Thread by @kaveri59872487

#CovidIsNotOver This is my 15th semester teaching RN and NP students about Covid 19 pathophysiology. Not a lot has changed except for how much damage we now know the virus causes. It still baffles me that people don’t know it’s airborne, don’t know the risks. 1

Semester after semester I see my maskless students filter in, dutifully taking notes on how the Covid virus attaches to ace2 receptors in the nose, throat, gut, kidneys, liver and pancreas first, then later the lungs 2

I remind them about the symptoms we see first- colds, sore throats, gi issues, elevated kidney & liver values. We then talk about the up regulation of bradykinin, a peptide that, among other things, induces clotting. 3

Then we talk about Covid pneumonia and how fluid that fills the lungs forms a hydrogel, which makes it very hard to intubate and ventilate. We talk about how high type 1 DM rates are, how many young people are having strokes and heart attacks from all the microclots. 4

None of this seems to faze them. Then I asked them to raise their hands if they had COVID. All of them did. Then I asked if they had COVID twice. 75-80% still had their hands up. Then I asked how many had it 3 times. About half of the class still had their hands up 5

I told them that having Covid 3 times increased their chances of long Covid by close to 40%. That’s when I started to see some students look worried. I also told them that the effects of Covid are cumulative and may show up much later. 6

A student asked if they would have any effects from having Covid once. I told them that they could, it is possible to have Covid sequelae, such as myocarditis or diabetes, after only one time. The vascular and immune effects are ongoing. 7

We then talked the enormous immune dysfunction caused by Covid. The virus causes the body to be in a constant inflammatory state. This depletes the white blood cells and platelets. It also damages wbcs so that they do not function as well. 8

I asked, if they get Covid 2 or 3 times a year, how long would it talk for their immune system to recover? Answer- 6 months to a year, perhaps more depending on severity and number of episodes. 9

Finally we talked about the Covid mitigations and public health system. They were incredulous to find out that WHO/CDC only recently admitted that Covid was airborne, a fact many thought was established. The same antiviral medications are being used as 2020-21. 10

I urged them to protect themselves- wear masks, ventilate, get the vaccine booster. A student asked why she should get it if it didn’t stop her from getting Covid. I told her that it would decrease the severity of the disease and likely reduce her risk of long Covid. 11

I worry about these students, going on to be HCWs. They are so smart, smarter than me. And yet they don’t see the risks. I get a lot more emails telling me they have Covid and can’t come to class. I do see a few more students wearing masks. 12

But to the majority- it’s one more disease to be tested on. 13 @ariccio

PS this is probably why we are suddenly seeing RSV in adults, mycoplasma pneumonias in kids, and other weird diseases we haven’t seen before.

@ariccio No one seems to realize that this is why we are seeing decrease immunity and increased disease, such as RSV in adults and rare mycoplasma PNA in children. 14

@scott_squires @ariccio And if you do talk about Covid, you are chastised or put down. It’s become an uncomfortable topic.