5 ms·

It's not even leaks, it's included in the Official Coronavirus Treatment Plan: "(4) Salvage therapy: for patients with severe ARDS, a recruitment maneuver is r

It's not even leaks, it's included in the Official Coronavirus Treatment Plan: "(4) Salvage therapy: for patients with severe ARDS, a recruitment maneuver is recommended. When human resources allow, prone ventilation should be carried out for 12 hours or more every day. " https://www.chinalawtranslate.com/coronavirus-treatment-plan-7/?lang=en https://www.chinalawtranslate.com/coronavirus-treatment-plan... There's simply a shocking degree of arrogance from the West to refuse to learn even the most basic things from Asia about this. For example, people are finally grudgingly admitting that CT scans could play a useful role in diagnostics after months of CDC & ACR denialism: https://www.statnews.com/2020/04/16/ct-scans-alternative-to-inaccurate-coronavirus-tests/ https://www.statnews.com/2020/04/16/ct-scans-alternative-to-... edit: More details in Jack Ma Foundation produced Handbook of COVID-19 Prevention and Treatment (3) Prone Position Ventilation Most critically ill patients with COVID-19 respond well to prone ventilation, with a rapid improvement of oxygenation and lung mechanics. Prone ventilation is recommended as a routine strategy for patients with PaO/FiO2 < 150 mmHg or with obvious imaging manifestations without contraindications. Time course recommended for prone ventilation is more than 16 hours each time. The prone ventilation can be ceased once PaO/FiO2 is greater than 150 mm Hg for more than 4 hours in the supine position. Prone ventilation while awake may be attempted for patients who have not been intubated or have no obvious respiratory distress but with impaired oxygenation or have consolidation in gravity-dependent lung zones on lung images. Procedures for at least 4 hours each time is recommended. Prone position can be considered several times per day depending on the effects and tolerance. https://www.alibabacloud.com/universal-service/pdf_reader?cdnorigin=video-intl&pdf=Read%20Online-Handbook%20of%20COVID-19%20Prevention%20and%20Treatment.pdf https://www.alibabacloud.com/universal-service/pdf_reader?cd...

carbocation 7y ago
MGH is proning a bunch of awake patients (who have the physical strength to do so) and about ~30% of our ventilated patients. There is no "shocking degree of arrogance from the West" but there may be a failure of adequate reporting, in this article and others, of what we are doing in hospitals.
- shalmanese 7y ago
  Except it's applied to literally every part of the Asian pandemic response from masks to contact tracing. Asian countries have been saying for months that there's not some magical technological solution to contact tracing, the tech helps maybe 10%. The rest of it is just plain on the ground shoe leather pounding, public communication and talking to people. Watch as Western countries start discovering as they roll out their automated contact tracing apps how little the tech plays a role in an effective contact tracing system.
  - carbocation 7y ago
    Regarding the contact tracing, etc, that you are describing (which is a bit beyond the article's scope, since it is talking about medical therapies): the West's failure is a political one. The experts in the West know and agree with everything you're saying.
  - dkdk8283 7y ago
    Contact tracing is a severe invasion of privacy and just another tool to increase surveillance. I will never submit to such measures.
    - shalmanese 7y ago
      Just so we're clear, can you explain succinctly the key details of how contact tracing has been implemented in the various countries that have rolled it out and which parts you object to? There's a lot of parameters in the "design space" of contact tracing. If you're objecting to simply the most extreme version of it, then duh, anyone would, including the Chinese.
      - pastage 7y ago
        That is hard to answer can you anser what kind of contact tracing are you missing in "the West", and what level of privacy invasion are you comparing it against. In the first stages of Corona we did a lot of old school contact tracing.
oldgradstudent 7y ago
> There's simply a shocking degree of arrogance from the West Not sure it is Western arrogance rather than standard medical arrogance. The video accompanying the NYT piece (5m:37sec) one doctor says: > We have large randomized controlled trials. The patients in those trials had met the same diagnostic criteria that are current patients meet. We should apply the results of the trials. This is insane for a new disease.
- stainforth 7y ago
  I don't understand the takeaway from the doctor's quote? Is the doctor saying they're not doing something special?
  - oldgradstudent 7y ago
    I should have quoted the previous sentence: > I'm arguing for evidence-based medicine, which is something we all purported to agree with before the outbreak hit. > We have large randomized controlled trials. The patients in those trials had met the same diagnostic criteria that are current patients meet. We should apply the results of the trials. The problem is that Covid-19 is caused by a NOVEL virus which has no evidence base. There should be at least some skepticism regarding the applicability of previous studies.

carbocation 7y ago

MGH is proning a bunch of awake patients (who have the physical strength to do so) and about ~30% of our ventilated patients. There is no "shocking degree of arrogance from the West" but there may be a failure of adequate reporting, in this article and others, of what we are doing in hospitals.

shalmanese 7y ago
Except it's applied to literally every part of the Asian pandemic response from masks to contact tracing. Asian countries have been saying for months that there's not some magical technological solution to contact tracing, the tech helps maybe 10%. The rest of it is just plain on the ground shoe leather pounding, public communication and talking to people. Watch as Western countries start discovering as they roll out their automated contact tracing apps how little the tech plays a role in an effective contact tracing system.
- carbocation 7y ago
  Regarding the contact tracing, etc, that you are describing (which is a bit beyond the article's scope, since it is talking about medical therapies): the West's failure is a political one. The experts in the West know and agree with everything you're saying.
- dkdk8283 7y ago
  Contact tracing is a severe invasion of privacy and just another tool to increase surveillance. I will never submit to such measures.
  - shalmanese 7y ago
    Just so we're clear, can you explain succinctly the key details of how contact tracing has been implemented in the various countries that have rolled it out and which parts you object to? There's a lot of parameters in the "design space" of contact tracing. If you're objecting to simply the most extreme version of it, then duh, anyone would, including the Chinese.
    - pastage 7y ago
      That is hard to answer can you anser what kind of contact tracing are you missing in "the West", and what level of privacy invasion are you comparing it against. In the first stages of Corona we did a lot of old school contact tracing.

oldgradstudent 7y ago

> There's simply a shocking degree of arrogance from the West Not sure it is Western arrogance rather than standard medical arrogance. The video accompanying the NYT piece (5m:37sec) one doctor says: > We have large randomized controlled trials. The patients in those trials had met the same diagnostic criteria that are current patients meet. We should apply the results of the trials. This is insane for a new disease.

stainforth 7y ago
I don't understand the takeaway from the doctor's quote? Is the doctor saying they're not doing something special?
- oldgradstudent 7y ago
  I should have quoted the previous sentence: > I'm arguing for evidence-based medicine, which is something we all purported to agree with before the outbreak hit. > We have large randomized controlled trials. The patients in those trials had met the same diagnostic criteria that are current patients meet. We should apply the results of the trials. The problem is that Covid-19 is caused by a NOVEL virus which has no evidence base. There should be at least some skepticism regarding the applicability of previous studies.