Now there’s good news: It appears that U.S. hospitals will need fewer than 17,000 devices to treat Covid-19 patients, according to one widely used model. What the final numbers will look like as the virus continues its march across the country is anyone’s guess. But there’s little doubt there will be thousands of ventilator survivors once the pandemic is over. And the quality of their lives is still an open question.
When Aguilar, 55, woke up in intensive care at the end of March, she found her wrists tied to the bed frame. That, she later learned, was to stop her from tearing out the tube that ran down her throat all the way to her lungs. It was connected to a mechanical ventilator that had been breathing for her for 10 days as she lay in a medically induced coma.
A nurse slowly peeled the tape off her face and, with a flick of her wrist, yanked out the tube. Aguilar had made it through the most harrowing phase of her Covid-19 gantlet.
Nurses and doctors lined the hallway outside her room in the 361-bed regional medical center, located halfway between Trenton, New Jersey, and New York City. When she looked up through the glass window, they started cheering and chanting. “Yay, Diana! You made it!” she remembers hearing.
“They were jumping and clapping, and everybody was so happy,” she says. “I didn’t know I had all these people waiting for me, waiting to see how I’d do.”
She hadn’t yet fully grasped how close she had come to death and the long odds she had just beaten. The cheers were also because many of the patients with whom she shared the ICU eventually were rolled out in body bags. Here’s why: The lungs are dynamic, delivering inhaled oxygen into the blood supply in seconds. If they aren’t working, the damage is swift. A person can go from healthy to dead in fewer than six minutes.
She also didn’t know that her husband, Carlos Aguilar, was in the room next to her. While Diana was sedated as the machine helped her breathe, Carlos had grown ill with the same virus. A few days earlier, he’d been admitted to the hospital. And hours after Diana regained consciousness, Carlos, 64, was sedated so doctors could slide a tube down his throat as his breathing worsened.
When a person inhales, oxygen flows through the trachea, down branches that divide again and again, to end in 600 million tiny buds of air sacs known as alveoli. The oxygen passes easily through their walls, just one cell thick, and into the blood stream, where it fuels the rest of the body.
Coronavirus and the inflammation it causes is like slime, clogging up the intricate system. One of the most troubling aspects is the virus’s ability to penetrate deep within the lungs, burrowing into cells and churning out viral particles. The issue isn’t just losing those cells in the lungs that are supposed to help oxygenate the body. The problem is the lungs then become the battleground for the fight, where the human immune system takes on the foreign invader. The tightly packed cells become so swollen from fluid and inflammation they stop functioning. Survivors have likened it to the sensation of drowning.
Because SARS-CoV-2 is new to the human body, the infection can trigger a massive immune response, says Christopher Petrilli, an assistant professor at NYU Langone Health in New York.