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Niticia Mpanga, a registered respiratory therapist, checks on an ICU patient at Oakbend Medical Center in Richmond, Texas. The mortality rates from COVID-19 in ICUs have been decreasing worldwide, doctors say, at least partly because of recent advances in treatment.
Mark Felix/AFP via Getty Images
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Mark Felix/AFP via Getty Images
Niticia Mpanga, a registered respiratory therapist, checks on an ICU patient at Oakbend Medical Center in Richmond, Texas. The mortality rates from COVID-19 in ICUs have been decreasing worldwide, doctors say, at least partly because of recent advances in treatment.
Mark Felix/AFP via Getty Images
If you think all the coronavirus news is bad, consider the uplifting story of Don Ramsayer.
The 59-year-old man from Cumming, Ga., is living evidence that doctors in intensive care units quickly figured out how to help more patients survive.
In early August, Ramsayer was helping his son pack up the car for his freshman year at The Citadel, the Military College of South Carolina. Ramsayer had been having night sweats and wasn’t feeling that well, but he tried to play it down.
“We got the last box packed and it was ready to go in the car, and I finally succumbed to my sister and kids, who said ‘Dad, something’s wrong. Go to the hospital.'”
Ramsayer, a software designer and self-described gym rat, had been diagnosed in November with a slow-moving form of leukemia. But the doctors at Emory Johns Creek Hospital, northeast of Atlanta, ran a few tests and concluded that his new symptoms were actually from COVID-19.
He was admitted to the hospital and got sicker and sicker over the weekend. Ramsayer recalls the doctors phoned his sister and told her to prepare for the worst, “because they did not think I was going to make it.”
As his health declined, doctors “basically threw everything in the kitchen sink at me,” he says. “Almost like Sherlock Holmes. ‘What can we try here? What can we try there to get in front of these things?’ “
Doctors gave him a newly available antiviral drug, remdesivir, as well as an experimental treatment called convalescent plasma. That involves transfusions of blood plasma from people who have recovered from COVID-19 and carry antibodies that might help fight the virus.
He also ended up on a ventilator for nine days, under heavy sedation.
Don Ramsayer and his sister Melanie Ramsayer speak over FaceTime on August 30. He’d been off the ventilator for 10 days and was finally recovered enough from COVID-19 to be moved out of the ICU.
Don and Melanie Ramsayer
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Don and Melanie Ramsayer
Ramsayer himself rather unexpectedly ended that phase of his treatment.
“Somehow I got out of the straps,” he says in an interview from his hospital bed. “I completely unhooked myself … and pulled the breathing tube out. And here’s the really funny thing. I’m obviously pretty doped up. They had me on all kinds of stuff and how I was even conscious, they aren’t even sure of that. The first thing I do is I say, ‘Can I have a Coke?’ “
He says doctors at first considered reinserting the breathing tube, but they saw he could breathe on this own well enough.
“I continued to improve from that point forward,” he says.
Ramsayer’s story is remarkable, considering his cancer and the complications of his case. But this story is far from unique.
“We have very much replicated what’s been seen worldwide, which is over time the mortality in ICUs have decreased,” says Dr. Craig Coopersmith, director of the Emory Critical Care Center. He oversees ICUs at five hospitals in the Emory system, including Johns Creek.
The decline in mortality related to COVID-19 varies month to month. At Emory it has been in the range of 20% to 50%. Coopersmith says there are lots of reasons for that.
A big one is that, when the first wave of Covid-19 hit Atlanta’s hospitals in April, doctors had no experience with the disease. Medical management of these patients is now, by comparison, routine.
“There’s certainly nothing routine about the pandemic,” Coopersmith says, “but in terms of how we’re managing it, once you have taken care of something for the tenth time, it is normal.”
Doctors can better handle common and serious complications like blood clots. They realized that patients do better if they aren’t lying on their backs all the time. Patients in Emory hospitals are encouraged to spend some time lying on their stomachs. That simple effort sometimes is enough to keep them out of the intensive-care unit.
A poster filled with photographs in Don Ramsayer’s hospital room — a reminder of those at home cheering him on.
Don and Melanie Ramsayer
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Don and Melanie Ramsayer
Ramsayer found it uncomfortable to sleep on his stomach — he says he has a couple of blown disks as a result of his days as a powerlifter — but he did sleep on his side when he could.
And while no medicine can cure COVID-19, a series of studies showed that steroids can benefit the sickest patients.
Emory, like many medical centers, had not been using steroids such as dexamethasone routinely to treat COVID-19 until a major study from the United Kingdom showed that these drugs reduce the risk of death among seriously ill patients.
“So that’s a tremendous success story,” Coopersmith says. “In just a few months we have a drug which is easily available everywhere and quite cheap, and which improves survival significantly in the ICU patient population.”
Indeed, steroids were part of Ramsayer’s treatment.
The trend in improving survival has been documented in intensive care units around the world. Even so, people treated in the ICU for COVID-19 are at higher risk of death than is the case for other viral lung diseases. Across the United States, hundreds of people still die daily from COVID-19.
Coopersmith credits some of the improvements in treatment to scientific advances, as was the case for steroids. He says it also helped that, for the past six months, all the attending physicians shared their observations and ideas with one another on a daily text chat, “and in that we find the art of medicine.”
Ramsayer also credits his own deep faith in God for getting him through the ordeal. When we spoke, he was getting ready to be discharged after more than five weeks in the hospital.
“I’m walking, sitting, I can get around. My only limitation is just my oxygen requirement,” he says. He considers that a mere inconvenience.
He’s eager to return to his work as a software designer, and to keep working with his doctors to figure out the right treatment for his leukemia.
“That’s something we’ll tackle once I get back on my feet.”
You can contact NPR Science Correspondent Richard Harris at rharris@npr.org.
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Georgia Pellegrini, a Texas-based chef and author, is raising money to air her show, called “Modern Pioneering,” on public television in the wake of economic hardships created by COVID-19.
(Georgia Pellegrini)
If self-sufficiency had a face, Georgia Pellegrini would be it.
After leaving a lucrative job on Wall Street more than a decade ago, Pellegrini enrolled in culinary school and embraced a life that relied on the land around her — teaching herself how to hunt the wild boar and squirrel of the Mississippi Delta, bow fish alligator gar in the bayous of Louisiana and forage weeds in urban sidewalk cracks for nourishing meals.
Pellegrini’s philosophy of self-sustainability is now more pertinent than ever. The COVID-19 pandemic has forced people everywhere to adapt their basic survival skills and learn what she calls “manual literacy” — or work with their hands — as modern-day conveniences such as restaurants and stores have shuttered their doors.
“Learning to rely on your own two hands is the most important thing we can do as humans,” said 39-year-old Pellegrini, who is also an author based in Austin, Texas.
“It’s incredibly empowering,” she said. “We’re seeing this resurgence in people baking their own bread or gardening for the first time. I think people are recognizing that becoming self-sufficient makes us far more immune to these global or local events. As hard as this time has been, it’s also brought a great lesson on how these skills are important to hold onto.”
Pellegrini’s philosophy of self-sustainability is now more important than ever, as the COVID-19 pandemic has forced people to work from the confines of their homes.
(Georgia Pellegrini)
Pellegrini — whose third book, “Modern Pioneering,” sold out on Amazon during the outbreak — had plans to share such valuable skills with American households in a new show to air on PBS. But due to economic hardship in the wake of COVID-19, Pellegrini was left without the essential funding to pay for the distribution costs. Now she’s launching a campaign to raise the money herself.
As of Thursday, Pellegrini had raised 40 percent of the required $30,000 on her crowdfunding site for the show, named “Modern Pioneering” after her book, a unique manual of basic garden-to-table recipes and life lessons — from learning how to preserve food for months in a pantry to assembling a 48-hour survival tool kit that can fit in a mint tin. She still has a way to go before July 1, the deadline for which to raise the funds.
“It’s been a frustrating blow to know that we’ve got this content ready to distribute and we don’t have the funds to pay for the distribution costs,” Pellegrini told Fox News.
“The episodes are already filmed and a top-notch producer and crew are on board,” she said. “We just need to raise enough money to pay for the distribution costs that will allow the show to reach 99 percent of U.S. households, giving free access to everyone regardless of whether they can afford cable or Netflix.”
Pellegrini, above, catches a rattlesnake in Sweetwater, Texas.
(Georgia Pellegrini)
A national rise in hunting applications and fishing licenses may be indicative of a desire to return to the life Pellegrini embodies. According to the Colorado Springs Gazette, Colorado Parks and Wildlife received 624,104 applications for its annual big game draw — an increase from last year. As of April 22, 14,443 fishing licenses had been sold in the state since registration opened on March 1, the newspaper reported.
In Vermont, resident fishing license sales are up by more than 50 percent from this time last year, and combination hunting and fishing license sales have increased by almost a quarter, according to an analysis by the Vermont Digger. Turkey hunting licenses are especially popular, with sales reportedly up 26 percent in time for the season’s start, which was May 1.
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“Long term, it has the potential to be really good,” Louis Porter, the Vermont Department of Fish and Wildlife commissioner, told the Vermont Digger, saying the upward trend in sales may “re-engage folks who have lost touch with how much they enjoyed standing in front of a lake with their kid, fishing.”
For Pellegrini, who grew up in New York’s Hudson Valley, the quest to live a self-sufficient life represents a cause greater than herself.
Pellegrini grew up in New York’s Hudson Valley.
(Georgia Pellegrini)
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“I wanted to create content that was truly valuable for people’s lives,” Pellegrini said. “I want to show them how they can find value where the rest of the world doesn’t think there is — whether it be creative ways to make the most with what they already have, or what is at their fingertips in nature.”
“Unfortunately, a lot of our higher education is not teaching such basic skills anymore and there’s a real need for it,” she added. “It’s really been only a generation or two since those skills have been lost, and we can get them back.”
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]]>Kenia Alcocer is used to sitting down at the kitchen table to crunch her family’s monthly budget and figure out how she can make ends meet.
But this month is different. Alcocer, 34, gave birth in January to her second child, a boy named Genaro, whose numerous health issues have added a huge financial strain on her family. Now, with the coronavirus pandemic putting millions of people out of work and increasing financial anxiety across the country, she doesn’t think she’ll be able to make rent.
“I’m having to choose whether I pay my rent or pay my medical bills or pay other stuff or buy food,” she said in a phone interview. “I also have a 5-year-old, my husband got laid off, and so these are the questions that everybody’s having to ask themselves.”
She added, “Rent is the last thing I want to think about during this crisis, and being evicted is the last thing I want to worry about.”
Alcocer is one of tens of thousands across the country who will join one of the largest coordinated rent strikes in decades Friday, affecting three of America’s largest cities — Los Angeles, New York and Philadelphia. Others have already begun.
Alcocer, an organizer with the group Union de Vecinos, which organized a rent strike in East Los Angeles this month, said the larger Los Angeles Tenants Union is planning a citywide rent strike. She predicted that its roughly 8,000 union members will forgo rent this month.
The tenants union had 3,000 members before the crisis. By March, it grew by a thousand, and in mid-April, it doubled to 8,000. She said the growth is a testament to the uncertain times.
“People are looking for something to join because they don’t know that to do,” she said. “The reason why our campaign is called ‘Food Not Rent’ is because we’re actually telling folks to choose your survival, choose your life, over paying your rent at this point.”
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Cea Weaver, the communications coordinator for Housing Justice for All, a coalition of 70 groups from across New York state representing tenants, homeless people and housing advocates, estimated that 10,000 people have pledged to strike.
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But, Weaver said, it’s not just about sticking it to landlords. They are also advocating for a relief fund for apartment owners, too. What Weaver hopes to see, she said, is “unprecedented government intervention” in the housing market because of the economic effects of the pandemic, and she wants this to be the chance to make the market more equitable.
“We’re in a moment where politically impossible things are possible, and a rent strike is not just about canceling rent for the crisis,” she said, citing the pace at which Congress moved to pass the massive $2 trillion relief package and other pandemic-related aid. “It’s about, like, opening up a whole new world of social housing.”
She added, “We don’t go back to go back to a world with 92,000 homeless New Yorkers and half our state can’t afford to pay their rent.”
Bob Pinnegar, CEO of the National Apartment Association, which has 81,000 members nationwide, said that April was a good month for apartment owners and that many saw tenants use credits cards to pay rent in advance of expected stimulus money.
But for May, he said, there’s uncertainty. He said the rent strike is “counterproductive” and would put more stress on the economy.
“There’s definitely growing concerns,” he said. “Everyone anticipates that there’s going to be distress, and it’s going to be more pronounced than April.”
Doug Bibby, president of the National Multifamily Housing Council, which represents the apartment industry, called the strike “reckless” because of the ripple effects on the housing market.
More than 43 million households are renters, according to the organization, and a wide enough strike could be devastating, he said.
“These people don’t think through who they’re hurting, and they’re disrupting the entire financial ecosystem in doing this,” he said. “They think they’re hurting the big, bad landlord, and what they’re really hurting are all kinds of people just like themselves, and they are spreading the economic malaise more broadly in the economy.”
He said, instead, that there should be a more directed focus on pressing local and federal lawmakers to intervene. He said his group, for instance, has been pushing for a sweeping bill promoted by Rep. Maxine Waters, D-Calif., which would provide $100 billion in direct relief to renters, as well as assistance for landlords and those experiencing homelessness.
Housing advocates fear mass evictions without government intervention. More than 30 states have moratoriums on evictions during the outbreak, but some will expire in the next month. Other states, like Colorado, have no such mandate, which has left evictions to courts and local governments, creating a patchwork of policies and ever-changing guidance.
In New York City, the American center of the pandemic, Mayor Bill de Blasio, a Democrat, has called for a rent freeze and a halt to evictions. Gov. Andrew Cuomo, who is also a Democrat, has signaled no willingness to cancel or freeze rents.
In California, Gov. Gavin Newsom, a Democrat, barred evictions through the end of May. Tenants must notify landlords within seven days of failing to pay and provide documentation proving that they were affected by the pandemic. Arizona created a $5 million fund to assist those struggling with paying rent because of the outbreak.
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But advocates want more direct relief to the most in need.
“We were already fighting for an eviction moratorium before the crisis, and now we’re seeing that that was possible during this crisis,” Alcocer said. “If banks are getting bailed out and corporations are getting bailed out, why aren’t poor people getting bailed out through this process, as well?”
She said some of the members of her organization didn’t get stimulus checks from the CARES Act because of their immigration status or have been unable to access unemployment benefits — and others are having to choose to potentially expose themselves to the virus by continuing to work.
New York state Sen. Michael Gianaris, a Democrat, introduced legislation calling for rent forgiveness, as well as financial relief for landlords.
“First and foremost we need to protect renters and tenants that are [in] desperate straits right now and from that point forward, landlords who rely on that rent to pay their bills should be next up the ladder,” he said in a news release announcing the bill.
The legislation calls for 90 days of rent forgiveness for residential and commercial tenants if they lost their work or businesses because of the pandemic, as well as a 90-day suspension of some mortgage payments.
“If the federal government showed up with some magic pot that paid people’s rent for them, that would solve the problem across the board,” he said. “I’m not prepared to wait and hope that happens, because in the meantime, people are already suffering.”
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