improvise

Recycle, Reuse, And Now Repurpose?

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With the arrival of the Coronavirus (COVID-19) we have had to adapt to a completely different way of life. Now most of us are staying away from having any unnecessary contact with other people to avoid catching the dreaded virus. The hoarders, that I talked about in my last column, are still stupidly hoarding and making it very difficult for the rest of us to obtain some of the simplest necessities of life including toilet paper. A problem, before not considered very serious, has become monumental. The public works departments over the country are having trouble with more and more sewer lines being blocked. That’s because people are having to adapt to running out of toilet paper. They are improvising and clogging up sewer systems at an unprecedented rate. Believe it or not, it’s not just the standard wipes that people are flushing. Torn up t-shirts and other cloth items have forced the Rotor-Rooter company to stretch their people to the limit trying to unplug the clogged sewer lines.

Marines
Improvise Adapt Overcome U.S. Marines Patch | Embroidered Patches

We’ve all had to become McGiver-like to adapt to not having exactly what we might need to get along. The Marine slogan “Improvise, Adapt, and Overcome” has become the rule for most of us. Back in the 1960s I worked in a small inner-city hospital in Rochester, New York as an orderly. Because the hospital didn’t have all of the  necessary equipment I was taught how to improvise such things as traction equipment needed for patients with spinal issues and other problems.

Me As An Orderly
Me Dressed In My Orderly Uniform mid 1960s | Photo by My Mother

It seems that a drug that is being used to fight blood clots might be able to be used to treat the respiratory symptoms of COVID-19. I have some experience with blood thinning medications. When I was working in that hospital, part-time during the school year and full time in the summer, I was also attending college. I ended up in the hospital with a fever of undetermined origin of 107 degrees and was taken from a college dorm room to the hospital at 4 am on November 22, 1966 the anniversary of the death of President John F. Kennedy. Four days later the doctors found a large blood clot in the femoral vein of my right leg and immediately operated to remove it. For a long period of time after that in order to prevent clot reformation I had to take the blood thinner Coumadin, the brand name of the drug Warfarin. The drug prevents clotting, but can also cause excessive bleeding if not continually monitored by blood tests.

Clot Buster
How Clot Busting tPA Works | Image by n.neurology.org

Now another clot busting drug could be of great help in relieving the respiratory damage being done by COVID-19. A March 25, 2020 article published on MedicalXpress.com titled “Repurposing a drug for blood clots: A stop-gap measure to treat respiratory distress in COVID-19 was written by Anne Trafton, from the Massachusetts Institute of Technology (MIT). The drug is called tissue plasminogen activator (tPA) and is also known as a clot buster which is given to heart attack and stroke victims. If administered quickly enough it can dissolve a clot before it can cause permanent damage. The new idea is to give the drug to COVID-19 patients who don’t have the use of a ventilator or where the ventilator isn’t helping.

Ventilator
Ventilator Equipment At McGill Research Institute Toronto | Photo by cbc.ca

Recent data from China and Italy indicates that the respiratory failure in COVID-19 patients could be as a result of serious blood clotting. Three hospitals in Massachusetts and Colorado are planning to use tPA on seriously ill COVID-19 patients. According to Michael Yaffe, a David H. Koch Professor of Science at MIT, quoted in the article “If this were to work, which I hope it will, it could potentially be scaled up very quickly, because every hospital already has it in their pharmacy. We don’t have to make a new drug, and we don’t have to do the same kind of testing that you would have to do with a new agent. This is a drug we already use. We’re just trying to repurpose it.”

The information coming from China and Italy shows that a significant number of patients who needed and were on a ventilator still died of respiratory failure. It seems they formed small blood clots in their lungs, called microthrombi, which prevent blood from reaching the air spaces in the lungs which is where the blood becomes oxygenated. Tests with animals and one human test indicate that this treatment with iPA could be a valuable weapon in the arsenal to decrease the mortality rate COVID-19 patients. I doubt this will be the last time I write about the pandemic that will sadly not be going away anytime soon.

For the latest information and updates on the Coronavirus outbreak there are sites you can visit. https://www.cdc.gov/coronavirus/2019-ncov/index.html and https://www.who.int/health-topics/coronavirus.

Let me know what you would like me to talk about or explain. You can email me at: [email protected].