8 ms·

If you told six month ago me that we'd be treating people who are high risk of this disease the same as people with low risk I would have been in complete disbe

If you told six month ago me that we'd be treating people who are high risk of this disease the same as people with low risk I would have been in complete disbelief.

rscho 6y ago
What's unbelievable is that we started this pandemic by treating people as if we knew nothing not only about this virus, but also by throwing all ARDS experience to the trash. I will remember our experts telling us to intubate early and withhold steroids for a very long time. We killed a lot of people because a minority wanted to show off. This is depressing.
- Lewton 6y ago
  Experts didn't suggest withholding steroids just because they wanted to show off. Doctors in the field withheld steroids because the steroids they were giving patients with covid-19 was actively killing them. It took a long time to find out what steroids could safely be used for treatment
  - rscho 6y ago
    When I say 'we killed', it's myself included in a very personal way. I am an ICU doctor working on the frontline at one of the largest european university hospitals. And I am not a resident anymore. Yes, they were show-offs and they still are. There is no justification for throwing away years of clinical experience with ARDS based on the personal opinions of a few who want to steal the spotlight by relying on novelty. They deserve to be despised, and I can say that with full confidence because I know a few of them personally.
    - Lewton 6y ago
      Is what I wrote wrong? Is it not true that in the beginning they saw an increase in fatalities when treating with certain kinds of steroids?
      - rscho 6y ago
        I never downvote, so not me. BTW yes, they said that. And now we see that using them and trying to keep people breathing by themselves, we do much better (big surprise). I do a lot of medical research and I am fully confident in saying that to decide to go against the grain based on preliminary data is irresponsible in medicine. As a personal note, the attitude of medical researchers and the loosening of ethical and legal boundaries pertaining to research I saw in the first wave make me puke.
        Lewton 6y ago
        > I never downvote, so not me Appreciate it (and your reply!) I think the issue was that most of the decisions made, over-reliance on intubation, withholding steroids, etc where made in the beginning, in places were the hospitals were overloaded and there was this sense of urgency and panic. Then some random study is showing a 18% fatality rate in severe cases with steroids Vs 14% without, giving the impression that this virus works like no other
        rscho 6y ago
        In my opinion, reverting to more usual intubation practices is really a major improvement. For some reason, people tend to forget that mechanical ventilation is not a treatment but merely a supportive measure. > some random study is showing a 18% fatality rate in severe cases with steroids Vs 14% without, giving the impression that this virus works like no other Exactly. And I think that this goes to show that the current dynamics of medical research are highly toxic. The synergy between the 'publish or perish' motto and the myriad of Excel spreadsheet warriors who go on to become influential professors kills a lot of people.
Aachen 6y ago
Yeah let's get all the young people infected, having one percent of that population die is fine right? Next, they'll surely never talk to the people at risk. Their grandparents can sit at home and be more bored to death and lonely than they usually already are and have young people, which are allowed out, to bring them food. Couldn't possibly go wrong. How do you picture different kinds of measures per risk group going? People can already choose to isolate more, disinfect more, keep distance more, etc. if they find themselves at risk. The compulsory measures are a bare minimum to prevent unnecessary deaths and keep the long term impact to a minimum. You can find a new job next year and live on government benefits in the meantime (or is the worst-case scenario for you not unemployment and boredom? Well, infecting loved ones would be worse in these times but you don't seem to find that very worrying) but if you're one of today's corona deaths you can't find another life.
- _-___________-_ 6y ago
  > Yeah let's get all the young people infected, having one percent of that population die is fine right? Are you really claiming with a straight face that the chance of a young person who gets infected dying is 1/100? Would love to see you try to provide a source for that...
  - Aachen 6y ago
    Are we really going to split hairs over what the exact percentage is or can we talk about the point? To me it seems like crazy talk to pose something, which would cause millions of deaths, to be unbelievable not to do. I'd be much more interested in how they think this could possibly work in a safe manner than debating whether it causes 5 per thousand or 10 per thousand (a sibling comment said 0.63%, so 6.3 million among the billion young people we have). Something something straight face.
    - _-___________-_ 6y ago
      You’re probably two orders of magnitude off. Not exactly splitting hairs. (Sibling comment is talking about CFR, not IFR.) Any conclusions you might reach based on that kind of exaggeration of the risk are pretty meaningless.
deleted 6y ago
[deleted]

If you told six month ago me that we'd be treating people who are high risk of this disease the same as people with low risk I would have been in complete disbelief.

rscho 6y ago

What's unbelievable is that we started this pandemic by treating people as if we knew nothing not only about this virus, but also by throwing all ARDS experience to the trash. I will remember our experts telling us to intubate early and withhold steroids for a very long time. We killed a lot of people because a minority wanted to show off. This is depressing.

Lewton 6y ago
Experts didn't suggest withholding steroids just because they wanted to show off. Doctors in the field withheld steroids because the steroids they were giving patients with covid-19 was actively killing them. It took a long time to find out what steroids could safely be used for treatment
- rscho 6y ago
  When I say 'we killed', it's myself included in a very personal way. I am an ICU doctor working on the frontline at one of the largest european university hospitals. And I am not a resident anymore. Yes, they were show-offs and they still are. There is no justification for throwing away years of clinical experience with ARDS based on the personal opinions of a few who want to steal the spotlight by relying on novelty. They deserve to be despised, and I can say that with full confidence because I know a few of them personally.
  - Lewton 6y ago
    Is what I wrote wrong? Is it not true that in the beginning they saw an increase in fatalities when treating with certain kinds of steroids?
    - rscho 6y ago
      I never downvote, so not me. BTW yes, they said that. And now we see that using them and trying to keep people breathing by themselves, we do much better (big surprise). I do a lot of medical research and I am fully confident in saying that to decide to go against the grain based on preliminary data is irresponsible in medicine. As a personal note, the attitude of medical researchers and the loosening of ethical and legal boundaries pertaining to research I saw in the first wave make me puke.
      - Lewton 6y ago
        > I never downvote, so not me Appreciate it (and your reply!) I think the issue was that most of the decisions made, over-reliance on intubation, withholding steroids, etc where made in the beginning, in places were the hospitals were overloaded and there was this sense of urgency and panic. Then some random study is showing a 18% fatality rate in severe cases with steroids Vs 14% without, giving the impression that this virus works like no other
        rscho 6y ago
        In my opinion, reverting to more usual intubation practices is really a major improvement. For some reason, people tend to forget that mechanical ventilation is not a treatment but merely a supportive measure. > some random study is showing a 18% fatality rate in severe cases with steroids Vs 14% without, giving the impression that this virus works like no other Exactly. And I think that this goes to show that the current dynamics of medical research are highly toxic. The synergy between the 'publish or perish' motto and the myriad of Excel spreadsheet warriors who go on to become influential professors kills a lot of people.

Aachen 6y ago

Yeah let's get all the young people infected, having one percent of that population die is fine right? Next, they'll surely never talk to the people at risk. Their grandparents can sit at home and be more bored to death and lonely than they usually already are and have young people, which are allowed out, to bring them food. Couldn't possibly go wrong. How do you picture different kinds of measures per risk group going? People can already choose to isolate more, disinfect more, keep distance more, etc. if they find themselves at risk. The compulsory measures are a bare minimum to prevent unnecessary deaths and keep the long term impact to a minimum. You can find a new job next year and live on government benefits in the meantime (or is the worst-case scenario for you not unemployment and boredom? Well, infecting loved ones would be worse in these times but you don't seem to find that very worrying) but if you're one of today's corona deaths you can't find another life.

_-___________-_ 6y ago
> Yeah let's get all the young people infected, having one percent of that population die is fine right? Are you really claiming with a straight face that the chance of a young person who gets infected dying is 1/100? Would love to see you try to provide a source for that...
- Aachen 6y ago
  Are we really going to split hairs over what the exact percentage is or can we talk about the point? To me it seems like crazy talk to pose something, which would cause millions of deaths, to be unbelievable not to do. I'd be much more interested in how they think this could possibly work in a safe manner than debating whether it causes 5 per thousand or 10 per thousand (a sibling comment said 0.63%, so 6.3 million among the billion young people we have). Something something straight face.
  - _-___________-_ 6y ago
    You’re probably two orders of magnitude off. Not exactly splitting hairs. (Sibling comment is talking about CFR, not IFR.) Any conclusions you might reach based on that kind of exaggeration of the risk are pretty meaningless.

deleted 6y ago

[deleted]