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UChicago doctors see ‘remarkable’ success using ventilator alternatives

uchicagomedicine.org

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Re: UChicago doctors see ‘remarkable’ success using ventilator alternatives

#51

Post by azinman2 »

fragmede wrote: post #43
not_a_moth wrote: post #24

Earlier quoted context omitted.

Yes, rather absurdly, I learned about him like a month ago on ZeroHedge when they started following him; he was brushed off for weeks, his message being, "Look at patient behavior, this is not actually ARDS, our ventilator strategy is probably wrong." Crazy to think that so many doctors around the world, experts, and policy makers didn't really question the fundamental nature of the disease, and perhaps telling that…

Dr Ignaz Semmelweis had this ludicrous theory, back in 1846, of “cadaverous particles” causing high deaths in women who had just given birth. Despite evidence that it worked , he spent the rest of his life trying to get people to listen. The doctors of the day were so threatened by the possibility that they were the ones killing their patients that they rejected the practice. We haven’t culturally evolved much furthe…

Probably because there are so many ludicrous theories that are just plain wrong, and likely they outnumber the crazy ideas that will turn out to be true. Just look at MMS / injecting bleach debacle going on.

Re: UChicago doctors see ‘remarkable’ success using ventilator alternatives

#52

Post by eternalny1 »

ceejayoz wrote: post #31
amluto wrote: post #18

Earlier quoted context omitted.

Is management of an HFNC patient simple enough that it could be done outside a hospital? I’m imagining a converted stadium or similar area in which patients use HFNC and everyone who isn’t a patient puts on serious PPE before entering and takes it off only when they’re quite far away.

Or staff it with recovered healthcare workers.

'No evidence' that recovering from Covid-19 gives people immunity, WHO says

https://www.france24.com/en/20200425-no-evidence-that-recove...

Re: UChicago doctors see ‘remarkable’ success using ventilator alternatives

#54

Post by newacct583 »

joshgel wrote: post #12
DanielBMarkham wrote: post #7

One of the most interesting parts of this press release, following it on other boards, is the immediate "We already do that. Nothing new here." That kind of reply would immediately lead me to think it was just a useless release, but then I see people posting comments along the lines of "No, we don't do that. In fact, we have a policy against doing that because of the danger of aerosolization" For my hacker/systems wo…

Even better would be randomized experimental data that this was better than an alternative... 'It works' can mean lots of different things...

If that study takes a few months to finish, be reviewed and published, it's very clearly not "better".

Science is important, but there are times like this where brute intuitive engineering is the only tool available.

Re: UChicago doctors see ‘remarkable’ success using ventilator alternatives

#55

Post by roywiggins »

eternalny1 wrote: post #52
ceejayoz wrote: post #31

Earlier quoted context omitted.

Or staff it with recovered healthcare workers.

'No evidence' that recovering from Covid-19 gives people immunity, WHO says https://www.france24.com/en/20200425-no-evidence-that-recove...

There's no evidence, but should we expect evidence? Has anyone looked?

The Bayesian prior that they should have some level of immunity is pretty high, seems to me. Exactly how long and how strong such immunity is a good question, but it would be really unlikely if there was no immunity.

Re: UChicago doctors see ‘remarkable’ success using ventilator alternatives

#56

Post by ceejayoz »

eternalny1 wrote: post #52
ceejayoz wrote: post #31

Earlier quoted context omitted.

Or staff it with recovered healthcare workers.

'No evidence' that recovering from Covid-19 gives people immunity, WHO says https://www.france24.com/en/20200425-no-evidence-that-recove...

There was no evidence of human-to-human transmission early on, too.

“No evidence” is not “evidence against immunity”. It means we don’t know yet.

Re: UChicago doctors see ‘remarkable’ success using ventilator alternatives

#57

Post by achillesheels »

DanielBMarkham wrote: post #15
joshgel wrote: post #12

Earlier quoted context omitted.

Even better would be randomized experimental data that this was better than an alternative... 'It works' can mean lots of different things...

It's an excellent point. Learning is not the same as science, and we need randomized trials to actually be sure of anything. Unfortunately, in the middle of a pandemic, that's not going to happen with enough speed to prevent a lot of people dying. The perfect can be the enemy of the good enough. We don't have to guess or learn about the mass of an electron; that's been well-established through great lab work. But not…

And unfortunately, there are doctors that will not make a move on an experimental therapy without it going through IRB approval, as I am learning with my own efforts at introducing a portable nebulizer biocidal therapy. Some will not take chances unless they see safety data first - they will let their patients and colleagues die first.

As a former biomedical engineering researcher, this pandemic has been profoundly eye-opening in learning about the resistance to advancing the state of the art of medicine in the USA. (I’m not even speaking about the knee jerk reaction towards banning nebulizers in hospitals thanks to a flimsy NEJM letter last month reporting coronavirus aerosol contaminations.)

Re: UChicago doctors see ‘remarkable’ success using ventilator alternatives

#58

Post by achillesheels »

not_a_moth wrote: post #24
theobeers wrote: post #5

One of the most active figures in this debate has been a New York doctor named Cameron Kyle-Sidell. He frequently posts interesting sources on Twitter: https://twitter.com/cameronks

Yes, rather absurdly, I learned about him like a month ago on ZeroHedge when they started following him; he was brushed off for weeks, his message being, "Look at patient behavior, this is not actually ARDS, our ventilator strategy is probably wrong." Crazy to think that so many doctors around the world, experts, and policy makers didn't really question the fundamental nature of the disease, and perhaps telling that…

Yes it is. Frankly my view of the medical professional community is much lower now. MDs are really just glorified infantry on the frontlines. The lack of creativity, which presupposes degrees of original and independent thought, is striking.

Re: UChicago doctors see ‘remarkable’ success using ventilator alternatives

#59

Post by beagle3 »

fragmede wrote: post #43
not_a_moth wrote: post #24

Earlier quoted context omitted.

Yes, rather absurdly, I learned about him like a month ago on ZeroHedge when they started following him; he was brushed off for weeks, his message being, "Look at patient behavior, this is not actually ARDS, our ventilator strategy is probably wrong." Crazy to think that so many doctors around the world, experts, and policy makers didn't really question the fundamental nature of the disease, and perhaps telling that…

Dr Ignaz Semmelweis had this ludicrous theory, back in 1846, of “cadaverous particles” causing high deaths in women who had just given birth. Despite evidence that it worked , he spent the rest of his life trying to get people to listen. The doctors of the day were so threatened by the possibility that they were the ones killing their patients that they rejected the practice. We haven’t culturally evolved much furthe…

There’s a saying, “progress is made one funeral at a time”, especially in science but also in other areas; smbc had a good comic about it too a whole back (am in mobile and can’t find it now).

Linus Pauling famously and successfully used all his night to reject the idea of quasicrystals. The Updated concept of crystals was adopted shortly after his death; i can’t say I was able to track the history - there is an enormous amount of whitewashing - but it seems initially everyone rejected quasicrystals, but eventually people started to look at ahechtman’s evidence - and accept it, except not publicly because the luminaries of the field led by Pauling rejected it. And then Pauling’s funeral allowed the science to finally advance.

Re: UChicago doctors see ‘remarkable’ success using ventilator alternatives

#60

Post by caymanjim »

gus_massa wrote: post #40
DanielBMarkham wrote: post #15

Earlier quoted context omitted.

It's an excellent point. Learning is not the same as science, and we need randomized trials to actually be sure of anything. Unfortunately, in the middle of a pandemic, that's not going to happen with enough speed to prevent a lot of people dying. The perfect can be the enemy of the good enough. We don't have to guess or learn about the mass of an electron; that's been well-established through great lab work. But not…

> Unfortunately, in the middle of a pandemic, that's not going to happen with enough speed to prevent a lot of people dying. How are you sure that this method is not worse than the ventilator method and will kill even more people during the pandemic? How many death did they get with this method? How many death would they had got with the ventilator method?

90% of people on ventilators die. It's hard to do much worse. And with numbers like that, I think it's perfectly ethical to try anything reasonable.
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