Vietnam puts Coronavirus hit UK pilot on ECMO as Boris Johnson enters ICU
ECONOMYNEXT – Doctors in Vietnam’s Cho Ray hospital have put a British pilot whose lungs were damaged from Coronavirus on external blood oxygenation support as Prime Minister Boris Johnson was transferred intensive care, as his condition worsened.
Patient 91, a pilot of Vietnam Airlines, a British national was admitted to the Ho Chi Minh City Tropical Diseases Hospital on March 18 with high fever, Saigon-based Phapluat newspaper reported.
At the time of admission he had a parenchymal injury in the right lung and interstitial tissue damage, doctors said.
Initially given CPAP (continuous positive airway pressure which is non-invasive) he was later intubated and put on a ventilator.
However Patient 91 continued to have high fever and showed a high viral load and his condition deteriorated.
On April 06, a team from Saigon’s Cho Ray hospital put the patient on a an external blood oxygenation machine.
ECMO in Negative Pressure Room
Extracorporeal membrane oxygenation (ECMO) machines take blood out and pump it back in with oxygen replacing the functions of both lungs and heart. ECMO is a technology derived from heart-lung machines used during transplant surgery.
He was in a negative pressure room, Phapluat said.
ICUs usually have positive pressure to stop germs coming in from outside with post-operative surgical patients being the most common inmates.
Negative pressure rooms stop germs from getting out.
Doctors in Vietnam have been using the ECMO machines to treat seriously ill patients since 2012 and had unleashed on COVID-19 to bring back elderly patients from the brink of death.
Up to April 06, Vietnam has confirmed 245 Coronavirus patients and 95 had recovered so far. No patient had died.
The British pilot, however, was only 43 years old. Many young persons have died in other countries. In Sri Lanka a 44-year-old returnee from Italy died despite not having any complications.
Vietnam had been aggressively tracing contacts using the military intelligence and community support to find patients and their close contacts (F1) and the next level of contact (F2) to stop community transmission.
Patient 91, the UK pilot who had gone to a St.Patrick’s Day party at Buddha Bar in Ho Chi Minh City, – shortly before all bars and massage parlors were closed – triggered a city-wide hunt for patrons.
As soon as the patient is found, the Health Ministry publishes a contact diagram with a timeline where the patient had been asking people to come forward.
The diagram is given wide publicity.
Anyone in Vietnam can also log into a Health Ministry app, developed by Viettel, a state telecom company, input their symptoms and get a assessment of their condition. The app gives advice on whether to self-quarantine or go to the hospital.
The app will show the closest designated hospital with a Google map, which the person can call or get chat support. The public can also submit information about their friends or neighbors.
Terms like F1 (first contact), F2 (the contact of contacts) and (F3) are bywords among residents of Ho Chi Minh City and Hanoi where, where most of the foreigners and returnees who brought the virus were resident.
Researchers in Vietnam have published a paper saying all close contacts have to be tested and the tracing strategy moved to the next level if a contact turns out to be positive. No quarantined person should be released without being tested twice, they said.
Vietnam had 16 First Wave cases from China and successfully stamped it out with aggressive contact tracing.
The Second Wave from Western countries that did not block arrivals from China or quarantine them began in February and March.
Vietnam was also the first country to stamp out SARS according to the World Health Organization.
There have been few locals as community transmission had been mostly contained up to now.
About 150 of the confirmed cases are foreigners, reports said. Many of the rest are returnees or immediate family members.
But Prime Minister Nguyen Xuan Phuc warned the public not to be complacent, maintain social distance and be prepared for the next wave community transmission outbreaks.
“The current prevention and control strategy is social isolation, search for cases, localization of epidemic suppression by the method of” locking from the outside, stamping out from the inside,” Vietnam’s TouiTre newspaper quoted PM Phuc as saying.
But from April 15, the health sector, regional governments would have to be prepared for the next wave, he said.
On April 07, at least one person was discovered apparently without any external connection.
Authorities in Sri Lanka are braced for local transmission outbreaks from next week.
Already a three-wheeler driver and a child who is not a close contact of any identified person has been found. (Colombo/Apr07/2020)