April 15, 2020
Since the original post here on 3/10/2020 Dr. Harch has been communicating nearly daily with the Chinese physician group who had the initial experience treating COVID-19 pneumonia and respiratory failure in Wuhan, China. The goal, based on Dr. Harch’s 29 years of interface with academic physicians, institutions, and governments where decisions to implement a medical therapy are based on published information in peer-reviewed medical journals, has been to get Dr. Xiaoling’s, Chen’s, and colleagues’ original five case series published in an English language medical journal. Simultaneously, recommendations would be made on safety features for delivering HBOT to patients while protecting healthcare workers and other patients.
Because of the urgency/emergency in trying to disseminate this information safely Dr. Harch reviewed all of the data, organized the Chinese experience, and presented it to the governors of New York and Louisiana, the two hardest-hit U.S. epicenters of the pandemic and their medical staffs. The goal was to have government sponsored HBOT application in safe hospital settings. Their response was that they wanted to see published information on the Chinese experience, reinforcing the original plan to get the Chinese HBOT data published in an English-language scientific/medical journal. When these responses were received Dr. Harch tried to convert his clinic to an exclusive COVID-19 treatment center, but due to the severe condition of the patients, the need for ambulance transport daily from the hospital to the clinic, and the lack of reimbursement for this transport, this plan had to be abandoned and a formal application made for a study to be done.
Yesterday, my published Commentary article was released by Medical Gas Research which is attached. It will be in the June issue of Medical Gas Research and should appear on their website shortly. The graph in the Commentary is from the Chinese 5 case series, showing the daily increase in blood oxygen saturation with each HBOT. With permission from the Chinese authors I have also posted their two case reports, a ventilator patient, and a severe patient who was deteriorating and refused intubation. That second case report is the most severe patient in their five-patient series. The severe patient’s case report was translated to English for me by the Chinese authors. I am awaiting the translation of the ventilator patient case report. Also listed below is the English language version of the manuscript released by Dr. Xiaoling to colleagues in China earlier in the pandemic out of urgency to spread their experience. The recipients put it on the internet and it has circulated in several forms. The final version of this, reformatted, and partially grammar corrected for English by Dr. Harch with stronger arguments on the rational for HBOT in COVID-19 is awaiting the Chinese author’s permission to release once the Chinese journal has published this version.
Lastly, the Chinese infection control procedures for their multi-place chamber are listed, along with a picture of the console/department staff of the hyperbaric unit. They do not have a picture of the “inside” attendants. The “inside” attendants actually never entered the multiplace chamber with the patients. They remained in a separate lock from which they could enter the patient lock if necessary. In the treatment of 35 patients no hyperbaric staff entered the treatment lock. None of the medical staff contracted COVID-19. Of the 35 patients, 29 were less severe than those described above. The Chinese doctors stated that these patients would have all improved without HBOT, but once the patients witnessed how rapidly the severe patients improved they demanded HBOT from the hospital administration. The administrators “pressured” the HBOT staff to treat the less severe patients. All 35 recovered and were discharged from the hospital “cured.” Since then Dr. Harch has communicated with a physician team at another hospital in Wuhan that has treated 34 patients. They stated that it was a clinical urgency that prompted their attempt at HBOT. They performed no “study,” but are now collating their data to present. Purportedly, hyperbaric physicians in Pakistan, Iran, Thailand, and Japan have also begun treating COVID-19 patients.
The net result of all of this is that the Chinese experience with HBOT in COVID-19 is duplicating the Cunningham experience with Spanish Flu in 1918. There are now multiple studies that have been launched on HBOT in COVID-19. HBOT appears to be treating the hypoxemia and underlying pathology (lung inflammation) in COVID-19.