Patterico's Pontifications

3/21/2020

David Lat, 44, Is on a Ventilator

Filed under: General — Patterico @ 8:05 pm



In 2015, Mrs. P. and I were invited by Alex Kozinski to the Richard H. Chambers Courthouse in Pasadena (the Pasadena courthouse where the Ninth Circuit houses several judges), to attend a talk by David Lat (formerly of Above the Law) about his then-new novel Supreme Ambitions. David signed my copy of the book with some very kind words, and we exchanged emails later that year after I finished the book, in which emails he was (again) very kind to me.

Today, he is in critical condition on a ventilator in a Manhattan hospital with COVID-19. He s 44 years old.

David Lat is in critical condition and has been has been put on a ventilator at NYU Langone Hospital in Manhattan, where his fight with the coronavirus has taken a turn for the worse, according to his husband, Zachary Baron Shemtob.

In a phone interview on Saturday evening, Shemtob said that at some point late Friday night or early Saturday morning, Lat, founder of the legal blog Above the Law and now a widely recognized legal recruiter, was put on a ventilator after “his oxygen levels dropped.”

“He’s not doing great,” Shemtob said, adding that the NYU Langone doctors and other staff “are really attending to him. They’re taking it hour by hour, day by day.”

. . . .

Shemtob, a former clerk for U.S. Court of Appeals for the Second Circuit Judge Robert Sack and a former associate at Cooley, echoed a message that Lat himself delivered during a phone interview on Wednesday night. “I just want people to know how serious this can be,” Shemtob said.

Does Lat have a pre-existing condition? Well, yes, but … he has been quite a healthy person for someone with a condition:

In Lat’s Wednesday interview and in Twitter posts and threads he posted last week from his hospital bed, he said that he’s generally been a very healthy person. He’s run two New York City marathons and until recently did intense interval training each week and walked about 25 miles a week, as well.

Lat said that he does have exercise-induced asthma. Shemtob on Saturday said the asthma may be making it harder for Lat to deal with COVID-19, which affects the respiratory system.

“It’s scary. It’s scary to be a mostly healthy person who now can’t even walk 5 feet,” Lat said on Wednesday.

If you have been going around thinking you are invincible, untouchable by the coronavirus because you are under 60 years of age, think again. This is serious stuff.

I’ll be praying for David to pull through. I think he will. But as he said: it’s scary.

15 Responses to “David Lat, 44, Is on a Ventilator”

  1. This is serious stuff.

    Yes, it is. My best wishes to Mr. Lat for a speedy recovery.

    nk (1d9030)

  2. Best wishes for full recovery.

    I’d never heard of exercise-induced asthma.

    https://www.mayoclinic.org/diseases-conditions/exercise-induced-asthma/symptoms-causes/syc-20372300
    _

    harkin (b64479)

  3. I have a kid with that. It is real. I am so sorry this happened.

    DRJ (15874d)

  4. I fear that before this is all over, no one will have escaped having a personal connection to this plague.

    May God bless Mr. Lat with a full recovery, and lift up his loved ones through this dreadful time.

    Glenn Wyant (a56320)

  5. I’m sorry this has happened to such a healthy, young man. I just read this from March 17 on his Twitter account:

    Folks, this #CoronavirusOutbreak is no joke. I’ll give you occasional updates, tweeting from “Above the Hospital Bed,” about how serious #COVID19 aka #coronavirus can be. Think of this as #LatsCovid19Journal, my thoughts on #LivingWithCovid.

    How quickly he went downhill. In just a few days, he went from tweeting about his illness, promising to give updates, and now things are in a very grim state. This should be a warning to all of us about how fast the virus can move.

    Dana (4fb37f)

  6. That’s terrible. I hope he recovers.

    You may want to bring this very recently published study to his physicians’ attention—Wu, G., Peng, C., Liao, W. et al. Melatonin receptor agonist protects against acute lung injury induced by ventilator through up-regulation of IL-10 production. Respir Res 21, 65 (2020).

    Abstract
    Background
    It is well known that ventilation with high volume or pressure may damage healthy lungs or worsen injured lungs. Melatonin has been reported to be effective in animal models of acute lung injury. Melatonin exerts its beneficial effects by acting as a direct antioxidant and via melatonin receptor activation. However, it is not clear whether melatonin receptor agonist has a protective effect in ventilator-induced lung injury (VILI). Therefore, in this study, we determined whether ramelteon (a melatonin receptor agonist) can attenuate VILI and explore the possible mechanism for protection.

    Methods
    VILI was induced by high tidal volume ventilation in a rat model. The rats were randomly allotted into the following groups: control, control+melatonin, control+ramelteon, control+luzindole, VILI, VILI+luzindole, VILI + melatonin, VILI + melatonin + luzindole (melatonin receptor antagonist), VILI + ramelteon, and VILI + ramelteon + luzindole (n = 6 per group). The role of interleukin-10 (IL-10) in the melatonin- or ramelteon-mediated protection against VILI was also investigated.

    Results
    Ramelteon treatment markedly reduced lung edema, serum malondialdehyde levels, the concentration of inflammatory cytokines in bronchoalveolar lavage fluid (BALF), NF-κB activation, iNOS levels, and apoptosis in the lung tissue. Additionally, ramelteon treatment significantly increased heat shock protein 70 expression in the lung tissue and IL-10 levels in BALF. The protective effect of ramelteon was mitigated by the administration of luzindole or an anti-IL-10 antibody.

    Conclusions
    Our results suggest that a melatonin receptor agonist has a protective effect against VILI, and its protective mechanism is based on the upregulation of IL-10 production.

    There are multiple lines of evidence hinting that melatonin may be helpful in providing for less severe COVID-19 pathology, including that those with highest levels of melatonin (young children, pregnant women, and their fetuses) suffer the least death and disability. It is, if nothing else, a potent antioxidant, natural, and with a great safety profile. I realize a specific receptor antagonist was used in this study. Perhaps it will give his treatment team ideas?

    Make America Ordered Again (23f793)

  7. *antagonist

    Make America Ordered Again (23f793)

  8. Hope your friend makes it, Patrick.

    Dave (1bb933)

  9. 8. Ditto.

    Gryph (08c844)

  10. I am sorry to hear this.

    Dustin (b18b7a)

  11. I’m 66 with lifelong asthma. I get it. I really get it. For me this is not some ideological exercise. I HAVE a dog in the hunt, and I am truly sorry that Mr Lat is where he is. This whole thing sucks and there are no good choices.

    But I still believe that this thing will have to run its course. We can bend the curve, but we cannot make it go away and at some point other lives are put at risk by economic ruin. People like me can isolate with less trouble than people who are still in the workforce. Let us do that, it is our lives to risk. There are a few others as well, obviously, but not every able-bodied human is at risk. But I see no reason that the next generations have to be impoverished like my parent’s generation was.

    Kevin M (ab1c11)

  12. Patterico, When I listen to your Sunday Bach cantata link and read your post tomorrow, I’ll be praying for your friend Mr. Lat.

    JoeH (f94276)

  13. I added a word to the post to make it clear David was kind to me in our email exchange, not in the book (in which I do not appear).

    Patterico (115b1f)

  14. David Lat is a “friend” in a similar way that many of you are my “friends” — some Internet communication and (in his case) one meeting in person. We’re not particularly close, but I have followed his work over the years and admired it, and he was apparently aware of my work when we met as well. I am pulling for him like I’m pulling for everyone attacked by this disease. His story is a bit more shocking because he’s young, relatively healthy, and some of us know him. And the fact that he has a form of asthma causes me real concern. It’s a cautionary tale, and *should* cause everyone to take the threat seriously.

    Patterico (115b1f)


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