“It’s so very sad, it’s so very tragic,” respiratory therapist describes stages of severe COVID

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AUGUSTA, Ga. (WJBF) – Difficulty breathing is a major complication of COVID-19 that often leads to death. It’s something respiratory therapists know all too well, as they see the progression of severe COVID from beginning to end.

NewsChannel 6 sat down with the Director of Respiratory Care for Adults and Pediatrics at AU Health, Jennifer Anderson, to walk through what a patient experiences during the stages of severe COVID, from the bedside perspective. Anderson says this strain of COVID is much more aggressive than anything she’s seen before.

“Every respiratory therapist in this hospital sees every single COVID patient, and they support those patients throughout their stay here, and it is very exhausting,” Anderson said. “One of the things I hear from them– if they only knew. Of course you hear families later say, ‘Oh, we just didn’t realize how very bad it was.'”

Anderson says the speedy and aggressive escalation of severe COVID begins before a person ever arrives at the hospital. They will experience difficulty breathing and mistake it for a cold or seasonal allergies. But several days later, with much more difficulty breathing, a patient comes to the ER. There the patient is given antivirals, steroids and supplemental oxygen.

“Sometimes these interventions will be all you need, but you will stay in the hospital awhile,” Anderson said.

If a patient is lucky, this is enough, and they’re sent home with supplemental oxygen to be weaned off of in the coming days. But this isn’t the case for every patient.

“Maybe you were out on a regular hospital unit. Now you need to go to ICU. You’re not doing well at all,” Anderson said. “We’ve tried doing interventions out on the floor, we’ve given you treatment, they tend to make you feel a little bit better, but now you need a lot more support.”

The respiratory therapist now uses non-invasive ventilation through an oxygen mask. Anderson says they try to avoid intubation, but non-invasive ventilation won’t be powerful enough for some patients as they progress through the stages of severe COVID.

“They end up having to put that tube down in their lungs, we call it an intubation. Those patients have to be supported with full mechanical ventilation. A lot of times, because of this disease, it’s really difficult to get the air in,” Anderson said.

For some, the lungs become tired and fibrous, and it’s too difficult to breath on their own. Now the patient must be put on an ECMO machine, which is heart-lung machine.

“What we end up doing is sedating and paralyzing these people,” Anderson said.

Patients must be face down in a position called proning to allow for better blood oxygenation. This treatment lasts many days, often weeks. Anderson says this is the scariest part.

“We had a 16-year-old who has come off now and he’s doing great. He’s trying to regain his strength because he was on ECMO for 13 days. I mean you look at being on ECMO for two weeks,” Anderson said.

Anderson says it’s a limited resource, and at AU, only two patients can be on an ECMO machine at a time.

“I’m very proud to say that we have had some good successes recently with very young patients who had to be put on ECMO,” Anderson said. “We’re very lucky here at AU to have an adult ECMO program. Not a lot of hospitals do.”

Anderson says she’s proud of the recent success with the 16-year-old recovering, as well as a 26-year-old, and a 33-year old.

“These are young people,” Anderson said. “Once you get to that ECMO phase, it’s very serious. There is not this resource [ECMO machines] everywhere #1, and #2, once these people go on, they stay on for a number of days. And then you have all kinds of complications.”

For patients who do not recover, the final stages of severe COVID begin. A patient experiences multiorgan failure, and their family members make end of life decisions.

“I want folks out there to know that right now in our hospital we have forty-four COVID patients on ventilators. Forty-four. And of that forty-four, one was vaccinated. One.”

Anderson says family members of many of her patients say if only their loved one had known how serious this virus is, maybe they would have gotten the vaccine. Anderson says her and fellow respiratory therapists know all too well just how serious and aggressive the virus it, especially for those who are unvaccinated.

“It’s so very sad. It’s so very tragic. They want to live their lives and they want to get on with the things that would be normal. And then on the other hand, a lot of this gets missed, as far as how severe it is,” Anderson said.


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