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Open Source Ventilator Project

opensourceventilator.ie

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Re: Open Source Ventilator Project

#131

Post by pbhjpbhj »

DoreenMichele wrote: post #51
pbhjpbhj wrote: post #43

Earlier quoted context omitted.

Non-invasive alternatives to "breathing for someone whose lung function has fallen below life-sustaining levels" sounds like [deadly] bullshit. I'm not sure coughing in the shower is going to do it for someone about to die from hypoxemia?

Cystic fibrosis accounts for about a third of all adult lung transplants in the US and about half of all pediatric lung transplants. At the time that I was diagnosed with a relatively mild form of it, life expectancy in the US was 36. So I have a quite serious lung condition and I used to own and use (and sterilize at home) various forms of mechanical intervention. I no longer use mechanical intervention, in part bec…

IANAMedic: I assumed you/a loved one had CF. As I understand it CF creates a thick mucus that blocks the lungs.

But Covid19 reportedly destroys pilii, and the cells that bare them, and when the immune response kicks in fully it attacks lung tissue as well as the virus.

_If_ this understanding of mine is corrext, then it seems clearing the lungs in CF opens them to take oxygen that's there (if the mucus is moved the underlying lung function is still enough), but in Covid19 even if cleared the lung tissue is damaged and can't process enough oxygen from a regular supply; people need higher pressure and/or higher saturation oxygen for a period in order to recover lung function.

Maybe I'm wrong.

It's certainly not wrong to share how you clear lungs affected by CF if you're explicit about any limitations in your knowledge.

As an example of this that seems counterfactual to me -- as a medically uninformed person -- BiPAP, which is commonly used for CF sufferers I gather, at least one critical care source suggests is not really useful for Covid19 (https://emcrit.org/ibcc/COVID19/#noninvasive_ventilation_(Bi... ) treatment.

The problem with suggesting treatments is that people may resort to self-treatment alone and not seek proper medical care; that could cost lives. So I think your analysis is wrong if you're suggesting 'giving advice can't be harmful'.

Re: Open Source Ventilator Project

#132

Post by lern_too_spel »

arcticbull wrote: post #129
lern_too_spel wrote: post #126

Earlier quoted context omitted.

No. IFR is mortality rate at the end of the epidemic. CFR exactly matches IFR if all infections are diagnosed.

No because you don’t know how many of them will die. In your definition you know the R not the F. Look, I’m quoting the WHO report. You’re welcome to take it up with them.

R is ratio or risk. It is directly computed from C and F just as it is directly computed from I and F.

I don't seen any quotes in your comment.

Re: Open Source Ventilator Project

#133

Post by DoreenMichele »

pbhjpbhj wrote: post #131
DoreenMichele wrote: post #51

Earlier quoted context omitted.

Cystic fibrosis accounts for about a third of all adult lung transplants in the US and about half of all pediatric lung transplants. At the time that I was diagnosed with a relatively mild form of it, life expectancy in the US was 36. So I have a quite serious lung condition and I used to own and use (and sterilize at home) various forms of mechanical intervention. I no longer use mechanical intervention, in part bec…

IANAMedic: I assumed you/a loved one had CF. As I understand it CF creates a thick mucus that blocks the lungs. But Covid19 reportedly destroys pilii, and the cells that bare them, and when the immune response kicks in fully it attacks lung tissue as well as the virus. _If_ this understanding of mine is corrext, then it seems clearing the lungs in CF opens them to take oxygen that's there (if the mucus is moved the u…

I stated as clearly as I could that I have a form of CF. I also happen to have a son with the same diagnosis I have.

CF often results in significant lung damage. I used to have a hole in my left lung. I don't appear to have such anymore.

The tissue is often eaten away by infection over the course of years and a drop in lung function below a certain point is the typical reason for lung transplant. People with CF are the single largest recipient group for lung transplants, as far as I know and based on the figures I'm aware of.

So lung damage with CF is common and it is routinely quite substantial. They are kept functional with daily air clearance techniques that can be done independently. Some of them do not involve mechanical intervention.

Even if you have impaired lung function in terms of tissue damage, removing the fluids and phlegm can help the impaired tissues function as well as possible in spite of other issues.

I did my best to state up front that this will be helpful in some cases but not others. I did my best to define where it is likely to be helpful: Where you have fluid build up and inflammation as the primary reason you might need a ventilator. I already covered the fact that if there are other problems going on, this may not help you.

I initially suggested treatments in response to people asking what could be done on their own if there is no medical care available or from home because I happen to know a lot about that and I'm not seeing a lot of other people speak up or provide "reputable sources" for that kind of information.

I no longer belong to any CF lists in part because I have heard the same accusations before: That providing information about what works for me is somehow irresponsible, even though CF, like covid19, is very deadly and doctors don't really know how to fix it.

Somehow, keeping my mouth shut and letting them die is deemed to be the responsible thing to do and I honestly don't understand that position at all. It really sounds much more like "cover your ass legally" than "give a damn about the welfare of your fellow human being."

I've been careful in how I have framed my remarks and given limitations and provisos as best as possible.

I stand by my two suggestions that:

1. Widespread use of ventilators may foster nasty secondary infections and I'm unhappy at seeing the world rush to provide homemade ventilators instead of rushing to provide less invasive alternatives without such a risk.

2. If you have no other options and can't get appropriate medical care, here are a few things you can try if you are desperate and have no better answers and seem likely to die if you don't do something.

I am not responsible for people choosing to use that information under less dire circumstances and I don't believe it is somehow better to deny the world such information on the theory that a few people might do something stupid with it. People are dying because there aren't enough supplies to go around. Good information can be life saving.

I don't expect my lack of happiness about the rush to create ventilators to make much, if any, real difference. But maybe it will. Maybe someone who is a medical professional will take that to heart and it will help prevent a second pandemic of antibiotic resistant secondary infections.

I'm not suggesting "giving advice can't be harmful." I'm suggesting that, under the current conditions, denying ordinary people information because they aren't medical professionals and might misuse it is likely to be worse.

Re: Open Source Ventilator Project

#134

Post by arcticbull »

lern_too_spel wrote: post #132
arcticbull wrote: post #129

Earlier quoted context omitted.

No because you don’t know how many of them will die. In your definition you know the R not the F. Look, I’m quoting the WHO report. You’re welcome to take it up with them.

R is ratio or risk. It is directly computed from C and F just as it is directly computed from I and F. I don't seen any quotes in your comment.

Case fatality rate is defined as the fatality rate of known cases. You can’t know the final mortality rate until everyone’s either dead or recovered. While anyone has it, it’s preliminary, and it’s called the CFR. Happy to dig the report up for you but this is just a logical conclusion.

CFR matches IFR not when all cases are diagnosed but when all cases are resolved.

Re: Open Source Ventilator Project

#135

Post by mannykannot »

AstralStorm wrote: post #27
DoreenMichele wrote: post #16

I made some remarks about ventilator alternatives here: https://news.ycombinator.com/item?id=22624959 To pull out some pertinent details: Ventilators for covid19 seem to be mostly for inflammation and fluid in the lungs (aka pneumonia), not lung or chest paralysis. If you need a ventilator due to inflammation or fluid build up, you can do other things to address those issues. If you are doing home care for serious lu…

Please don't be silly. You cannot physically cough hard enough with dropped O2 sats like that, and even strong healthy people will be unable to fully evacuate matter from lungs, especially biofilms. Next time you propose an alternative, provide actual data supporting it. As a test, start doing it at say peak of a 2200 meter mountain. (That would be 90% with no acclimation.) See how far you can go. Sleeping positions…

Not all cases are worst-case. Every person who can manage, through these techniques, a symptom that would otherwise need a ventilator, reduces the demand.

Re: Open Source Ventilator Project

#136

Post by lern_too_spel »

arcticbull wrote: post #134
lern_too_spel wrote: post #132

Earlier quoted context omitted.

R is ratio or risk. It is directly computed from C and F just as it is directly computed from I and F. I don't seen any quotes in your comment.

Case fatality rate is defined as the fatality rate of known cases. You can’t know the final mortality rate until everyone’s either dead or recovered. While anyone has it, it’s preliminary, and it’s called the CFR. Happy to dig the report up for you but this is just a logical conclusion. CFR matches IFR not when all cases are diagnosed but when all cases are resolved.

As I pointed out in my earlier comment, IFR is not mortality rate. It is the fatality rate to date of those who have been infected. IFR equals mortality rate at the end of an epidemic. CFR will only equal the mortality rate at the end of an epidemic if all infections have been diagnosed. That is, if C=I.

Re: Open Source Ventilator Project

#137

Post by easytiger »

joe_the_user wrote: post #128
chrisseaton wrote: post #114

Earlier quoted context omitted.

> My main goal is to make clear the urgency of this situation. It’s not ok to deliberately over-estimate numbers in order to achieve this goal. That was my original point at the top of this thread. You may think it’s ok because the ends justify the means, but it’s still wrong and dangerous.

It’s not ok to deliberately over-estimate numbers in order to achieve this goal. That was my original point at the top of this thread. I have given the reasons that I believe 1/5 is in no way overestimate. I don't have any to think you are arguing in bad faith yourself, simply that you're mistaken on a very important point. However, you are resorting imputing bad faith on my part simply through your disagreement with…

> have given the reasons that I believe 1/5 is in no way overestimate

No. You have not.

Re: Open Source Ventilator Project

#138

Post by easytiger »

ummonk wrote: post #104
fulafel wrote: post #103

Earlier quoted context omitted.

The WHO conclusions have been widely challenged. The cruise liner and the 3000 pop Italian village are the well studied exposed populations so far I think and they indicate a big asymptomatic percentage.

The cruise ship showed a ~50% symptomatic rate, so any stats based on symptomatic patients are probably only off by a factor of 2. Note that both South Korea and China outside Wuhan do extensive contact tracing and testing of people an infected individual can be determined to have interacted with, so they pick up a good deal of asymptomatic cases too.

The cruise ship demographic is extremely relevant.

Re: Open Source Ventilator Project

#139

Post by ldng »

__blockcipher__ wrote: post #72
ldng wrote: post #56

Earlier quoted context omitted.

I don't think this project wants to create panic. To me it rather is trying to help and be prepared. I'd rather have too many than too few. Plus, we don't know when the site was set up. Two weeks ago ? Four weeks ago ? Our collective knowlegde is changing every day. Could just be they have been busy and did not find the time to update it ? And finally, blueprint for a cheap OSS FEV will always be useful. COVID or not…

They’re not arguing against having an open source spec, they’re just pointing out that you can do the open source ventilator thing while not spreading misinformation. Please don’t confuse the two. It’s hard enough to fight the misinformation as is without well-intentioned people such as yourself introducing red herrings. Again, your point is coming from a good place. But we need to be really careful about not accepti…

This is one line on a whole page. And if usually people should cross-reference at the very least 3 reputable sources before accepting an informations as true. Maybe it is a good time to ingrain that message along the "wash your hands"

Re: Open Source Ventilator Project

#140

Post by easytiger »

lern_too_spel wrote: post #122
easytiger wrote: post #94

Earlier quoted context omitted.

No it isn't. If you are asking someone where they get numbers from them write some incorrect numbers in the pursuit of whatever agenda is not a good look. As of Monday, - 274,504 people tested - 8,400 cases - 81 deaths - 0.96% CFR > so CFR is very close to IFR On what basis do you make that statement. It's clearly indefensible https://www.google.com/amp/s/www.businessinsider.com/coronav...

> If you are asking someone where they get numbers from them write some incorrect numbers in the pursuit of whatever agenda is not a good look. > As of Monday > - 81 deaths > - 0.96% CFR I should say the same of you. Why are you posting numbers from 5 days ago? As of yesterday when I made that comment, Korea has 102 deaths and 1.16% CFR. >> so CFR is very close to IFR > On what basis do you make that statement. It's…

That provides no basis? Feel free to elaborate
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