COVID why do suffers have such different outcomes

I don't know if this helps clarify the issue. My consultant told me that patients who were put on the shielding list (deemed extremely, critically vulnerable) were those who were almost certainly unlikely to survive if they contracted Covid.

Some of us were advised that being admitted to Covid ICU and ventilation were not an option, and that we should have a conversation with our families regarding this, in the event of contracting Covid. Not a pleasant conversation to have with family.

My consultant literally put the fear of death in me.

I know I'm at high risk of severe symptoms maddyone. That's why I've been so careful and have gone over and beyond the "rules". It's been my decision to minimise risk as far as possible, not just because I fear dying, but because I know how much it would disrupt my life. I don't have anybody to care for me if I were ill and not being able to do even the small amount of work I still have would be disastrous for me financially. It's also why I get so cross when people mock others for being "scared". It's also why I take such an interest in what's going on because I don't like being cooped up more than anyone else.

Marydoll
That is helpful information. I’m not surprised that your consultant put the fear of death in you, what a horrible thing to be told. Having said that, although I was not officially shielded, my daughter, a doctor, managed also to terrify me. She told me that there would be insufficient ventilators and age and health conditions could be a factor in deciding who might get a ventilator if needed. So much the same as what your consultant said Marydoll. We totally shielded at first, and I didn’t leave the house for several weeks, only relaxing that as summer progressed and numbers fell.

growstuff
I understand why you took those precautions. We were lucky in having two of our three children nearby, who collected our Click and Collect for us, and could do any essential shopping. They also delivered my mother’s shopping to her in her sheltered apartment. Having someone nearby makes an enormous difference when you’re not going out. Also I’m lucky in that I have a husband who didn’t have severe Covid and is looking after me magnificently. Many Gransnetters live alone and don’t have someone to take such good care of them.

My mum 89 contracted covid whilst in hospital. She had a mild dose, didn’t need any intervention. The main problem seemed to be delerium. Since being home though, she seems more ill.
She feels sick all the time, has a lot of pain in her back, and joints and last week ended up back in hospital with severe breathing problems and d&v.
She’s home now ,but still very unwell ,mostly bedridden. All the tests proved negative. So we’ll have to assume this is long covid.

At the beginning of the pandemic, I listened to a very forthright professor who was in charge of intensive care in a very large London hospital.

He made it very clear that there would eventually be a time when decisions would have to be made about who to ventilate, as there would not be enough ventilators. Who would you choose, the young previously fit man with his life ahead of him or the frail, elderly patient with multiple comorbidities? For me it's a no brainer.

That is why if you are asked to shield, you should do it. It doesn't matter how fit you think you are in later years, you have no idea how Covid will affect you.

Fortunately, as treatments have improved, fewer people are being ventilated. Unfortunately, (and you can look up the statistics yourself) if you are ventilated, the outcome isn't that positive.

There's some debate about the average case mortality rate, partly because nobody really knows for sure how many people have been infected. Nevertheless, it's much much higher than average amongst the elderly and in certain groups, including those who are considered clinically extremely vulnerable.

Nobody really knows why some individuals are affected, although it seems some theories have been discounted. It's probably something to do with T cells and ACE2 receptors and the amount of inflammation already existing. People aren't tested for them, so don't really know what's going on inside their body. There's still a lot of research to be done on auto-immune conditions, which aren't that well understood and there could be a link. Who knows?

Even something as common as T2 diabetes isn't properly understood. I developed it when I was 36. I wasn't overweight, ate reasonably healthily and was quite fit. I don't have a family history. My sisters have never developed it, although both are overweight. It's known that there are various risk factors, but there are still people who are atypical. It's now thought that it has something to do with inflammation, but nothing is known for certain. There's an answer somewhere, but it hasn't been found yet and I suspect it's the same for allegedly low risk people and Covid.

Meanwhile, beware the snake oil salesmen who will undoubtedly get in on the act of flogging magic cures.

Just about the only thing that is known for sure is that infection spreads by human interaction and the virus won't give you a "get out of jail free card" even if you have an excuse for meeting other people.

Good posts Marydoll and growstuff.

My daughter told me right at the beginning that ventilating patients doesn’t lead to the best outcomes, that as you say Marydoll that many ventilated patients would die anyway. You are right, if doctors have to decide between a young, previously fit person, and an older person with other comorbidities, who would any of us choose? Doctors were told in their Covid training that these decisions would have to be made. I know this because my daughter attended these training session and reported to me. She was of course intending to terrify me. She wasn’t cruel, she trying to ensure I took notice and survived.

As growstuffhas indicated, treatments have improved. I consider myself to lucky to have avoided Covid at the beginning because the consultants who treated me, using a plethora of drugs and treatments, including oxygen at 40% initially, perhaps wouldn’t have been so knowledgeable at the beginning.

I don't know that any choices have had to made. The demand for ventilators was never as great as anticipated. However, I have read of cases where people are so frail that ventilation wasn't even considered, because it would cause too much trauma.

Yes growstuff you’re correct, and many companies rushed into making ventilators at the beginning, but as you say, ventilation wasn’t always the best option for patients. Also you’re right in saying that these horrible choices didn’t have to be made, but during her training sessions, my daughter was told that this would be the case, based I suppose on the number of ventilators available in the country last March. No one knew that so many new ventilators would be available so soon.

Doctors make those kind of decisions all the time. My father was denied a lung cancer op because it was felt his heart wasn't strong enough. As it was, he lived for another couple of years in relative comfort and without the trauma of surgery. He wouldn't have survived Covid.