators or high-flow nasal cannulas. These methods ensure precise gas concentration and flow rate control, allowing healthcare professionals to optimise oxygenation levels and support organ function.

Neonatal and Pediatric Care:

Medicinal oxygen plays a crucial role in neonatal and pediatric care. Premature babies or newborns with respiratory distress syndrome often require oxygen support for their underdeveloped lungs. Pediatric patients with bronchopulmonary dysplasia or cystic fibrosis also benefit from oxygen therapy. Specialised delivery systems, such as incubators or oxygen hoods, provide a controlled oxygen-rich environment to support respiratory function and promote healthy growth and development in neonates and children.

The Impact on Patient Outcomes

Oxygenation and Tissue Perfusion:

Adequate oxygenation is essential for maintaining tissue perfusion, which refers to delivering oxygen to vital organs and tissues. Therapeutic oxygen helps increase saturation levels in the blood, ensuring that organs receive the life-giving gas they need to function optimally. Proper tissue perfusion supports organ health and helps prevent organ damage or failure, ultimately improving patient outcomes.

Reduced Mortality Rates:

Timely administration of medical-grade oxygen significantly reduces mortality rates, particularly in respiratory failure or critical illness cases. When patients experience low saturation levels or are unable to maintain adequate oxygenation, their organs can suffer irreversible damage. By promptly addressing its deficiencies through administering clinical oxygen, healthcare professionals can improve patient outcomes and enhance survival rates.

Enhanced Healing and Recovery:

Therapeutic oxygen supports healing in patients recovering from surgical procedures, trauma, or critical illness. It is crucial in cellular metabolism, collagen synthesis, and tissue regeneration. Adequate levels of oxygen facilitate the production of new blood vessels, promote wound healing, and support the body’s natural repair mechanisms. Ensuring optimal oxygenation accelerates healing, reduces the risk of complications, and promotes faster recovery.

Medical oxygen is an invaluable resource in healthcare, playing a crucial role in ensuring patient safety and saving lives. Its applications are far-reaching, from emergency medicine to critical care and chronic respiratory conditions. By understanding the significance of medical-grade oxygen, addressing challenges, and embracing advancements, healthcare systems can provide optimal care, improve patient outcomes, and positively impact countless lives.

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Metapneumovirus causes many of the same symptoms as COVID 19 such as a bad cough, fever and a possible lung infection.

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A mix of respiratory viruses continue to circulate in B.C., such as respiratory syncytial virus and the virus that cause COVID-19.

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But health experts say there’s another virus that may cause similar symptoms as COVID.

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It’s called the human metapneumovirus (HMPV,) and while for most people symptoms will be mild, it can also cause a lung infection, severe cough, sore throat and fever, much like the coronavirus. U.S. health authorities have said that hospitalized cases of HMPV spiked this spring, especially among children, seniors and those with weak immune systems.

But is that happening in B.C.? Here’s what health officials say:

What is human metapneumovirus?

HMPV is a respiratory syncytial virus and most people who are infected experience mild symptoms similar to a cold, according to the Centers for Disease Control and Prevention (CDC). The symptoms last a week, and go away without treatment in healthy individuals. More serious cases can lead to lung infection and severe cough. The CDC says it’s spread through close contact, coughing and sneezing, and is more common in winter and spring.

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It can cause upper and lower respiratory disease in people of all ages, especially young children, older adults and those with weakened immune systems.

HMPV is in the Pneumoviridae family along with respiratory syncytial virus (RSV), and was discovered in 2001, according to the B.C. CDC.

Symptoms include cough, fever, nasal congestion and shortness of breath. Clinical symptoms can progress to bronchitis or pneumonia.

Are there cases of it in B.C.?

Yes.

Since the start of March, 7,990 samples have been tested in B.C., with 510 detections of the virus, according to the B.C. CDC.

The positivity rate in early spring was about 10 per cent and has since declined to below five per cent as of Thursday. The agency said the rates are much lower than COVID.

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How do I treat it?

Currently, there’s no vaccine for HMPV or antiviral drugs so doctors focus on treating the patients’ symptoms. The B.C. CDC says people can help prevent the spread of the virus by washing hands, and avoiding contact with people who are sick.

What should people do if they think they have it?

People who have cold-like symptoms should practise respiratory etiquette (coughing and sneezing into a tissue or your elbow) and wash their hands frequently and properly. They’re asked to stay home from work or school, not to share cups and utensils, and to refrain from kissing.

Those who have difficulty breathing or a severe cough that won’t go away should see a doctor.

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SciCheck Digest

Ventilators can be lifesaving for critically ill COVID-19 patients. A social media claim that a new study shows ventilators killed “nearly all” COVID-19 patients is “quite wrong,” according to the study’s co-author. Ventilator-associated complications can contribute to deaths, but patients are typically put on ventilators when they would otherwise die.


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COVID-19 can cause lung damage and respiratory failure. In patients who are unable to breathe well enough to supply oxygen to their bodies, mechanical ventilators can be lifesaving and give them time to recover. Ventilators help people breathe by pushing air into their lungs via a tube inserted down their windpipe.

Yet, social media posts have shared an article from the People’s Voice with a false headline: “Official Report: Ventilators Killed Nearly ALL COVID Patients.” The People’s Voice, formerly News Punch, frequently publishes articles with false and inflammatory headlines.

The posts misrepresent the conclusions of a study published in April in the Journal of Clinical Investigation. The idea that ventilators — and not COVID-19 — killed nearly all COVID-19 patients is “quite wrong,” study co-author Dr. Benjamin Singer, a pulmonary and critical care physician at Northwestern Medicine, told us.

Rep. Thomas Massie, a Republican from Kentucky, also misrepresented the conclusions of the study, tweeting, “How many COVID patients died due to the use of ventilators? A recent examination of the data suggests quite a few.”

The idea that ventilators are dangerous, and not COVID-19, is a misinterpretation of his data, Singer said. “It’s not the ventilator that was the cause of death,” he said. “The ventilator was very much life support for these patients. It was ultimately COVID-19” that caused the deaths.

Singer’s study looked at 585 people put on ventilators due to respiratory failure between 2018 and 2022 at Northwestern Memorial Hospital. These people primarily had COVID-19 or some other infectious disease, such as another viral or bacterial illness.

Around half of these very sick patients who required mechanical ventilation — people who likely would have died without the intervention — went on to survive their illness. The survival rate was similar whether they had COVID-19 or another disease and was consistent with the survival rate for COVID-19 patients on ventilators found in another, larger study.

Singer’s study explored the degree to which a known ventilator-related complication called ventilator-associated pneumonia contributes to death, finding that the complication is more common in people with COVID-19 and, when unresolved, is linked to death. VAP is usually treated with antibiotics.

People with COVID-19 likely have an elevated risk of VAP because they stay on ventilators for longer-than-average periods. COVID-19 also affects the immune system and damages the surface of the lungs in unique ways, Singer said, which could potentially make the lungs more susceptible to secondary infections.

VAP contributes to death in some COVID-19 and other infectious disease patients, explained Dr. Mark Metersky, a pulmonary and critical care physician and professor at the University of Connecticut School of Medicine who was not involved in the study.

However, virtually all of these patients would have died if they had not been put on a ventilator, he said. “It’s not that the ventilator killed them, the ones who died. It’s that the ventilator failed to save them.”

A related claim in a popular post — that medical professionals put patients on ventilators due to financial incentives — is also unsupported by evidence, as we and other fact-checkers previously explained. It’s standard for hospitals to get more money for patients, such as those on ventilators, who require more care.

Study Explored Ventilator-Related Pneumonia

VAP typically occurs as a form of secondary pneumonia, which means it shows up in patients who already have another pneumonia diagnosis, such as pneumonia resulting from COVID-19, the flu or a bacterial infection.

People are diagnosed with pneumonia when their lungs become swollen with fluid from a respiratory infection. VAP typically arises from bacteria introduced to the lungs via the patient’s breathing tube.

Singer’s new paper finds that once very sick COVID-19 patients are on ventilators, they are at greater risk of VAP compared with other similarly ill pneumonia patients, he said.

Further, the paper found that “whether that ventilator-associated pneumonia was cured or not was a major determinant of whether patients went on to live or die in the ICU,” he said. However, just being diagnosed with VAP was not associated with a higher risk of death.

Based on these conclusions, the People’s Voice article makes a false claim, which was shared widely: “Nearly all COVID-19 patients who died in hospital during the early phase of the pandemic were killed as a direct result of being put on a ventilator, a disturbing new report has concluded.”

First, many hospitalized COVID-19 patients have died who never went on ventilators. And Singer’s study was not limited to “the early phase of the pandemic” but rather went through March 2022.

As we’ve said, this line of thinking is also misleading because it does not make it clear that the patients on ventilators would have typically died without them. It is also untrue that Singer’s study showed that ventilator-related complications killed “nearly all” ventilated patients who died.

The People’s Voice article explains its reasoning by saying that “most patients” put on ventilators because of COVID-19 developed VAP. “So while COVID-19 may have put these patients in the hospital, it was actually a secondary infection brought on by the use of a mechanical ventilator that caused their deaths,” the article says.

In reality, 57% of COVID-19 patients on ventilators in the study developed VAP and a quarter of other ventilated pneumonia patients did. Around half of all patients with VAP died, which was “not significantly different” from the death rate in patients on ventilators who didn’t have VAP, according to the study.

Singer and his colleagues did find that patients whose VAP was not successfully treated were more likely to die than patients whose VAP resolved, indicating a connection between VAP and poor outcomes. The study was not randomized, and the researchers write that they cannot definitively determine that unresolved VAP — and not some other factor associated with it — leads to poor outcomes.

Metersky was skeptical that VAP is that much of a contributor to mortality, pointing to other studies that show a lower rate of VAP in pneumonia patients than was found in Singer’s study.

“Yes, some patients who are put on a ventilator will develop a fatal complication,” Metersky said. “Probably 1 in 100” patients put on a ventilator develop fatal VAP, he said, based on data from before the pandemic. Since about twice as many COVID-19 patients develop VAP compared with other pneumonia patients on ventilators, he said that would indicate that around 2% of people with COVID-19 who go on a ventilator die of VAP.

“But there are other complications,” Metersky said. These can include damage to the lungs from high oxygen and the air pressure from the ventilator or side effects from drugs used to sedate people on ventilators, for instance. “That’s why we don’t put a patient on a ventilator unless they absolutely need it,” he said.

Regardless, “it’s ridiculous to go from that study to say that the ventilators are killing all these people,” Metersky said, referring to the claim that nearly all COVID-19 deaths were caused by ventilators.

Early Ventilation Did Not Cause Mass Deaths

Other false claims, reviewed previously by others, state that overuse of ventilators played a major role in the first wave of COVID-19 deaths.

There were some suggestions very early in the pandemic that doctors should put COVID-19 patients on ventilators earlier than other pneumonia patients, Singer and Metersky both said, out of concern that respiratory failure might progress very quickly. 

This was soon followed by calls for caution in ventilating patients early, and these practices quickly stopped, Singer said. “The standard indications for initiation of mechanical ventilation are really the same as they always have been” for patients with pneumonia, he said, regardless of whether they have COVID-19.

Multiple facts about the early ventilation recommendations are unclear. First, there was no standard definition of what experts meant when recommending “early” ventilation. Decisions on when patients require mechanical ventilation are based on the best judgment of their doctors as they monitor multiple indicators. Doctors want to be sure the ventilator is truly necessary — that the patient is headed toward death from respiratory failure without it. But they also don’t want to wait until the patient has organ damage from lack of oxygen.

Second, it’s unclear how widespread early ventilation was. Singer mentioned that his own recent paper showed that Northwestern Medicine put patients with COVID-19 on ventilators after a similar amount of time in the ICU as other pneumonia patients. Others have pointed out that some doctors at the beginning of the pandemic took measures to avoid putting patients on ventilators due to shortages.

Finally, it’s uncertain what impact early ventilation had on patients. The available research, recently reviewed in a blog post by epidemiologist Gideon Meyerowitz-Katz, a Ph.D. candidate at the University of Wollongong in Australia, indicates that early versus later ventilation did not appreciably affect COVID-19 deaths. For instance, a review study that pooled and analyzed data from multiple studies found that going on a ventilator within a day of entering the ICU versus later had no impact on mortality.

It is possible that people occasionally were put on ventilators who could have avoided them, but this is difficult to quantify.

“There were probably a small number of patients who got put on a ventilator who ultimately might not have needed it,” Metersky said. “As we learned more about the disease, we learned to recognize that some patients may not need the ventilator. But it wasn’t this big conspiracy that we put everyone on the ventilator even though they could have gone home instead.”

Editor’s note: SciCheck’s articles providing accurate health information and correcting health misinformation are made possible by a grant from the Robert Wood Johnson Foundation. The foundation has no control over FactCheck.org’s editorial decisions, and the views expressed in our articles do not necessarily reflect the views of the foundation.

Sources

Pulmonary Manifestations.” COVID-19 Real-Time Learning Network. Updated 22 Feb 2022.

Tobin, Martin and Manthous, Constantine. “Mechanical Ventilation.” American Journal of Respiratory and Critical Care Medicine. Published 15 Jul 2017. Updated April 2020.

Adl-Tabatabai, Sean. “Official Report: Ventilators Killed Nearly ALL COVID Patients.” The People’s Voice. 13 May 2023.

Jones, Brea. “Posts Fabricate Charge Against Bill Gates in Philippines.” FactCheck.org. 10 Mar 2023.

Spencer, Saranac Hale. “Hate Crimes Hotline Headline Is Wrong.” FactCheck.org. 30 Nov 2018.

Yandell, Kate. “Posts Share Fake Chelsea Clinton Quote About Global Childhood Vaccination Effort.” FactCheck.org. 10 May 2023.

Gao, Catherine A. et al. “Machine Learning Links Unresolving Secondary Pneumonia to Mortality in Patients with Severe Pneumonia, Including COVID-19.” The Journal of Clinical Investigation. 27 Apr 2023.

Massie, Thomas (@RepThomasMassie). “How many COVID patients died due to the use of ventilators? A recent examination of the data suggests quite a few. ‘The investigators found nearly half of patients with COVID-19 develop a secondary ventilator-associated bacterial pneumonia.’” Twitter. 15 May 2023.

Nolan, Margaret B. et al. “Mortality Rates by Age Group and Intubation Status in Hospitalized Adult Patients From 21 United States Hospital Systems During Three Surges of the COVID-19 Pandemic.” Chest. 29 Jan 2023.

Frequently Asked Questions about Ventilator-Associated Pneumonia.” CDC website. Updated 9 May 2019.

Adele – Conspiracy Queen ???? (@truth.bomb.mom). “Such a bummer that this happened ????.” Instagram. 21 May 2023.

Fichera, Angelo. “Hospital Payments and the COVID-19 Death Count.” FactCheck.org. 21 Apr 2020.

Kertscher, Tom. “Fact-Check: Hospitals and COVID-19 Payments.” PolitiFact. 21 Apr 2020.

Pneumonia – Causes and Risk Factors.” NIH website. Updated 24 March 2022.

Pneumonia – What Is Pneumonia?” NIH website. Updated 24 Mar 2022.

Kohbodi, GoleNaz A. et al. “Ventilator-Associated Pneumonia.” Updated 10 Sep 2022.

Metersky, Mark L. et al. “Trend in Ventilator-Associated Pneumonia Rates Between 2005 and 2013.” JAMA. 13 Dec 2016.

Melsen, Wilhelmina G., et al. “Attributable Mortality of Ventilator-Associated Pneumonia: A Meta-Analysis of Individual Patient Data from Randomised Prevention Studies.” Lancet Infectious Diseases. 25 Apr 2013.

Metersky, Mark L. et al. “Temporal Trends in Postoperative and Ventilator-Associated Pneumonia in the United States.” Infection Control and Hospital Epidemiology. 3 Nov 2022.

Meyerowitz-Katz, Gideon. “Did Ventilators Kill People During COVID-19?” Medium. 25 May 2023.

Howard, Jonathan. “Intubations and Accusations: Doctors Were ‘Just Going Crazy, and Intubating People Who Did Not Have to Be Intubated.’” Science-Based Medicine. 19 Sep 2021.

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Marino, Ryan (@RyanMarino). “And -anecdotally- I was treating COVID patients in 2020. It was bleak and terrifying. They were incredibly sick and we actually did not have enough ventilators as we needed for this disease. I still remember the panicky feeling of using every possible attempt to avoid intubation.” Twitter. 15 May 2023.

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ACROSS AMERICA — Cases of a little-known respiratory illness that is especially dangerous for young children — human metapneumovirus, or HMPV — and mimics the symptoms of other common respiratory diseases spiked this spring, according to Centers for Disease Control and Prevention health data.

The symptoms of the lower lung infection include a deep cough, fever, runny nose, sore throat and shortness of breath, which are also symptoms of RSV, influenza and COVID-19. As cases of those illnesses began to subside, HMPV was just getting started in many parts of the country, according to the CDC data.

At the mid-March peak of HMPV, nearly 11 percent of specimen tests nationwide were positive. That’s about 36 percent higher than the average, pre-pandemic seasonal peak of 7 percent HMPV test positivity.

Viruses are responsible for a range of respiratory infections from the common cold to severe bronchitis and pneumonia. With improvements in molecular testing, more viruses have been detected, including pneumovirus isolated two decades ago by Dutch scientists in children with respiratory illnesses.

Medical experts don’t know the full burden of HMPV because testing is rarely done until the patient has to be hospitalized. Dr. John Williams, a pediatrician at the University of Pittsburgh, told CNN that HMPV cases are at least equal to RSV and influenza.

The CDC recommends that physicians and clinics test for it regularly.

Respiratory infections are the leading cause of death in children under 5 worldwide and a major reason for hospitalizations of young children in developed countries. According to the CDC, HMPV also poses risks for older adults and people with weakened immune systems.

According to a 2020 study in The Lancelot Global Health journal, an estimated 14 million children under 5 worldwide had HMPV infections in 2018, resulting in 600,000 hospitalizations and more than 16,000 deaths.

Several pharmaceutical companies are working on vaccines, including COVID-19 vaccine maker Moderna, which just completed a clinical trial testing an mRNA vaccine against HMPV.

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Of Edward Simonetta

It is a chronic respiratory disease characterized by the finding, on chest CT scans (computed tomography), of dilatation of the bronchi and by daily symptoms such as cough, tiredness, shortness of breath

My father was diagnosed with bronchiectasis: what are they?
and how are they treated?

He answers Edward Simonettareferent for the Bronchiectasis Program, Pulmonary Unit, Humanitas Institute, Milan

Bronchiectasis is a chronic respiratory disease characterized by the finding, on chest CT scan (computed tomography), of bronchial dilatation and from everyday symptoms such as cough, tiredness, shortness of breath, profuse production of phlegm and sometimes the presence of blood in the sputum. Patients with bronchiectasis may present
recurrent bronchitis or pneumonia
, which often require antibiotic treatment. The symptoms and frequency of bronchitis vary from case to case, so the impact of this disease on the quality of life is extremely heterogeneous.

In Italy there are more and more patients suffering from bronchiectasis, with an estimated prevalence of one person affected every 2,000 adults. In the presence of bronchiectasis, it is necessary to carry out various blood and instrumental tests to identify the cause, however, in about half of the patients, it is not possible to trace the etiology of the disease. Bronchiectasis can develop as a result of many conditions, including previous lung infections, immune deficiencies, and genetic disorders (such as cystic fibrosis) or they can be associated with pathologies such as chronic bronchitis from smoking, asthma, gastroesophageal reflux, rheumatoid arthritis, inflammatory bowel disease or other rarer causes. The natural history of bronchiectasis disease is characterized by a vicious circle, with a succession of bronchial infections of various kinds (bacterial, fungal or viral), inflammation of the bronchi, reduction of the defenses of the airways and consequently greater susceptibility to new infections.

The reduction of the defenses of the airways, the repeated respiratory infections and the frequent use of antibiotics facilitate the onset of chronic bacterial infections in the lungs, also due to multiresistant bacteria that are difficult to treat with common antibiotics. The clinical management of patients with joint bronchiectasis requires a specialist pulmonary evaluation and in the most complex cases it is necessary to have access to structures that have multidisciplinary groups dedicated to the treatment of pathology. We need an individualization of the treatment on a case-by-case basis, with paths of Respiratory physiotherapy and close clinical and microbiological monitoring to reduce symptoms, prevent episodes of bronchitis and improve patients’ quality of life.

June 2, 2023 (change June 2, 2023 | 07:00)



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Patients who use inhaled corticosteroids (ICS) to treat chronic obstructive pulmonary disease (COPD) have higher rates of tuberculosis and pneumonia than those who do not use ICS, according to study findings published in the International Journal of Chronic Obstructive Pulmonary Disease.

Tuberculosis and pneumonia are recognized as serious side effects of ICS in patients with COPD, yet overprescription of ICS appears common for this population. Investigators in South Korea sought to examine the real-world impact of ICS on COPD prognosis. Mortality, acute exacerbations, and pneumonia were primary endpoints. Secondary endpoints were heart failure, arrhythmia, hypertension, diabetes mellitus, osteoporosis, lung cancer, cerebrovascular stroke, ischemic heart disease, and tuberculosis were secondary endpoints.

The researchers conducted a retrospective observational study using the Korean National Health and Nutrition Examination Survey (KNHANES) database (including survey data from about 10,000 individuals each year) linked to Health Insurance and Review Assessment (HIRA) data (comprehensive health-care treatments, procedures, pharmaceuticals, and diagnoses for about 50 million beneficiaries in South Korea). The current study included data on 978 patients (4.1% women) with COPD from January 2009 through December 2012; based on their ICS use status, these patients were assigned to the ICS cohort (n=85; mean [SD] age, 66.7 [8.9] years) or the non-ICS cohort (n=893; mean age, 63.7 [9.7] years). The 85 eligible patients using ICS all had a prescription for inhaled respiratory medication for at least 120 days during the observation period (ICS, 13 patients; ICS/long-acting beta-agonists [LABA], 42 patients; ICS/LABA/long-acting muscarinic antagonist [LAMA], 30 patients).

All participants smoked currently or formerly, had a 10 pack-year smoking history with no history of cancer, had a pre-bronchodilator ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) less than 0.7, and were at least 40 years of age. Cox proportional hazard regression analysis was used to identify variables significantly associated with the occurrence of mortality, acute exacerbation, and pneumonia development.

Our data demonstrated that the ICS users had a higher rate of pneumonia and tuberculosis and the concomitant pneumonia was independently associated with higher mortality, highlighting the importance of cautious and targeted administration of ICS in COPD.

At study enrollment, common comorbidities included hypertension (33.2%), diabetes mellitus (12.2%), and hypercholesterolemia (6.5%), and those using ICS had lower FEV1, lower FEV1/FVC ratio, and higher smoking levels than those who did not use ICS upon enrollment.

In comparing the ICS and non-ICS cohorts, the researchers found the ICS cohort had higher rates of acute exacerbations, tuberculosis, and pneumonia as well as hospitalization due to respiratory causes (all P <.05).  Multivariate analyses further showed that: (1) acute COPD exacerbations were independently associated with the development of pneumonia (P <.05); (2) pneumonia, ICS therapy, FEV1, and older age were independently associated with acute exacerbation occurrence (P <.05); (3) concomitant pneumonia (hazard ratio, 3.353; P =.004) was independently associated with higher mortality (P <.05); and (4) mortality rates did not differ between patients who used ICS vs those who did not.

Study limitations include the underpowered sample size of patients using ICS and the fact that the observation period for this study occurred prior to implementation of current therapeutic standards for COPD.

“Our data demonstrated that the ICS users had a higher rate of pneumonia and tuberculosis and the concomitant pneumonia was independently associated with higher mortality, highlighting the importance of cautious and targeted administration of ICS in COPD,” investigators concluded. They wrote “The number of subjects enrolled in our study is not big enough to conclude the harmful side effects of ICS in subgroups of COPD.”

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Sepsis is a severe inflammatory response to infection. Infections of the lungs (such as pneumonia), bladder, digestive system or kidney are common precipitating factors. According to the Centers for Disease Control (CDC), more than 1.7 million adults develop sepsis each year in the United States — which equates to a diagnosis every 20 seconds.

It is the most common cause of death in hospitals, with one in three hospital patients dying due to sepsis. Let’s take a look at this serious health crisis and learn how to recognize it before it is too late.

Is Sepsis Contagious?

Sepsis itself is not contagious. However, some of the underlying infections that cause sepsis can be contagious. Most of them are bacterial, although there are also some viral and fungal infections that can lead to sepsis.

Because sepsis is a chain reaction immune response throughout the body, certain people are more susceptible to it during the time they are fighting an infection. 

Recognizing Sepsis

The risk factors that increase the likelihood of developing sepsis include having a weakened immune system, being over 65 or under age 1, having undergone recent antibiotic treatment, taking corticosteroids, the use of catheters or breathing tubes, certain chronic diseases (kidney disease, COPD and diabetes) and being in an ICU. 

An acronym that is used to recognize sepsis is TIME: temperature change, infection, mental status change and extremely ill.

Mild sepsis is largely survivable when identified quickly and treated with antibiotics and fluids. Many people make a full recovery from mild sepsis, but it takes an average of 3 to 10 days. In cases of severe sepsis, critical care treatments can last a month or longer. 


Read More: The History of the Polio Vaccine


The Stages of Sepsis

There are three stages of sepsis. Although it is possible for sepsis to start slowly, more often than not, it will progress quickly. In fact, it is possible for the progression from infection to septic shock to occur in less than 24 hours. The stages of sepsis are as follows: 

1. Sepsis

Stage one is referred to as Systematic Inflammatory Response Syndrome (SIRS). While it may be difficult to recognize, if two out of the three factors below are present, a sepsis diagnosis may be considered.

  • Body temperature of greater than 100.4 degrees F or less than 96.8 degrees F

  • Heart rate faster than 90 beats per minute

  • Breathing rate of more than 20 breaths per minute

  • Suspected or confirmed infection (based on white blood cell count)

2. Severe Sepsis

In the second stage, severe sepsis impacts the organs. It can affect any organ, including kidneys, lungs, liver or heart. Acute respiratory distress syndrome (ARDS) can develop during this stage.

  • Abnormal heartbeat

  • Difficulty breathing

  • Abnormal pain

3. Septic Shock

Septic Shock is the most serious form of sepsis and includes the presence of dangerously low blood pressure, despite intravenous fluid replacement. Symptoms also include: 


Read More: What Would Happen If We Didn’t Have Vaccines?


Life Expectancy After Sepsis

Sepsis is a serious, life-threatening condition, particularly when it has progressed to septic shock. Statistics vary regarding survival rates, but the earlier sepsis is identified and treated, the greater chance for survival.

There are people who survive septic shock, but survival rates are lower for the elderly. Among those who survive septic shock, recovery is difficult, and symptoms can persist for months or years. 

Septic patients are treated in the ICU, and that can lead to post-intensive care syndrome, known as PICS. These patients’ lives are altered by ongoing physical, cognitive and emotional issues — including delirium.

Treating Sepsis

Critical care expert Dr. Wes Ely of Vanderbilt University developed a groundbreaking approach to reducing ICU patient harm that has been adopted by hospitals worldwide. He considers ICU (sepsis patients) related delirium a public health crisis in need of greater attention.

It is possible to make a full recovery after severe sepsis. However, the best way to prevent the development of sepsis to septic shock is early recognition of symptoms and prompt treatment.


Read More: Could You Spot the Signs of a Stroke?


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SciCheck Digest

Ventilators can be lifesaving for critically ill COVID-19 patients. A social media claim that a new study shows ventilators killed “nearly all” COVID-19 patients is “quite wrong,” according to the study’s co-author. Ventilator-associated complications can contribute to deaths, but patients are typically put on ventilators when they would otherwise die.


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COVID-19 can cause lung damage and respiratory failure. In patients who are unable to breathe well enough to supply oxygen to their bodies, mechanical ventilators can be lifesaving and give them time to recover. Ventilators help people breathe by pushing air into their lungs via a tube inserted down their windpipe.

Yet, social media posts have shared an article from the People’s Voice with a false headline: “Official Report: Ventilators Killed Nearly ALL COVID Patients.” The People’s Voice, formerly News Punch, frequently publishes articles with false and inflammatory headlines.

The posts misrepresent the conclusions of a study published in April in the Journal of Clinical Investigation. The idea that ventilators — and not COVID-19 — killed nearly all COVID-19 patients is “quite wrong,” study co-author Dr. Benjamin Singer, a pulmonary and critical care physician at Northwestern Medicine, told us.

Rep. Thomas Massie, a Republican from Kentucky, also misrepresented the conclusions of the study, tweeting, “How many COVID patients died due to the use of ventilators? A recent examination of the data suggests quite a few.”

The idea that ventilators are dangerous, and not COVID-19, is a misinterpretation of his data, Singer said. “It’s not the ventilator that was the cause of death,” he said. “The ventilator was very much life support for these patients. It was ultimately COVID-19” that caused the deaths.

Singer’s study looked at 585 people put on ventilators due to respiratory failure between 2018 and 2022 at Northwestern Memorial Hospital. These people primarily had COVID-19 or some other infectious disease, such as another viral or bacterial illness.

Around half of these very sick patients who required mechanical ventilation — people who likely would have died without the intervention — went on to survive their illness. The survival rate was similar whether they had COVID-19 or another disease and was consistent with the survival rate for COVID-19 patients on ventilators found in another, larger study.

Singer’s study explored the degree to which a known ventilator-related complication called ventilator-associated pneumonia contributes to death, finding that the complication is more common in people with COVID-19 and, when unresolved, is linked to death. VAP is usually treated with antibiotics.

People with COVID-19 likely have an elevated risk of VAP because they stay on ventilators for longer-than-average periods. COVID-19 also affects the immune system and damages the surface of the lungs in unique ways, Singer said, which could potentially make the lungs more susceptible to secondary infections.

VAP contributes to death in some COVID-19 and other infectious disease patients, explained Dr. Mark Metersky, a pulmonary and critical care physician and professor at the University of Connecticut School of Medicine who was not involved in the study.

However, virtually all of these patients would have died if they had not been put on a ventilator, he said. “It’s not that the ventilator killed them, the ones who died. It’s that the ventilator failed to save them.”

A related claim in a popular post — that medical professionals put patients on ventilators due to financial incentives — is also unsupported by evidence, as we and other fact-checkers previously explained. It’s standard for hospitals to get more money for patients, such as those on ventilators, who require more care.

Study Explored Ventilator-Related Pneumonia

VAP typically occurs as a form of secondary pneumonia, which means it shows up in patients who already have another pneumonia diagnosis, such as pneumonia resulting from COVID-19, the flu or a bacterial infection.

People are diagnosed with pneumonia when their lungs become swollen with fluid from a respiratory infection. VAP typically arises from bacteria introduced to the lungs via the patient’s breathing tube.

Singer’s new paper finds that once very sick COVID-19 patients are on ventilators, they are at greater risk of VAP compared with other similarly ill pneumonia patients, he said.

Further, the paper found that “whether that ventilator-associated pneumonia was cured or not was a major determinant of whether patients went on to live or die in the ICU,” he said. However, just being diagnosed with VAP was not associated with a higher risk of death.

Based on these conclusions, the People’s Voice article makes a false claim, which was shared widely: “Nearly all COVID-19 patients who died in hospital during the early phase of the pandemic were killed as a direct result of being put on a ventilator, a disturbing new report has concluded.”

First, many hospitalized COVID-19 patients have died who never went on ventilators. And Singer’s study was not limited to “the early phase of the pandemic” but rather went through March 2022.

As we’ve said, this line of thinking is also misleading because it does not make it clear that the patients on ventilators would have typically died without them. It is also untrue that Singer’s study showed that ventilator-related complications killed “nearly all” ventilated patients who died.

The People’s Voice article explains its reasoning by saying that “most patients” put on ventilators because of COVID-19 developed VAP. “So while COVID-19 may have put these patients in the hospital, it was actually a secondary infection brought on by the use of a mechanical ventilator that caused their deaths,” the article says.

In reality, 57% of COVID-19 patients on ventilators in the study developed VAP and a quarter of other ventilated pneumonia patients did. Around half of all patients with VAP died, which was “not significantly different” from the death rate in patients on ventilators who didn’t have VAP, according to the study.

Singer and his colleagues did find that patients whose VAP was not successfully treated were more likely to die than patients whose VAP resolved, indicating a connection between VAP and poor outcomes. The study was not randomized, and the researchers write that they cannot definitively determine that unresolved VAP — and not some other factor associated with it — leads to poor outcomes.

Metersky was skeptical that VAP is that much of a contributor to mortality, pointing to other studies that show a lower rate of VAP in pneumonia patients than was found in Singer’s study.

“Yes, some patients who are put on a ventilator will develop a fatal complication,” Metersky said. “Probably 1 in 100” patients put on a ventilator develop fatal VAP, he said, based on data from before the pandemic. Since about twice as many COVID-19 patients develop VAP compared with other pneumonia patients on ventilators, he said that would indicate that around 2% of people with COVID-19 who go on a ventilator die of VAP.

“But there are other complications,” Metersky said. These can include damage to the lungs from high oxygen and the air pressure from the ventilator or side effects from drugs used to sedate people on ventilators, for instance. “That’s why we don’t put a patient on a ventilator unless they absolutely need it,” he said.

Regardless, “it’s ridiculous to go from that study to say that the ventilators are killing all these people,” Metersky said, referring to the claim that nearly all COVID-19 deaths were caused by ventilators.

Early Ventilation Did Not Cause Mass Deaths

Other false claims, reviewed previously by others, state that overuse of ventilators played a major role in the first wave of COVID-19 deaths.

There were some suggestions very early in the pandemic that doctors should put COVID-19 patients on ventilators earlier than other pneumonia patients, Singer and Metersky both said, out of concern that respiratory failure might progress very quickly. 

This was soon followed by calls for caution in ventilating patients early, and these practices quickly stopped, Singer said. “The standard indications for initiation of mechanical ventilation are really the same as they always have been” for patients with pneumonia, he said, regardless of whether they have COVID-19.

Multiple facts about the early ventilation recommendations are unclear. First, there was no standard definition of what experts meant when recommending “early” ventilation. Decisions on when patients require mechanical ventilation are based on the best judgment of their doctors as they monitor multiple indicators. Doctors want to be sure the ventilator is truly necessary — that the patient is headed toward death from respiratory failure without it. But they also don’t want to wait until the patient has organ damage from lack of oxygen.

Second, it’s unclear how widespread early ventilation was. Singer mentioned that his own recent paper showed that Northwestern Medicine put patients with COVID-19 on ventilators after a similar amount of time in the ICU as other pneumonia patients. Others have pointed out that some doctors at the beginning of the pandemic took measures to avoid putting patients on ventilators due to shortages.

Finally, it’s uncertain what impact early ventilation had on patients. The available research, recently reviewed in a blog post by epidemiologist Gideon Meyerowitz-Katz, a Ph.D. candidate at the University of Wollongong in Australia, indicates that early versus later ventilation did not appreciably affect COVID-19 deaths. For instance, a review study that pooled and analyzed data from multiple studies found that going on a ventilator within a day of entering the ICU versus later had no impact on mortality.

It is possible that people occasionally were put on ventilators who could have avoided them, but this is difficult to quantify.

“There were probably a small number of patients who got put on a ventilator who ultimately might not have needed it,” Metersky said. “As we learned more about the disease, we learned to recognize that some patients may not need the ventilator. But it wasn’t this big conspiracy that we put everyone on the ventilator even though they could have gone home instead.”

Editor’s note: SciCheck’s articles providing accurate health information and correcting health misinformation are made possible by a grant from the Robert Wood Johnson Foundation. The foundation has no control over FactCheck.org’s editorial decisions, and the views expressed in our articles do not necessarily reflect the views of the foundation.

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Tobin, Martin and Manthous, Constantine. “Mechanical Ventilation.” American Journal of Respiratory and Critical Care Medicine. Published 15 Jul 2017. Updated April 2020.

Adl-Tabatabai, Sean. “Official Report: Ventilators Killed Nearly ALL COVID Patients.” The People’s Voice. 13 May 2023.

Jones, Brea. “Posts Fabricate Charge Against Bill Gates in Philippines.” FactCheck.org. 10 Mar 2023.

Spencer, Saranac Hale. “Hate Crimes Hotline Headline Is Wrong.” FactCheck.org. 30 Nov 2018.

Yandell, Kate. “Posts Share Fake Chelsea Clinton Quote About Global Childhood Vaccination Effort.” FactCheck.org. 10 May 2023.

Gao, Catherine A. et al. “Machine Learning Links Unresolving Secondary Pneumonia to Mortality in Patients with Severe Pneumonia, Including COVID-19.” The Journal of Clinical Investigation. 27 Apr 2023.

Massie, Thomas (@RepThomasMassie). “How many COVID patients died due to the use of ventilators? A recent examination of the data suggests quite a few. ‘The investigators found nearly half of patients with COVID-19 develop a secondary ventilator-associated bacterial pneumonia.’” Twitter. 15 May 2023.

Nolan, Margaret B. et al. “Mortality Rates by Age Group and Intubation Status in Hospitalized Adult Patients From 21 United States Hospital Systems During Three Surges of the COVID-19 Pandemic.” Chest. 29 Jan 2023.

“Frequently Asked Questions about Ventilator-Associated Pneumonia.” CDC website. Updated 9 May 2019.

Adele – Conspiracy Queen ???? (@truth.bomb.mom). “Such a bummer that this happened ????.” Instagram. 21 May 2023.

Fichera, Angelo. “Hospital Payments and the COVID-19 Death Count.” FactCheck.org. 21 Apr 2020.

Kertscher, Tom. “Fact-Check: Hospitals and COVID-19 Payments.” PolitiFact. 21 Apr 2020.

“Pneumonia – Causes and Risk Factors.” NIH website. Updated 24 March 2022.

“Pneumonia – What Is Pneumonia?” NIH website. Updated 24 Mar 2022.

Kohbodi, GoleNaz A. et al. “Ventilator-Associated Pneumonia.” Updated 10 Sep 2022.

Metersky, Mark L. et al. “Trend in Ventilator-Associated Pneumonia Rates Between 2005 and 2013.” JAMA. 13 Dec 2016.

Melsen, Wilhelmina G., et al. “Attributable Mortality of Ventilator-Associated Pneumonia: A Meta-Analysis of Individual Patient Data from Randomised Prevention Studies.” Lancet Infectious Diseases. 25 Apr 2013.

Metersky, Mark L. et al. “Temporal Trends in Postoperative and Ventilator-Associated Pneumonia in the United States.” Infection Control and Hospital Epidemiology. 3 Nov 2022.

Meyerowitz-Katz, Gideon. “Did Ventilators Kill People During COVID-19?” Medium. 25 May 2023.

Howard, Jonathan. “Intubations and Accusations: Doctors Were ‘Just Going Crazy, and Intubating People Who Did Not Have to Be Intubated.’” Science-Based Medicine. 19 Sep 2021.

Tobin, Martin J. et al. “Caution about Early Intubation and Mechanical Ventilation in COVID-19.” Annals of Intensive Care. 9 Jun 2020.

Anesi, George L. “COVID-19: Respiratory care of the nonintubated hypoxemic adult (supplemental oxygen, noninvasive ventilation, and intubation).” UpToDate. Updated 22 May 2023.

Marino, Ryan (@RyanMarino). “And -anecdotally- I was treating COVID patients in 2020. It was bleak and terrifying. They were incredibly sick and we actually did not have enough ventilators as we needed for this disease. I still remember the panicky feeling of using every possible attempt to avoid intubation.” Twitter. 15 May 2023.

Mansfield, Erin. “As the Coronavirus Curve Flattened, Even Hard-Hit New York Had Enough Ventilators.” USA Today. 28 Apr 2020.

Papoutsi, Eleni et al. “Effect of Timing of Intubation on Clinical Outcomes of Critically Ill Patients with COVID-19: A Systematic Review and Meta-Analysis of Non-Randomized Cohort Studies.” Critical Care. 25 Mar 2021.



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Have you been sick in the last few months? I’m talking about a really nasty upper respiratory tract infection. Symptoms include sore throat, stuffy nose, fever and a horrible hacking cough! If that sounds like a typical cold, I am here to tell you that it’s much worse. I speak with some authority because I am pretty sure I caught this virus around mid-March. That’s when human metapneumovirus (aka HMPV) was spreading like crazy.

Human Metapneumovirus (HMPV)

The CNN headline (May 29, 2023) about HMPV caught our attention:

Doctors say this is the most important virus you’ve never heard of

We had never heard of HMPV, but it certainly sounded like what hit our family. We had all traveled to Longmont, Colorado, for a memorial service. Everyone tested for COVID before leaving home and again when we arrived in Colorado. We also tested when we got back home several days later.

One person came from Portland, Oregon and was sniffling and coughing. She was negative for COVID, several times. But within a few days of returning home, almost everyone was sick with a really nasty upper respiratory tract infection. We all tested again, and again we were all negative for COVID-19.

Most of us were coughing up a storm. And the cough persisted for weeks. It took me almost two months to fully get over the lung infection. That makes me think that we caught human metapneumovirus!

HMPV Spiked In Mid March!

Here is a link to the CDC’s human metapneumovirus (hMPV) data for the US. It comes from The National Respiratory and Enteric Virus Surveillance System (NREVSS).

If you look at the graph you will see that cases of HMPV started showing up in January, 2023. They peaked in March and were starting to decline towards the end of April. Those dates certainly corresponded to our upper respiratory tract infections.

What Is HMPV Anyway?

According to the CDC:

“Human metapneumovirus (HMPV) can cause upper and lower respiratory disease in people of all ages, especially among young children, older adults, and people with weakened immune systems. Discovered in 2001, HMPV is in the Pneumoviridae family along with respiratory syncytial virus (RSV).”

What jumps out for me is that this virus was only “discovered” in 2001 by Dutch researchers. That means a lot of healthcare providers probably never learned about it in school. It has almost assuredly been making people sick for many decades, though.

Although the symptoms are similar to the common cold, there is nothing common about HMPV. This virus is within the Paramyxoviridae family. It is a major cause of respiratory infections in humans, but it has flown under the radar for a long time. I’ll bet you never heard of HMPV before either.

The CDC describes symptoms this way:

“Symptoms commonly associated with HMPV include cough, fever, nasal congestion, and shortness of breath. Clinical symptoms of HMPV infection may progress to bronchitis or pneumonia and are similar to other viruses that cause upper and lower respiratory infections. The estimated incubation period is 3 to 6 days, and the median duration of illness can vary depending upon severity but is similar to other respiratory infections caused by viruses.”

That certainly describes our experience. Our family came down with this “bug” within about 3 to 6 days of exposure. And it was a lot worse than the “common cold.” For most people, it acts like a horrible cold, but for the very young and the very old, it can be deadly.

There are no easy tests for HMPV, no vaccinations and no treatments.

The CDC offers the standard recommendations for any viral infection. It tells doctors to advise patients to follow these steps:

  • Wash their hands often with soap and water for at least 20 seconds (see CDC’s Clean Hands Save Lives!).
  • Avoid touching their eyes, nose, or mouth with unwashed hands.
  • Avoid close contact with people who are sick.

That’s pretty much what the CDC told us at the start of the COVID pandemic. How well did that work?

Can You Avoid Catching HMPV?

Let’s be honest, we do not have good strategies to prevent virus-related upper respiratory tract infections. All the experts we have consulted over the last few years point out that viruses like SARS-CoV-2 float through the air. Plexiglass barriers and six feet of distance will not protect you from all of them.

Just imagine someone smoking a cigar in a supermarket or a bank. I know that is hard to visualize these days, but humor me. If you can see smoke or even smell it, chances are pretty good you are breathing in particles that are comparable to viruses.

Dr. Linsey Marr is one of the world’s leading experts on viral transmission and air quality. We have interviewed her a couple of times on our nationally syndicated public radio show. Here is a link to Show 1253: The Lessons of COVID-19 on How to Avoid Airborne Viral Transmission. You can listen to the streaming audio by clicking on the arrow inside the green circle below Dr. Marr’s photo. It is well worth a few minutes of your time.

Final Words:

You hear a lot from the CDC about upper respiratory tract infections such as influenza and respiratory syncytial virus (RSV). By the way, the FDA recently announced (May 3, 2023) that it approved an RSV vaccine (Arexvy). On May 31, 2023 Pfizer announced that it too had received approval to sell an RSV vaccine (Abrysvo). These vaccines have the green light for “individuals 60 years and older.”

You will no doubt be encouraged to get a flu shot this coming fall and, if you are over 60, an RSV vaccination. No one will say much, if anything, about HMPV. And yet it probably causes as much illness as influenza or RSV (Viruses, Jan. 2013).

Did you catch a nasty upper respiratory tract infection in the last few months? If so, please share your experience in the comment section below. If you had a cough, please describe it so that other readers will have some sense of what it was like.

Please share this article with friends and family so that they too will learn about HMSV. It’s easy. Just scroll to the top of the page and click on the icons for email, Twitter or Facebook. You can also encourage your contacts to subscribe to our free newsletter at this link. Thank you for supporting The People’s Pharmacy.

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