What is ECMO and vac vs. unvac facts

Yes, Labor Day has come around again and Covid is still very much with us. So here we go with some more news you can use.

1.?What is ECMO? You probably never heard of ECMO before the pandemic and with good reason. It was hardly ever needed or used. Now ECMO is in such high demand, there is not nearly enough to go around. ECMO stands for extracorporeal membrane oxygenation. The short version is this is an extremely high-tech way of taking blood out of the body, circulating it through a machine and re-oxygenating it while completely bypassing the lungs. With the Covid pandemic, we have an unprecedented number of patients in respiratory and ventilatory failure in our ICUs. Respiratory failure is the most common cause of death from severe Covid infections, and ECMO can be used as a last-ditch attempt to save a patient whose lungs are not functioning adequately to support life. Some patients have recovered after being on the ECMO machine for over 4 months. During the time a patient is on ECMO, they are usually completely unconscious on the ventilator and require 24-hour care by at least one if not two or three nurses, technicians and doctors. Approximately 50% of patients who start on ECMO survive, and their rehabilitation is long and difficult. Rehabilitation includes physical therapy as well as psychological and spiritual support after an experience that was prolonged and near death. Currently, the rate-limiting steps with ECMO are the limited number of hospitals that have this equipment and the shortage of staff trained to run it. ECMO costs around $5000 to $10,000 per day.

?2.?Are breakthrough cases overhyped? Much attention has been paid recently to vaccinated persons getting Covid, with a great deal of fear and anxiety generated about this issue. Some facts are in order. A recent article in the New York Times summarized the recent data. The chance of a vaccinated person contracting Covid is around 1 in 5000 persons per day – and less if you are in a low Covid area and practice basic precautions. It is true that the viral loads in the noses and throats of unvaccinated and vaccinated persons are similar, but vaccinated persons reduce that viral load very quickly and are far less likely to transmit to another person or get very sick. On any given day, approximately 1 per million vaccinated people are admitted to a hospital because of Covid. Those are very good odds. Vaccinated persons can look at Covid more like the flu. You can still get it, but your odds of getting very sick or transmitting it are really low. And just like with the flu, vaccinated people should avoid large indoor crowds, wear masks, wash hands, and stay away from unvaccinated or immune compromised people as much as possible.