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Scans of the lungs of the sickest COVID-19 patients show distinctive patterns of infection, but so far those clues offer little help in predicting which patients will pull through. For now, doctors are relying on what’s called supportive care that’s standard for severe pneumonia.Doctors in areas still bracing for an onslaught of sick patients are scouring medical reports and hosting webinars with Chinese doctors to get the best advice on what works and what hasn’t.One thing that’s clear around the globe: Age makes a huge difference in survival. And one reason is that seniors’ lungs don’t have as much of what geriatrics expert Dr. Richard Baron calls reserve capacity.“At age 18, you have a lot of extra lung capacity you don’t use unless you’re running a marathon,” explained Baron, who heads the American Board of Internal Medicine. That capacity gradually declines with age even in otherwise healthy people, so “if you’re an old person, even a mild form can overwhelm your lungs if you don’t have enough reserve.”Here’s what scientists can say so far about treating those who become severely ill.HOW DOES COVID-19 HARM THE LUNGS?The new coronavirus, like most respiratory viruses, is spread by droplets from someone’s cough or sneeze. The vast majority of patients recover, most after experiencing mild or moderate symptoms such as fever and cough. But sometimes the virus makes its way deep into the lungs to cause pneumonia.Lungs contain grapelike clusters of tiny air sacs called alveoli. When you breathe, oxygen fills the sacs and passes straight into blood vessels that nestle alongside them. Pneumonia occurs when an infection -- of any sort, not just this new virus -- inflames the lungs’ sacs. In severe cases they fill with fluid, dead cells and other debris so oxygen can’t get through.If other countries have the same experience as China, about 5% of COVID-19 patients could become sick enough to require intensive careHOW DOES THAT DAMAGE APPEAR?Doctors at New York’s Mount Sinai Health System analyzed 121 chest CT scans shared by colleagues in China and spotted something unusual.Healthy lungs look mostly black on medical scans because they’re full of air. An early infection with bacterial pneumonia tends to show up as a white blotch in one section of one lung. Pneumonia caused by a virus can show up as hazy patches that go by a weird name -- “ground glass opacities.”In people who get COVID-19 pneumonia, that haze tends to cluster on the outside edge of both lungs, by the ribs, a distinctive pattern, said Dr. Adam Bernheim, a radiologist at Mount Sinai.As infection worsens, the haze forms rounder clusters and gradually turns more white as the air sacs become increasingly clogged.HOW TO TREAT THE PNEUMONIA?There are no drugs so far that directly attack the new coronavirus, although doctors are trying some experimentally, including an old malaria treatment and one under development to treat Ebola.“The best treatment we have is supportive care,” said Dr. Aimee Moulin, an emergency care physician at the University of California Davis Medical Center.That centers around assistance in breathing when the oxygen levels in patients’ blood starts to drop. For some people, oxygen delivered through a mask or tubes in the nose is enough. More severely ill patients will need a breathing machine.“The goal is to keep the person alive until the disease takes its course” and the lungs begin to heal, explained Mount Sinai’s Dr. Neil Schachter.The very worst cases develop an inflammatory condition called ARDS -- acute respiratory distress syndrome — that floods the lungs with fluid. That’s when the immune system’s attempt to fight infection “is going crazy and itself attacking the lung,” Baron explained.Many things besides the coronavirus can cause the condition, and regardless of the cause, it comes with a high risk of death.WHAT ELSE IS IMPACTED?Severe pneumonia of any sort can cause shock and other organ damage. But in a webinar last week, Chinese doctors told members of the American College of Cardiology to watch for some additional problems in severe COVID-19, especially in people with heart disease. The worst off may need blood thinners as their blood starts to abnormally clot, and the heart itself may sustain damage not just from lack of oxygen but from the inflammation engulfing the body.Another caution: The sickest patients can deteriorate rapidly, something a hospital in Kirkland, Washington, witnessed.Of 21 patients who needed critical care at Evergreen Hospital, 17 were moved into the ICU without 24 hours of hospital admission, doctors reported last week in the 4639

SAN DIEGO — A man has died after falling into a river at Yosemite National Park on Christmas Day.Few details about the man's death were released Friday by the park. A park spokesman told the Associated Press that a statement was not issued sooner and the investigation was taking longer than usual because of the government shutdown.The man reportedly suffered a head injury on December 25 in the Silver Apron area, between Vernal and Nevada Falls, according to ABC affiliate 488

Sam Johnson, a onetime prisoner of war in Vietnam and Republican Texas congressman who was the U.S. House's oldest member when he stepped down in 2019 at age 88, has died. He was 89.His former spokesman, Ray Sullivan, said Johnson died at a Plano hospital of natural causes unrelated to the coronavirus. Johnson was flying a bombing mission in 1966 when he was shot down and wounded.He was imprisoned in the infamous "Hanoi Hilton" for nearly seven years, much of it in solitary confinement. Johnson was elected to Congress in 1991 and vowed to stay a maximum of 12 years, but eventually served more than double that. 629

SPRINGFIELD, Ill. (AP) — Illinois Gov. J.B. Pritzker has ordered the state's residents to remain in their homes except for essential needs, joining similar efforts in California and New York to limit the spread of the coronavirus. Pritzker's order announced Friday will still allow the state's 12.6 million residents to seek essentials including groceries and medicine. The order will take effect Saturday. Pritzker had previously ordered all schools statewide to shut down and limited gatherings to 50 people to limit the spread of the coronavirus in the state. He also closed dine-in service at bars and restaurants. 630

Spring is just days away! That means a lot of people are gearing up to “spring clean” their homes. But it’s also a great time to “spring clean” your health!One of the best parts about spring: more sun shine. "Having sun exposure before noon is scientifically proven to help you with mood and sleep,” says Dr. Kate Johnson, a family medical practitioner. Dr. Johnson says sunblock is a must for your skincare regimen, and the higher the SPF the better. "Even though we can get vitamin D from the sun, we can take that in a supplement to protect our skin," she says. Come spring, there are plenty of new fruits and vegetables in season, including apricots, asparagus, strawberries and artichokes. Unfortunately, when nature is in full bloom, that means allergies are, too. So, before they strike, stock up on nasal sprays. "You want to hop on those right now,” Dr. Johnson says. “I recommend dosing them at bedtime." When taking care of your health this spring, it’s a good time to ditch the “I can’t exercise” mentality. "If you are not an avid exerciser currently, I recommend starting with walking,” Dr. Johnson recommends. “[It’s] a fantastic way to go, and I like to tell my patients to start with 5 minutes is a great start, and we can build as we go." Remember, no matter the season, sleep is key! Don't let anything come between you and rest. Dr. Johnson recommends putting you phone down before sleep, as it can interfere with falling asleep. 1466