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What doctors on the front lines wish they’d known a month ago

nytimes.com

181–190 of 192 posts

Re: What doctors on the front lines wish they’d known a month ago

#181

Earlier quoted context omitted.

Arguably we should. For that matter, we should really do more about traffic fatalities. Bringing that down would be far easier per person than fixing flu or coronavirus. We're not going to, though, and it's becoming less clear why COVID-19 is an exception. It reminds me some of 9/11--it's flashy and freaking everyone out, which leads to irrationally conservative behavior.

It's because it is a much bigger immediate problem. Look at the Mortality Surveillance section on https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidvi... That's with lock downs . It's also hard to say what individual behavior would look like absent government orders to close businesses. Retail business could well be way down without any orders.

I think the original US lockdowns should have happened far sooner and been far more stringent. In my ultra-liberal state, the governor decided just within the last week or two that schools should definitely be closed until July. Idiot.

But, as we pass the initial peak and have better experience and surveillance, we should very carefully consider what to do next. Just locking down for a year or two is not the "safe" option.

Re: What doctors on the front lines wish they’d known a month ago

#182

Earlier quoted context omitted.

In ICU and on ventilation are not the same thing.

Exactly I have been in an ICU and I was on those annoying nasal oxygen and not itubated

Trust me, having a canula is much more pleasant than intubation.

Re: What doctors on the front lines wish they’d known a month ago

#183
post #87
post #69

Earlier quoted context omitted.

Confounding factor: obesity rates and comorbidities From a glance, the US averages 3x the incidence rate of obesity as Sweden. Obese patients with existing health problems will result in substantially worse outcomes from Covid-19.

Where are you getting those numbers. From this study it looks like 20% of Swedish adults are obese. That's compared to 36.5% of US adults. Also the swedish study is from 2012, so it's probably slightly higher now. https://www.sciencedaily.com/releases/2016/06/160604050632.h...

https://commons.m.wikimedia.org/wiki/File:Obesity_country_co...

Re: What doctors on the front lines wish they’d known a month ago

#184

Earlier quoted context omitted.

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…

Contact tracing is a severe invasion of privacy and just another tool to increase surveillance. I will never submit to such measures.

You can spend a years under full quarantine then. Just like Mary Mallon did.

Re: What doctors on the front lines wish they’d known a month ago

#185

Earlier quoted context omitted.

Ask him why he downvoted me. I'm really curious what guideline he thinks I violated.

Hi, I downvoted your post. I think `dang hit the nail on the head in re: why I didn't reply (don't really want to argue since arguing on this topic has occupied more of my recent HN activity than I really like; and I'm busy doing other things). I certainly don't think your original post violated HN policy by any means, but that isn't the threshold for downvoting on HN as far as I understand. I downvoted because the m…

He... nor Dr. Gattanoni are asserting that it doesn't meet the criteria for ARDS, but rather that it's not typical ARDS.

Gattanoni states:

However, the patients with Covid-19 pneumonia, fulfilling the Berlin criteria of ARDS, present an atypical form of the syndrome. Indeed, the primary characteristics we are observing (confirmed by colleagues in other hospitals), is the dissociation between their relatively well preserved lung mechanics and the severity of hypoxemia.

Re: What doctors on the front lines wish they’d known a month ago

#186

Here in suffering Sweden 80% of covid patients in intensive care survive. I read that 80% of NY ICU patients on ventilation dies. Are we perhaps using less mechanical breathing devices here i Sweden? Edit: this didn’t come out right... couldn’t find total icu death rate but have read stories about high mortality in NY.

I'd love to know where you got those statistics. I couldn't find anything on country mortality rates for COVID-19 ICU patients. However, since the US obesity rate is way higher than Sweden, it is surprising that the COVID-19 death rate in the US is around five percent, while it is around ten percent for Sweden. Of course, Sweden has decided not to impose a lockdown, so I have no idea how much that might be overwhelmi…

In swedish:

https://www.svt.se/nyheter/inrikes/over-80-procent-overlever...

Re: What doctors on the front lines wish they’d known a month ago

#187
post #161

Earlier quoted context omitted.

You might have a mistaken idea of how HN works, which is maybe why you've been finding it frustrating. On HN, it has always been ok to downvote a comment because one disagrees with it: https://news.ycombinator.com/item?id=16131314 Sure that's controversial, but the controversy is perennial. People have been making exactly the same arguments about it for a dozen years now, and that's just on HN—the debate goes back we…

Are these comments from pg in 2008 the main source that downvoting signals disagreement? If so, I would suggest you document it somewhere more prominent. Perhaps you could add guidelines on downvoting. When more is known about covid-19 I plan to come back to this thread and see who was right. If Dr Cameron Kyle-Sidell was wrong, totally off-base, on the wrong track... then maybe you're right... maybe this system does…

Even if there was a more prominently stated, formal policy about when downvotes are appropriate, it would make no material difference; the overwhelming majority of downvote-inclined people will downvote any comment that gives them a negative feeling.

That said, some of the best comments are ones that carry an argument that most people would disagree with, but are worded persuasively and/or informatively enough that they attract upvotes. It's difficult to achieve but well worth aiming for.

Outside of encouraging that, I'm not sure what else dang is meant to do. Discussion platforms that try to enforce policies like requiring explanations for any downvotes don't seem to have substantially better quality discussions.

Re: What doctors on the front lines wish they’d known a month ago

#188

Earlier quoted context omitted.

Ask him why he downvoted me. I'm really curious what guideline he thinks I violated.

Hi, I downvoted your post. I think `dang hit the nail on the head in re: why I didn't reply (don't really want to argue since arguing on this topic has occupied more of my recent HN activity than I really like; and I'm busy doing other things). I certainly don't think your original post violated HN policy by any means, but that isn't the threshold for downvoting on HN as far as I understand. I downvoted because the m…

The New York Times video features Dr Corey C. Hardin at Mass General. The user carbocation is a "a cardiology fellow at the Massachusetts General Hospital" He is a colleague of the guy featured....

My link is to the twitter account of the doctor that disagrees with the doctor at Mass General.

This is a clear case... as I suspected... of the people in the article trying to manipulate the discussion about how they are perceived.

Re: What doctors on the front lines wish they’d known a month ago

#189

Earlier quoted context omitted.

Hi, I downvoted your post. I think `dang hit the nail on the head in re: why I didn't reply (don't really want to argue since arguing on this topic has occupied more of my recent HN activity than I really like; and I'm busy doing other things). I certainly don't think your original post violated HN policy by any means, but that isn't the threshold for downvoting on HN as far as I understand. I downvoted because the m…

The New York Times video features Dr Corey C. Hardin at Mass General. The user carbocation is a "a cardiology fellow at the Massachusetts General Hospital" He is a colleague of the guy featured.... My link is to the twitter account of the doctor that disagrees with the doctor at Mass General. This is a clear case... as I suspected... of the people in the article trying to manipulate the discussion about how they are…

One dead giveaway of people getting their friends and colleagues to manipulate the way they are perceived on social media... is when your comment is quickly downvoted... before any casual user would have had time to absorb it.

Re: What doctors on the front lines wish they’d known a month ago

#190
post #183
post #87

Earlier quoted context omitted.

Where are you getting those numbers. From this study it looks like 20% of Swedish adults are obese. That's compared to 36.5% of US adults. Also the swedish study is from 2012, so it's probably slightly higher now. https://www.sciencedaily.com/releases/2016/06/160604050632.h...

https://commons.m.wikimedia.org/wiki/File:Obesity_country_co...

That chart is from data collected between 1996 and 2003. It is very outdated.
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