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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

SEOUL, South Korea — South Korea is reporting its first death from a new virus, as the mayor of a southeastern city urges its 2.5 million people to stay inside as infections linked to a church congregation spike. The mayor of Daegu says citizens should wear masks even indoors if possible. The city and nearby areas have reported 56 new cases in the past two days. The mayor says the rising infections could soon overwhelm the city’s health system and is asking for urgent help from the central government. Health officials say many of the new patients went to services at a church that were attended by a previously confirmed virus patient or contacted her elsewhere. 680

TAMPA, Fla. — Purely Elizabeth is voluntarily recalling several of its granola products due to possible contamination with plastic, rocks or glass.The recalled products were distributed in stores across the country and via the company's website.The recalled products all contain cashews.The company says no injuries or illnesses have been reported due to the possible contamination.Purely Elizabeth is asking consumers who purchased the products not to consume them and contact the company for a free replacement.The UPC codes on the affected products are printed in black on the bottom of bags of granola and on the bottom of the bars packaging near the nutritional facts panel. The "Best By Dates" are stamped on the back of the packaging in black ink.The recalled products are as follows:Product NamePackage SizeUPC CodeBest By DatesGreenWise Cranberry Cashew Granola12oz41415-1830502/05/20Coconut Cashew Grain-Free Granola16oz85514000294611/30/19; 12/3/19; 12/5/19; 12/4/19Coconut Cashew Grain-Free Granola8oz85514000270010/19/19Banana Nut Butter Grain-Free Granola8oz85514000272410/17/19; 12/12/19Banana Nut Butter Grain-Free Bar1.4oz85514000209011/26/19Chocolate Sea Salt Grain-Free Bar1.4oz85514000208311/28/19Peanut Butter Grain-Free Bar1.4oz85514000207611/29/19Coconut Cashew Grain-Free Bar1.4oz85514000213711/27/19; 12/20/19; 12/21/19Pumpkin Spice with Ashwagandha Superfood Grain-Free Granola8oz81058903015812/7/19The complete list of recalled products with package photos can be viewed on the company website at 1537

Researchers thought they had a way to keep hard-to-treat patients from constantly returning to the hospital and racking up big medical bills. Health workers visited homes, went along to doctor appointments, made sure medicines were available and tackled social problems including homelessness, addiction and mental health issues.Readmissions seemed to drop. The program looked so promising that the federal government and the MacArthur Foundation gave big bucks to expand it beyond Camden, New Jersey, where it started. But a more robust study released Wednesday revealed it was a stunning failure on its main goal: Readmission rates did decline, but by the same amount as for a comparison group of similar patients not in the costly program.“There’s real concern that the response to this would be to just throw up our arms” and say nothing can be done to help these so-called frequent fliers of the medical system, said study leader Amy Finkelstein.Instead, researchers need to seek better solutions and test them as rigorously as new drugs, said Finkelstein, of the Massachusetts Institute of Technology and the National Bureau of Economic Research.Federal grants and research groups at MIT paid for the study, which was 1236

Singapore is set to become the first country in the world to ban ads for unhealthy drinks with high sugar content in what it says is the latest move in its ongoing "war on diabetes."The ban, which will apply to "the least healthy" sugar-sweetened beverages, will cover all media platforms including print, broadcast and online, said Edwin Tong, Senior Minister of State for the city-state's Ministry of Health.He told reporters at a press conference on Thursday that the decision was made after a "public consultation" in the form of a survey.Soft drinks, juices, yogurt drinks and instant coffee would all be affected by the new regulation, the ministry said in a press release.The ministry also says it will continue to gather consumer and industry feedback in the next few months, before announcing further details on its implementation next year.In addition to an ad ban, the ministry announced that sugary drinks would also be required to display a color-coded, front-of-pack nutrition label to list nutritional quality and sugar content.Tong said the two measures were only the first steps in the city-state's efforts to combat diabetes. Two other proposals, including the possibility of introducing an excise duty or even an outright ban on high-sugar drinks, are still "on the agenda.""We intend to study them more carefully," he added. "We want to find measures that are sustainable in the long-term, that shape not just market consumption behavior but also on the supply side to drive reformulation."'War on diabetes'High consumption of sugary drinks is associated with obesity and greater risks of developing chronic diseases like diabetes and heart diseases. According to the 1700

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