EMCrit

Also EMCrit’s IBCC project has a chapter on COVID: https://emcrit.org/ibcc/covid19/ And it’s a recurring subject on their podcast: https://emcrit.org/

There are quite a few, and it's always the best option when possible. Most of the complications you hear about from "routine surgery" relate to the management of the patient's airway while they are sedated. An awake patient can maintain their airway. If you're interested in how these sorts of things can wrong, here's a well done reenactment of such a case: http://emcrit.org/misc/the-new-elaine-bromiley-videos/

I also find many of the discussions helpful, however when the language used becomes particularly charged it is harder to pick out the helpful parts of the discussion and it discourages many people from contributing. Even if it is still helpful to have one such discussion, repeating the same arguments in multiple discussions per day is not helpful. At least to me, it makes sense to try to focus discussions on the most interesting articles every few days and not have running coronavirus discussions every day. If you are interested in the medical side of coronavirus I happened to find the emcrit.org site recently. I don't know much about them but you can read discussions from actual doctors about the medical side of treating coronavirus and some of the different treatment approaches they are using (you will need to know or learn some medical terminology). E.g. they discussed how "awake prone" seems to be helpful, although a doctor with a fairly bad case added that for him sitting up (even at night) seems to be the most helpful. https://emcrit.org/ The other place I have been checking regularly is Trevor Bedford's (of the Seattle Flu Project) twitter account where he has posted some interesting threads on genetic sequencing of the virus and what it reveals about how it is spreading. https://twitter.com/trvrb

IANAMedic: I assumed you/a loved one had CF. As I understand it CF creates a thick mucus that blocks the lungs. But Covid19 reportedly destroys pilii, and the cells that bare them, and when the immune response kicks in fully it attacks lung tissue as well as the virus. _If_ this understanding of mine is corrext, then it seems clearing the lungs in CF opens them to take oxygen that's there (if the mucus is moved the underlying lung function is still enough), but in Covid19 even if cleared the lung tissue is damaged and can't process enough oxygen from a regular supply; people need higher pressure and/or higher saturation oxygen for a period in order to recover lung function. Maybe I'm wrong. It's certainly not wrong to share how you clear lungs affected by CF if you're explicit about any limitations in your knowledge. As an example of this that seems counterfactual to me -- as a medically uninformed person -- BiPAP, which is commonly used for CF sufferers I gather, at least one critical care source suggests is not really useful for Covid19 (https://emcrit.org/ibcc/COVID19/#noninvasive_ventilation_(BiPAP_&_… ) treatment. The problem with suggesting treatments is that people may resort to self-treatment alone and not seek proper medical care; that could cost lives. So I think your analysis is wrong if you're suggesting 'giving advice can't be harmful'.

This, as well as Disseminated Intravascular Coagulation(DIC). https://en.wikipedia.org/wiki/Disseminated_intravascular_coagulation https://emcrit.org/ibcc/covid19/#disseminated_intravascular_coagulatio…

> it's less of an issue. The situation that would warrant this would likely also warrant full PPE just to enter a unit or building. Isn't it still important not to spray covid everywhere? See for example this post: https://emcrit.org/emcrit/covid-airway-management/ > Critical Note: If you use the vent for preox, you MUST disconnect the vent circuit proximal to the viral filter before removing the mask. Otherwise, COVID will be sprayed all around the room!!!!! See Triple C below. {EDIT: genuinely don't know why this got downvotes.}

It’s really hard to know what to make of this data without a control arm. The patient selection becomes key to estimating the effect of on the outcomes, but the patients were not all extremely sick to start, and the patient inclusion criteria is super unclear. https://emcrit.org/pulmcrit/pulmcrit-eleven-reasons-the-nejm-paper-on-…

There is a growing consensus that constant positive pressure is what many patients need: https://emcrit.org/ibcc/covid19/ Developing a closed mask that doesn't contaminate everyone around them might do much good.

Nice find. I find this interesting too:"Internet Book of Critical Care (IBCC): COVID-19" (Written by a pulmonologist): https://emcrit.org/ibcc/covid19/

RT-PCR tests can be way worse than this. https://i1.wp.com/emcrit.org/wp-content/uploads/2020/03/perfctpcr.jpg?… https://emcrit.org/ibcc/COVID19/

There is quite some discussion of it here https://emcrit.org/pulmcrit/split-ventilators/ It has certain disadvantages (like not being able to trigger a breath on yiur own)

This is another article seems to be written by someone who has deep knowledge about this topic. https://emcrit.org/pulmcrit/split-ventilators/ Continuous mandatory ventilation (CMV) is required, however it is necessary to accept permissive hypercapnia.

What are you saying, that thalassaemia is protective against COVID? Thalassaemia protects against malaria because blood cells (the home of the parasite during a phase of its lifecycle) are destroyed up to 3-4x faster than in non-thalassaemia traits (where they last on average for 120 days). Chloroquine seems to work by interfering with cellular binding and entry of SARS-CoV-2 on the ACE2 receptor (amongst other mechanisms) This is why only people with training or understanding should speak about medical matters, there is enough rubbish out there (particularly at the moment) without you adding to the noise (0) https://emcrit.org/ibcc/covid19/#chloroquine

You forgot the Respiratory Therapists. As a former respiratory therapist I understand you concern about a project like this. I doubt anything beyond a CPAP machine is helpful for home care without risking a ventilator lung injury which is often characterized as the same lung pathology that COVID-19 creates in the acute respiratory cases. That said, at home you could help at home patients relieve some symptoms until proper medical attention is available by doing positive breath holding exercises and chest percussion therapy to recruit more alveolar activity. Paging Dr. Scott Weingart https://emcrit.org/emcrit/some-additional-covid-airway-management-thou…

A metric that may be useful: fragility index. How many positive results would need to be reversed to have the p-value exceed 0.05? Seems applicable for low-powered studies such as this one. Details: https://emcrit.org/pulmcrit/fragility-index-ninds/

That's what I thought too, until I had a one off face swelling and throat closing event after eating a new food and went to an allergist, only to learn I was not allergic and have had successful re-eatings of that food. What I learned from the allergist is, histamine angioedema is essentially the same thing as anaphylaxis, and is treated the same, but is different in cause in that repeat exposure to the food item will not cause a repeat episode. I'm not a doctor either, but according to my allergist (who is), most people who think they are allergic to some random thing that most people have never heard of people being allergic to, are not in fact allergic to that thing. Reading the full text of the article you linked it looks like their criteria cover both angioedema and anaphylaxis and add the two together. Here's some additional info: https://knyamed.com/blogs/difference-between/angioedema-vs-anaphylaxis https://emcrit.org/ibcc/angioedema/#diagnosis_of_angioedema

You make some interesting claims, do you have any sources? Would be interested to read more. > They have made crazy claims about their Covid research since March 2020 while serious scientists who have produced stuff that actually works were more focused on stuff in the lab. They continue to make outlandish claims, for example claiming they had developed the first ever monoclonal antibody drug for Covid. This was in the weeks after Trump and ex NJ Gov Christie were successfully treated with Regeneron's and Eli Lilly's monoclonal antibody drugs respectively, and of course the British press and Oxford boosters spread it around in the media. From what I can tell, it looks like Oxford started their trial in September [1] and all other reference I can find for the other drug you are mentioning, "bamlanivimab", seems to come after that date. Not sure why this is such an issue? The trials for example started in October [2]. The second reference there also seems quite critical of the drug you are mentioning: * Bamlanivimab showed no benefit in the ACTIV-3 trial involving hospitalized patients with COVID-19. * Bamlanivimab failed to achieve the primary endpoint of viral load reduction in a trial involving outpatients with COVID-19 (BLAZE-1). It may have caused some debatable improvements in secondary endpoints. * Eli Lilly is now testing a cocktail of bamlanivimab plus another antibody. The company seems to realize that bamlanivimab might have some efficacy, but it’s far from a…

The Internet Book of Critical Care is a collaborative effort by front-line docs to share information about promising therapies and approaches to COVID. It's really interesting, and broken down by bullet points. Check it out, and get an idea of how actual doctors in the field are approaching this thing. https://emcrit.org/ibcc/covid19/ Joah Farkas, an associate professor of Pulmonary and Critical Care Medicine at the University of Vermont who runs IBCC isn't bullish on Vit D. https://covidprotocols.org/protocols/therapeutics/ Neither is Brigham and Women's Hospital, which is Harvard Medical School's teaching and research hospital. https://hms.harvard.edu/affiliates/brigham-womens-hospital Neither is U Penn academic medical department. http://www.uphs.upenn.edu/antibiotics/COVID19.html Neither is the American Thoracic Society. https://www.thoracic.org/covid/covid-19-guidance.pdf Neither is anyone at my academic teaching hospital. A lot of really smart people with decades of experience in the field, and a direct clinical role have collected a variety of approaches that seem to work. Unfortunately, none of them have characterized Vit D as a 'game changing drug.' I think it might be wise to hold off on phrases like 'game changing' with regards to Vitamin D. Not to say that it may not eventually play a role as part of a multifaceted approach.