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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 re

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/ 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/ 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 https://hms.harvard.edu/affiliates/brigham-womens-hospital Neither is U Penn academic medical department. http://www.uphs.upenn.edu/antibiotics/COVID19.html http://www.uphs.upenn.edu/antibiotics/COVID19.html Neither is the American Thoracic Society. https://www.thoracic.org/covid/covid-19-guidance.pdf 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.

delhanty 6y ago
Re: "game changer", I was referencing the comment by war1025 that polyclonal anti-bodies were a game changer. >Sounds like Trump got a similar cocktail from a different company. The speed of his recovery and the fact that him having Coronavirus isn't even part of the news cycle anymore seems like a strong indicator that the treatment is probably a game changer. >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.' Sorry - I'm more impressed by a single randomized open label, double-masked clinical trial than I am by argument by authority. Perhaps we can check back here in a couple of years time ... I can't help remembering how actual doctors in the field were telling us back in February to "get a flu shot", or "masks only work for doctors who've been trained to put them on properly". I'm so happy that I'd already purchased my N95 masks in January while you guys were asleep.
- phobosanomaly 6y ago
  I advise you to scope out the definition of a pilot trial. Here's a cool one I found: "A pilot trial is a small study conducted to help design and assess the feasibility of doing a larger, full‐scale trial. They also investigate whether the methods and procedures are able to obtain the data that is needed to answer the question that will be addressed in the larger study." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6046600/#:~:text=1.1.,addressed%20in%20the%20larger%20study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6046600/#:~:tex.... You can contrast that with a clinical trial: "Clinical trials are research studies performed in people that are aimed at evaluating a medical, surgical, or behavioral intervention. They are the primary way that researchers find out if a new treatment, like a new drug or diet or medical device (for example, a pacemaker) is safe and effective in people. Often a clinical trial is used to learn if a new treatment is more effective and/or has less harmful side effects than the standard treatment." https://www.nia.nih.gov/health/what-are-clinical-trials-and-studies https://www.nia.nih.gov/health/what-are-clinical-trials-and-... Getting a flu shot is important. Please get yours this season so we can help reduce the spread of yet another deadly respiratory virus that kills thousands of people each year. There was a lot of debate about masks. As you can recall, a lot of frontline health professionals were dying because of a lack of PPE while carrying out incredibly risky procedures like intubation. Gondi, S., Beckman, A. L., Deveau, N., Raja, A. S., Ranney, M. L., Popkin, R., & He, S. (2020). Personal protective equipment needs in the USA during the COVID-19 pandemic. The Lancet, 395(10237), e90–e91. https://doi.org/10.1016/s0140-6736(20)31038-2 https://doi.org/10.1016/s0140-6736(20)31038-2 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31038-2/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... I'm happy that you have your N95 masks to keep you safe at Trader Joes (where all of us normal folks have been well-served with cloth masks and social distancing) because god forbid an emergency room nurse or doctor needed N95-level protection while securing a patient's airway after they stop breathing. I don't know what you're implying by the phrase 'argument by authority,' but we're talking about people who have spent their entire careers in the field of medicine. Normally we call those people 'scientists' and 'experts.' I'd trust Dennis Richie to know a thing or two about C, and if I wanted to know a little something about algorithms I wouldn't be done a disservice by chatting with Donald Knuth. Edit: I wrote this on my other comment too, but I wanted to put it here to make sure you saw it: First of all I'd like to preface this by saying that everything I write is with a light heart, and I'm not actually 'angry' or feeling any sort of ill will towards you. Everything is weird now with COVID, and sometimes when we say stuff on the internet it might sound more aggressive than it is intended to. So, no matter what our different opinions are I love you dude, and if we were in person I'd buy you a beer.

delhanty 6y ago

Re: "game changer", I was referencing the comment by war1025 that polyclonal anti-bodies were a game changer. >Sounds like Trump got a similar cocktail from a different company. The speed of his recovery and the fact that him having Coronavirus isn't even part of the news cycle anymore seems like a strong indicator that the treatment is probably a game changer. >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.' Sorry - I'm more impressed by a single randomized open label, double-masked clinical trial than I am by argument by authority. Perhaps we can check back here in a couple of years time ... I can't help remembering how actual doctors in the field were telling us back in February to "get a flu shot", or "masks only work for doctors who've been trained to put them on properly". I'm so happy that I'd already purchased my N95 masks in January while you guys were asleep.

phobosanomaly 6y ago
I advise you to scope out the definition of a pilot trial. Here's a cool one I found: "A pilot trial is a small study conducted to help design and assess the feasibility of doing a larger, full‐scale trial. They also investigate whether the methods and procedures are able to obtain the data that is needed to answer the question that will be addressed in the larger study." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6046600/#:~:text=1.1.,addressed%20in%20the%20larger%20study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6046600/#:~:tex.... You can contrast that with a clinical trial: "Clinical trials are research studies performed in people that are aimed at evaluating a medical, surgical, or behavioral intervention. They are the primary way that researchers find out if a new treatment, like a new drug or diet or medical device (for example, a pacemaker) is safe and effective in people. Often a clinical trial is used to learn if a new treatment is more effective and/or has less harmful side effects than the standard treatment." https://www.nia.nih.gov/health/what-are-clinical-trials-and-studies https://www.nia.nih.gov/health/what-are-clinical-trials-and-... Getting a flu shot is important. Please get yours this season so we can help reduce the spread of yet another deadly respiratory virus that kills thousands of people each year. There was a lot of debate about masks. As you can recall, a lot of frontline health professionals were dying because of a lack of PPE while carrying out incredibly risky procedures like intubation. Gondi, S., Beckman, A. L., Deveau, N., Raja, A. S., Ranney, M. L., Popkin, R., & He, S. (2020). Personal protective equipment needs in the USA during the COVID-19 pandemic. The Lancet, 395(10237), e90–e91. https://doi.org/10.1016/s0140-6736(20)31038-2 https://doi.org/10.1016/s0140-6736(20)31038-2 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31038-2/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... I'm happy that you have your N95 masks to keep you safe at Trader Joes (where all of us normal folks have been well-served with cloth masks and social distancing) because god forbid an emergency room nurse or doctor needed N95-level protection while securing a patient's airway after they stop breathing. I don't know what you're implying by the phrase 'argument by authority,' but we're talking about people who have spent their entire careers in the field of medicine. Normally we call those people 'scientists' and 'experts.' I'd trust Dennis Richie to know a thing or two about C, and if I wanted to know a little something about algorithms I wouldn't be done a disservice by chatting with Donald Knuth. Edit: I wrote this on my other comment too, but I wanted to put it here to make sure you saw it: First of all I'd like to preface this by saying that everything I write is with a light heart, and I'm not actually 'angry' or feeling any sort of ill will towards you. Everything is weird now with COVID, and sometimes when we say stuff on the internet it might sound more aggressive than it is intended to. So, no matter what our different opinions are I love you dude, and if we were in person I'd buy you a beer.