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CCMH COVID-19 treatment options

CCMH COVID-19 treatment options

The following is information on the treatment options for patients who are COVID-19 positive and seeking care from a Campbell County Health Clinic or are patients at Campbell County Memorial Hospital in Gillette, Wyoming.

Monoclonal antibody treatments

Monoclonal antibody treatment given early, within seven to 10 days of infection, can reduce the risk of a patient progressing to severe COVID-19 disease and needing hospitalization. The treatment can also shorten the duration of COVID-19 symptoms.

Monoclonal antibodies are laboratory-made molecules that act as substitute antibodies. They can help your immune system recognize and respond more effectively to the virus, making it more difficult for the virus to reproduce and cause harm.

A monoclonal antibody infusion program began August 23, 2021, in the Complex and Internal Medicine clinic. Like other medications, protocol is outlined by the FDA. To received the monoclonal antibody infusion treatment, patients must:

  • be within a 7-10 day window of having a COVID-19 positive test result
  • be at risk for bad outcomes and meet other criteria outlined by the FDA
  • and have a doctor’s order.

To learn more about the monoclonal antibody treatment that is helping patients with mild to moderate COVID-19 symptoms read "Regeneron COVID-19 treatment helping CCH patients," by Jake Goodrick, Gillette News Record reporter.

Supportive hospital care for COVID-19

Hospital care for COVID-19 is supportive care, which is treatment that supports the body’s organs. The most common symptom of COVID-19 is shortness of breath, which means that the lungs are not delivering enough oxygen to the rest of the body. When oxygen levels fall, this causes organ failure.

Your care team at the hospital will monitor oxygen levels and provide oxygen treatment to help the body get the oxygen it needs to survive. Some patients may only need a nasal cannula, a tube that’s placed in the nostrils to deliver oxygen. Other patients require an oxygen mask, which can deliver high concentrations of oxygen.

According to the CDC (U.S. Centers for Disease Control and Prevention), COVID-19 can damage the heart, blood vessels, kidneys, brain, skin, eyes, and gastrointestinal organs. It also can cause other complications. Severely ill hospitalized patients could be put on blood thinners to prevent or treat blood clots.

Remdesivir

The FDA has approved the antiviral drug Veklury (or remdesivir) for adults and certain pediatric patients with COVID-19 who are sick enough to need hospitalization. Created to fight Ebola, research shows that some patients recover faster after taking this drug. Veklury should only be administered in a hospital.

Ventilators in the ICU

Despite supportive care, some patients’ conditions can worsen, which will lead to transfers to the intensive care unit (ICU) for them to be monitored closely than other hospitalized patients.

If the patient cannot breathe effectively with oxygen therapy, doctors may place a breathing tube in the patient’s airway and provide ventilator treatment. A ventilator forces air and oxygen into the lungs. This treatment will require other drugs to help the patient remain asleep and comfortable.

In some cases, when a patient is placed on a ventilator or if our ICU is full, they will be transferred to a hospital that can provide a higher level of care. Other therapies that go beyond being placed on a ventilator include ECMO (extracorporeal membrane oxygenation) and lung transplant—both of which must be done at larger medical facilities outside of Campbell County, Wyoming.

ECMO is used when all other medical options have been exhausted. It’s commonly used for patients whose lungs can’t provide enough oxygen to their body or rid their body of carbon dioxide, patients whose heart can’t pump enough blood to the body and for those waiting to either get a heart or lung transplant.

An ECMO machine acts like a patient’s heart and lungs. A plastic tube about the size of your thumb is inserted into a large vein or artery through the neck, chest or groin. This tube allows for the patient’s blood to flow out of their body into an artificial lung called an oxygenator. This machine adds oxygen and removes carbon dioxide from the blood (like the lungs would) and then a pump sends the blood back into the patient through a separate tube like a heartbeat.

According to the CDC, the average length of hospitalization for survivors is 10 to 13 days.

What about Hydroxychloroquine or Ivermectin?

Early in the pandemic, the FDA granted emergency use authorized (EUA) for hydroxychloroquine (HCQ), but later withdrew it because mounting evidence showed the drugs "are unlikely to be effective in treating COVID-19 for the authorized uses in the EUA." HCQ and chloroquine (CQ) have serious side effects, including irregular heart rhythms and death.

The FDA has not approved ivermectin for use in treating or preventing COVID-19 in humans; however, some initial research is underway. The CDC did issue this health advisory reiterating that ivermectin does not treat or prevent COVID-19 on August 26. Ivermectin is not a medicine used for treating viruses. Ivermectin is approved for humans to treat some parasitic worms, head lice and some skin conditions like rosacea. It's most common use in the U.S. is to treat and prevent parasitic worm infections in animals.

It is extremely important to note that humans should never use medications indented for animals on themselves. Ivermectin for horses is not the same as ivermectin for humans. People who have taken ivermectin meant for horses have become very ill. You can also overdose on ivermectin, which can cause nausea, vomiting, diarrhea, hypotension (low blood pressure), allergic reactions (itching and hives), dizziness, ataxia (problems with balance), seizures, coma and even death. 

Reduce your risk of exposure to COVID-19

Like other respiratory illnesses, COVID-19 is believed to be mainly spread from person to person. To prevent illness and avoid being exposed to the virus, the Centers for Disease Control and Prevention (CDC) recommends washing your hands often, avoiding close contact with people who are sick, covering your mouth and nose with a cloth face cover when around others, covering coughs and sneezes, and cleaning and disinfecting frequently touched surfaces daily. To learn more about COVID-19 in Campbell County, Wyoming, visit www.cchwyo.org/covid19

CCH encourages you to talk with your health care provider about getting the COVID-19 vaccine. To learn where you can get a COVID-19 vaccine in Campbell County, Wyoming, or for more information about COVID-19 vaccines, please visit www.cchwyo.org/c19vaccine.

CCH is open, safe and ready to see you.

With almost 80 physicians, physician assistants and nurse practitioners in nearly 20 specialties, CCH is committed to your wellbeing right here at home. If you have been putting off a visit to your doctor for a regular checkup, contact them; they can help weigh your personal healthcare risk and avoid further delayed diagnoses.

Visit www.cchwyo.org/findadoc to find your provider or clinic.

Article written by Dr. Attila Barabas, Chief Medical Officer