Thai youth soccer player's health after rescue becomes focus

The rescue operation for the Thai soccer team on July 9 was halted after four more members were brought out of the cave. Photo: AP

The fate of 12 boys and their youth soccer coach has captured international attention after they were trapped in a flooded cave for more than two weeks. The players, aged between 11 and 16, have been in the spotlight.

Four boys were rescued on July 8, and according to a witness working with the rescue team, four more boys were brought out of the flooded cave system on July 9, meaning four more boys and their coach are still trapped inside.

A team of 13 cave diving experts from several countries and five members of the Royal Thai Navy entered the flooded underground tunnel system under the Mae Sai mountain range to reach the team on July 8. The divers traveled through a series of dark, flooded, muddy passages for nearly six hours.

The rescue has two parts: helping the boys who have been brought out of the cave, while continuing efforts to rescue the remaining boys and their coach still trapped inside. The operation paused overnight on July 8 to allow rescuers to rest and refill equipment such as oxygen tanks, and paused on July 9 after four more victims had been rescued.

Medical experts say the rescued boys will first need to be tested for oxygen deficiency in the cave. Thai officials revealed on July 6 that oxygen levels in the air inside the cave had dropped to a dangerous 15%.

“One of the main concerns right now is oxygen. They were in an area where oxygen levels were very low,” Dr. Darria Long Gillespie of the University of Tennessee School of Medicine told CNN. “As soon as they got out, that’s what we need to check: their oxygen levels and their breathing.”

The boys will also be tested for malnutrition, dehydration and a range of other health effects.

Dr. Carole Lieberman, a psychiatrist and avid diver, called it “a great feat” that some of the boys had been rescued. She said authorities would need to test the boys for post-traumatic stress and other psychological effects.

The lack of oxygen in caves, she asserted, “makes people feel less alert. It makes them move more slowly. Some people describe it as being drunk, and it also lowers their mood.”

It was important to relay the good news about the first rescued boys to those still trapped in the cave, she added.
“That will give them more confidence,” Lieberman said.

The four boys rescued on July 8 are being treated in isolation at a nearby hospital and have not been allowed to see their parents. Relatives of one of the boys said on July 9 that they had not yet been told the identities of the boys who were rescued and who was still trapped inside.

Thailand's Health Minister at Chiangrai Prachanukroh Hospital. Photo: CNN

Thai Health Minister Dr Jessada Chokedamrongsook confirmed that the boys may not be able to see their parents for 1-2 days after being rescued due to having to undergo treatment in hospital.

The young players “will be examined by doctors for 5-7 days,” the minister said. “They will be monitored every day.”

The hospital also issued a statement, saying that “the next step is to ensure the boys and their families are safe, as living in a cave is a different environment and could contain animals that could transmit any disease.”

“Anyone who has been in contact with the children, including their families, will be closely monitored to ensure they are not infected,” the hospital said. “They have been informed to call the disease control hotline… if they develop symptoms such as headache, nausea, muscle spasms or difficulty breathing.”

Royal Thai Navy Chief Aphakorn Yoo-kongkaew said on July 6 that oxygen levels in the cave had dropped to just 15%. According to the US Department of Occupational Safety and Health Administration, the “optimum threshold” of the amount of oxygen in the air needed for a person to breathe and maintain normal function is between 19.5% and 23.5%. If oxygen drops below that, the body begins to change and may face the risk of hypoxia.

Dr. Norman H. Edelman, senior scientific advisor to the American Lung Association, asserted that the boys' survival "all depends on the ventilation mechanisms and the size of the space."

Since the boys and their coach have been trapped in the cave for more than two weeks, Edelman “hypothesized” that there might be a ventilation system, though he cautioned that he did not have complete knowledge of the situation.

“The first thing that happens to the body when oxygen levels drop is it tells you to breathe more. It’s exactly like climbing a mountain and as you go to higher altitudes, the oxygen pressure drops,” Edelman said.

“So the first thing people feel is they need to breathe more, they may feel a little lightheaded, a little dizzy. They may have trouble sleeping, they may have headaches when they sleep,” he said.

The Thai soccer team was trapped in a cave for more than two weeks before being found. Photo: Royal Thai Navy

Another problem boys can experience when oxygen drops is an increase in carbon dioxide, a gas humans give off when they breathe, Edelman said.

“When carbon dioxide increases, people start to feel short of breath, maybe dizzy, maybe panic, but if it happens slowly enough, people adapt. It's like climbing a mountain, people eventually adapt to low oxygen levels, unless of course it's too low.”

Gillespie at the University of Tennessee, however, believes that the boys’ age is an advantage in helping them survive. “They are at the peak of their health,” she said. “If anyone can endure these low-oxygen moments and other physical challenges, it is young teenagers.”