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was time to take more aggressive measures. Eventually, Cai saw the scan himself. Instead of just that one white spot on one lung — something with the look of a dandelion gone to seed — there were dozens. The onslaught of the virus could be described as a toxic lava flow of infection that ravages the alveoli, the fragile, thin-membraned air sacs where gases are exchanged in each breath. It looked as if close to 40 percent of Cai’s lungs had succumbed in just five days.
Balani said that they were going to try to put him on a drug called remdesivir. The drug, a descendant of a broad antiviral medication developed a decade ago, was tried in treatment of Ebola with little success. It was more effective in inhibiting MERS in infected monkeys, according to a study published in February in The Proceedings of the National Academy of Sciences. The medication, which fools the virus into incorporating a modified building block into its RNA that stops it from replicating, is still in clinical trials. Many doctors have been cautiously optimistic about some promising research, including one case study published in The New England Journal of Medicine in late February. The first patient in Washington State to be found to have Covid-19 was severely ill when Gilead Sciences, the pharmaceutical company that made the drug, provided him with remdesivir for compassionate use — an effort to use a promising drug for people who are gravely ill when no other treatments are available; the patient recovered. Now Cai’s health had deteriorated to the point at which the hospital could apply for remdesivir for compassionate use. Just a few weeks later, overwhelmed by international demand, Gilead announced that it would stop approving new requests for compassionate use but greatly expanded its clinical trials at various hospitals.
That day, Cai was given chloroquine and Kaletra; he was also put on high-flow oxygen, that high-concentration oxygen delivered through the nose. The method allows patients at risk of respiratory failure to stave off intubation and ventilators; but because the patient
Cai’s second CT scan showing a rapid proliferation of the “ground glass” spots common in Covid-19 cases. He had lost close to 40 percent of his lung function to the virus in just five days.Credit...From James Cai
"The onslaught of the virus could be described as a toxic lava flow of infection that ravages the alveoli, the fragile, thin-membraned air sacs where gases
are exchanged
in each breath.
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