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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

RICHMOND, Va -- Governor Ralph Northam is expected to announce on Tuesday an executive order requiring Virginians to wear face coverings in public spaces where social distancing cannot be guaranteed at all times.Since asking Virginians to do their “homework” and obtain facial protection, officials with the Governors office continue to hint an order is coming.A source with knowledge of the order said it is expected to only apply when going inside Virginia businesses. The CDC and Virginia health officials have recommended wearing face cloth face coverings for many weeks, citing research that shows coronavirus is easily spread person to person by droplets expelled when someone speaks or coughs. Individuals who contracted COVID-19 but do not display symptoms are of particular concern to health officials, as businesses slowly begin to reopen their doors to the public."I think it's fair to say that people have gotten very creative with their facial protections," Northam said Friday. "Be ready on Tuesday to go out and about in your business when it's essential with facial protection,"The pending order comes several days after Northam faced pointed criticism for not wearing a mask during a visit to the Virginia Beach oceanfront Saturday. The Governor was photographed taking selfies and visiting with beachgoers without visible facial protection.“The Governor has repeatedly encouraged wearing face coverings inside or when social distancing is impossible. He was outside yesterday and not expecting to be within six feet of anyone,” a spokesperson said, adding that the Governor should have brought a mask with him during the visit.Final details of the facial covering order are still pending, so who will enforce it and how remains unclear. To this point, individuals have been responsible for obtaining and wearing a face mask in public spaces, and state agencies have distributed thousands of masks in low-income neighborhood around Richmond and elsewhere.Monday morning near St. John’s Church in Richmond, where Patrick Henry delivered his, "give me liberty or give me death” speech, protestors from the “Reopen Virginia Coalition” held another rolling rally in honor of Memorial Day and in opposition to what they call “government overreach.”“It’s not governments job to tell us what we have to do,” said David Britt, one of the group’s organizers. Britt said he keeps an American flag print bandana in his car and wears it when thinks others might feel uncomfortable. Still, he said a facial covering order is too little too late.“It’s shutting the barn door after the entire herd as already escaped,” Britt said. “When the Governor goes to Virginia Beach on Saturday, and hobs-nobs with folks, and in no way is social distancing, and is not wearing a mask, how am I supposed to take him seriously when he says I need to wear a mask?”On a sunny afternoon in Carytown, spotting people with a mask on or in-tow didn’t take long. Katie Wall and Matthew Richardson, who live in the Museum District, said they took mask guidelines seriously from the very beginning and support Northam’s pending order.“Indoors especially because that’s how it’s being transmitted from all the information I see,” Richardson said.“I would say at the grocery store or pharmacy like 90 percent of people are already doing it, so hopefully the other ten percent will get on board,” Wall said. “I would say it’s not about protecting you, but it’s about protecting other people specifically. Maybe high risk family members that you could transmit it to them and you wouldn’t even know that you did that.”In the long run, the effectiveness of a statewide mask order likely comes down to an individual’s willingness to wear them in public, no matter what enforcement mechanisms look like.“I don’t believe it makes a lick of difference, but I’m not going to plant a flag in the ground and say, ‘I will not wear a mask!’” said Britt with Reopen Virginia. “That’s just silly reactionary stuff, and that’s not what we’re about.”“I think it’s all different definitions of what freedom is because none of this is really freedom,” Wall said of coronavirus restrictions. “I want to be free of, in my opinion, other people’s poor decision making as well.”This article was written by Jake Burns for 4290

Special counsel Robert Mueller's confidential report on the Russia investigation is more than 300 pages, according to a Justice Department official and a second source with knowledge of the matter.The Justice Department official described the still-secret report as more than 300 pages, while a second official said it was between 300 and 400 pages, not including exhibits.The page length had been a mystery in the days following the announcement that Mueller had concluded his work last Friday, as the Justice Department continually declined to comment on the page count but called it "comprehensive." Attorney General Bill Barr's four-page summary of Mueller's report provided only few details of how it is structured, describing it as "divided into two parts."Even many members of Congress have been kept in the dark about the breadth of the report until recently.A Justice official confirmed that Barr discussed the page length on a call with House Judiciary Chairman Rep. Jerry Nadler on Wednesday. Nadler would only say the report was "very substantial" and less than 1,000 pages when asked by reporters.Barr on Sunday released a four-page memo stating that Mueller's investigation did not establish that the Trump campaign conspired with the Russian government before the election, but Democrats have demanded to see Mueller's full report and the underlying evidence.A small team at the Justice Department is working on determining what portions of the report can be made public, after scrubbing it for grand jury and other material related to ongoing investigations. 1586

Prosecutors have offered to drop solicitation charges against Robert Kraft in unusual deal that calls for admitting he would've been found guilty 158

ROCK SPRING, Ga. – A family in Georgia is grieving the loss of their 6-year-old son who died suddenly on the baseball field of a rare heart defect.Meghan Bryson said her son, Brantley Chandler, loved baseball and was on the ball field with his teammates getting ready to take a team picture when he collapsed.The next team picture snapped of the Rock Springs Mustangs would be at Lake Funeral home as they said their final goodbyes.Bryson said Brantley was born with a rare congenital heart defect called Hypoplastic Left Heart Syndrome.The 553