(suspenseful music) - [Narrator] You notice
shortness of breath and a stark pain in your chest, you might have lost your taste and smell and you're breathing like you just walked up
three flights of stairs, these symptoms signal a trip
to the emergency department of your local hospital. How will you be treated? When would you be put on a ventilator? And how could you develop a severe case of COVID-19 despite
being perfectly healthy. Before you rush in call
your doctor or hospital ahead of time, and describe your symptoms, you'll wanna do this because
your local emergency clinic might not have enough beds and may need to direct
you to another facility or your symptoms might
not be considered severe enough yet to require
treatment at the hospital. So it's best to check by phone first. But once you are admitted nurses will give you a COVID-19 test. Most patients will also have a set of blood tests taken from their veins. Doctors will then listen to your lungs and check the levels
of oxygen in your blood with a clip on finger monitor. Why are they doing that? Because if you have
severe COVID-19 symptoms, the oxygen levels in your
blood can drop too low. Since this can result in
life threatening damage to your vital organs, you'll get oxygen to breathe
through two small tubes that go just inside your nostrils or through a face mask, you'll then get a chest x-ray or a CT scan so that doctors can get
a better understanding of which areas of your lungs are inflamed. A CT scan also known as a
computerized axial tomography is a painless diagnostic
test that uses x-rays and computers to create
cross-sectional images of your body. A CT scanner is a large square or round x-ray machine with
a tunnel through the center. It helps doctors see into your lungs. During your CT scan
you will lie on a table that slowly passes through the tunnel. A giant ring called a gantry
will rotate around your body. It contains a tube that
releases x-ray beams and detectors that will measure the amount of radiation
absorbed by your body and these beams will capture many views of your body from different angles. As the gantry spins the
detectors will send data to a computer that creates
cross-sectional images or 3D models of your lungs, helping doctors diagnose the severity of your coronavirus infection. Once your doctors have all the data to determine the progress
of your COVID-19 infection, what treatments can
improve your condition? Well, some patients may
get standard antibiotics. These won't fight the coronavirus directly but could be beneficial if you develop an additional bacterial
infection in your lungs. But because there is no approved medicine specifically for COVID-19 you'll be relying on your immune system to fight off the virus and hope that oxygen therapy
combined with supportive care can help your body recover. If things go your way your immune system will start to produce antibodies to slowly kill the virus. But what happens if
your condition worsens? If the oxygen concentration in your blood then drops below critical levels, doctors can escalate your treatment to something called
high flow nasal oxygen, which means that a machine will be pushing air into your nose, warmed
to body temperature, and humidified with sterile fluid. You can get up to 60
liters of oxygen per minute and up to 100% concentration. If high flow nasal oxygen is
not an option or didn't help, doctors will start you
on mechanical ventilation in a last lifesaving effort. You will be given medication
via IV to put you to sleep. The first step in mechanical ventilation is called endotracheal intubation. Once you're asleep your
doctor will use an instrument called a laryngoscope. This device helps guide
the endotracheal tube to its proper position. Your doctor will tilt
your head back slightly and insert the laryngoscope through your mouth and
down into your throat. Taking special care to avoid contact with your teeth using a
special blade on the device. Your doctor will gently
raise the epiglottis, which is a flap of tissue
protecting your larynx as they advance the tip of the endotracheal tube into the trachea. Once the tube is in place your doctor will inflate a small balloon surrounding the tube
to make sure it remains snugly in place. They will then remove the laryngoscope and tape the tube to
the corner of your mouth to prevent it from being
jostled at a position. Your doctor will check to see that the tube is properly positioned in the lower part of the wind pipe by inflating your lungs with a special bag and listening for breathing sounds on both sides of your chest. If the end of the tube is too low both lungs will not receive
the same amount of air. In some cases, an x-ray is taken immediately after intubation to confirm the placement of the tube. Once the endotracheal tube
is in the proper position, your doctor will attach it
to the mechanical ventilator which will have especially designed pump that aids respiration by delivering well oxygenated air into the lungs and permitting carbon dioxide to escape. Levels of oxygen and carbon dioxide will be closely monitored to
confirm that the ventilator is working properly. At the beginning of the outbreak, some hospitals were putting patients on ventilators early
on in their treatment. This was due in part to concerns that less invasive ventilation procedures could cause viral particles
to disperse into the air. With more cases of COVID-19 to study, health professionals are
attempting to set guidelines for different types of respiratory failure and who ventilator treatment
would be best suited for. This includes recommendations
such as placing patients on their stomachs called
prone positioning, which evidence suggests helps increase the amount of oxygen that's
getting to their lungs. So with all this in
mind why does this virus cause only mild disease in most people but could turn fatal for
you despite being healthy? In such a case, it seems the worst damage may be caused by an
abnormal immune response to the infection rather
than by the virus itself. In simplified terms, when any cell in your body senses that there is something foreign, in this case, a virus. The immediate response of
the cell is to kill itself, a protective mechanism to
prevent it from spreading to other cells. The way this happens is that
cells in your immune system called macrophages, release small signaling
proteins called cytokines. Certain kinds of these trigger cell death. When many cells are doing
this at the same time a lot of tissue can die. This is what medical professionals call a cytokine storm. In COVID-19, this means
that lung tissue breaks down and the walls of the lungs tiny air sacks leak fluid through, causing pneumonia and
starving the blood of oxygen. Most of your cells in the tissue will die as a result of this
uncontrolled level of cytokines. It eats away your lungs to a point where they cannot recover. Your body is now attacking itself. Cytokine storms are
becoming a common occurrence in COVID-19 patients with severe symptoms and they seem to play a role in death in a large number of cases. Whether you would develop a cytokine storm may depend on genetic factors. Patients in studies with
the H1N1 influenza virus who developed cytokine storm syndrome often possessed subtle
genetic immune defects resulting in the
uncontrolled immune response. Now you are more likely to have developed these genetic immune defects as you age but there is also a small chance that you might have
a genetic predisposition to developing cytokine storms after infection with
the novel coronavirus. It's important to
mention that the complete picture of cytokine storms
is not yet well understood and the medical community is
still early in understanding the many aspects of the disease. A lot of findings and hypotheses need be confirmed in more
and larger clinical studies. But the good news is
that many clinical trials are underway to explore treatments used for other conditions that could halt cytokine
storms and fight COVID-19, as well as to develop new ones. There are currently
hundreds of clinical trials of proposed COVID-19 drugs already recruiting patients. So if you're lucky enough and make it through all
this you'll be weaned off the ventilator. You'll probably feel extremely exhausted but you can now step
down from critical care to a normal hospital ward, where you'll stay until you
can maintain safe oxygen levels by just breathing air. After that you can be discharged, go home and be reunited
with your loved ones. (gentle music) This video was a collaboration
with the What If channel, where we usually dive into
the hypothetical scenarios about the human body,
humanity, our planet, and the cosmos. Check out our channel by visiting the link in
the description below.
