Worth reading: Our history is a battle against the microbes. We lost terribly before science, public health, and vaccines

Welcome perspective from Max Roser of the excellent ourworldindata.org, a website I consider essential reading for everyone. The public health impact of vaccines simply cannot be overstated (as shown below). While infectious diseases like tuberculosis continue to claim lives, the death tolls of the past were almost unimaginable. Thanks to vaccination, countless lives have been…

COVID-19: Major study shows dexamethasone improves mortality among ventilated patients

The use of corticosteroids in systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) isn’t new, so it isn’t surprising that treatment of critically ill COVID-19 patients in the ICU has increasingly involved dexamethasone. Nevertheless, the first major results showing improvement in survival among ventilated COVID-19 patients given dexamethasone comes as very welcome…

“Conversation is the essence of palliative care”

A recent episode of Scott Weingart’s excellent EMCrit podcast featured a thoughtful discussion with Kei Ouchi, MD, on one of the most important aspects of emergency medicine and critical care; conservations regarding end-of-life care. The focus here is on rapid code status conversation. The podcast page offers a slew of useful links, and references the…

COVID-19: Why were some hospitals in NYC overwhelmed but not others?

ICYMI, I recently came across an NYT article that revealed some facts that are frankly shocking. “At Elmhurst Hospital in Queens, hundreds of Covid-19 patients arrived in need of more help than besieged medical workers could give. Patients were found dead in rooms. One medical resident described conditions as ‘apocalyptic.’ Yet at the same time,…

A Theoretical Model of the Pathophysiology of COVID-19

The latest episode of the EMCrit podcast features a discussion between Scott Weingart and Farid Jalali on the pathophysiology of COVID-19. Dr. Jalali’s wide-ranging insights on this complex, dynamic disease make this an absolute must-listen. EMCrit Wee – A Theoretical Model of the Pathophysiology of COVID-19 with Farid Jalali (Not a Single Thing Verified–Pure Musings)…

COVID-19: Could exposure to ‘common cold’ coronaviruses offer some protection against SARS-CoV-2?

Although not all that surprising in hindsight, the results of a paper recently published in Cell are nevertheless stunning: 40-60% of a group of individuals not exposed to SARS-CoV-2 were found to have T helper cells that were reactive to SARS-CoV-2. The article summary: “Understanding adaptive immunity to SARS-CoV-2 is important for vaccine development, interpreting…

Worth reading: COVID-19, a ‘supernova in human history,’ will need multiple perspectives to understand and manage

Another must-read article in STAT by Vinay Prasad and Jeffrey Flier: Covid-19, a ‘supernova in human history,’ will need multiple perspectives to understand and manage Prasad and Flier emphasize a critical point that’s too often ignored; much of the current pandemic’s harmful impact on the world (measured by suffering and death, not soulless abstractions like…

COVID-19: Remdesivir apparently shows “a clear-cut, significant positive effect,” but where’s the evidence?

There have been some bizarre, troubling developments regarding the purported anti-COVID drug, remdesivir. At the end of April, Anthony Fauci told reporters in the oval office that the NIH’s remdesivir trial showed “a clear-cut, significant positive effect.” From now on, remdesivir “will be the standard of care,” meaning that any new potential drugs to treat…