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  • Richard Cree

Pneumonia? Woo-Hoo!

Updated: Apr 25

Friday 17th April 2020

COVID Figures for 16th April

UK Hospital Deaths 861 / Total 13,729

James Cook cases on wards – 125

James Cook Hospital – Total deaths – 107

James Cook cases in Critical Care – 23 / 11 ventilated

Not the busiest night I’ve worked to be honest. Things were relatively calm with just three patients referred to us from the wards overnight.

Tom and James, the two registrars, and Janine the outreach nurse went to review them. The first patient was a nurse who has contracted the virus and had become unwell over the past few days. Luckily she appeared to be managing pretty well on CPAP and we were happy to leave her where she was. Janine would be keeping a very close eye on her.

We are now starting to see members of hospital staff becoming unwell. So far, three of my consultant colleagues have now contracted the virus. It’s likely that they have caught the virus from mixing with other members of staff rather than from the patients. Social distancing is very difficult to achieve in a busy hospital environment. Fortunately none of them have been too unwell or needed admission to hospital. None of us are looking forward to having to treat the people we normally work alongside.

We admit another lady with suspected COVID pneumonitis who has not being doing too well on the ward. She is not that old but has a dementia that has been caused by long-term alcoholism. She is very drowsy and vulnerable and if CPAP fails she will not survive. We can offer a higher level of nursing care than the ward and that may be enough to make a difference.

The last patient is a lady in her 50’s who has been in hospital for the past two days. She looks like she may have had a heart attack whilst at home and has been admitted with heart failure. She is now developing a bacterial pneumonia but we have yet to rule out coronavirus. We are starting to get a better understanding of what is likely to be COVID and what isn’t. I suspect she does not have the virus and it strikes me how quickly we have come to see alternative diagnoses as ‘good news’.

Only yesterday I saw a gentleman in his 60’s on the ward round. He had respiratory failure which I thought was unlikely to be due to coronavirus. Subsequently his swab results came back negative. I returned to tell him he didn’t have COVID pneumonitis and his breathlessness was due to a common-or-garden pneumonia instead. He was delighted and I swear he almost did a little dance. Normally, the mention of the word ‘pneumonia’ is enough to put the fear of God into most patients, not bring a smile to their face.

I should point out that we doctors use the term pneumonia to pedantically describe an acute infection of the lung tissue. Most often we mean a bacterial infection and tend to use the term pneumonitis to describe an infection caused by a virus or an inflammatory process. ‘Chest Infection’ is a term we use when talking to patients. Most people are under the impression that pneumonia is a more serious form of chest infection, hence the usual horrified reaction when we utter the word.

Being COVID negative, we were able to transfer him out of his isolation room to the ‘non-COVID’ ICU. When I checked on him before leaving for home this morning, he was doing well.


It's only pneumonia...

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