Month: July 2020

July 9, 2020

Saurabh Jha, MD interviews epidemiologist John Ioannidis.

Read interview at this link:

THE HEALTH CARE BLOG (THCB) Interview

Some quotes:

Because of the attention on coronavirus, we’re better at knowing that a deceased person had coronavirus than had the flu. This means we’re good at knowing when someone died with coronavirus – but not necessarily that they died from the infection. We assume that dying with coronavirus is dying from coronavirus.

[…]

Which brings me to NYC. It certainly faced the infection courageously head on.

[…]

At least three factors contributed to the high death toll in NYC: the disproportionate number of deaths in nursing homes (…)], and nosocomial [originating in hospital] spread of infection. Also, doctors were still learning how best to manage patients in the ICU and their approach to ventilatory support was probably too aggressive, in hindsight. I’m not blaming doctors. NYC was dealt a bad hand.

[…]

We needed extra precautionary effort in high-risk settings such as nursing homes, prisons, meat processing plants, and homeless shelters. The corollary of having high-risk groups is that there must be low-risk groups, and low-risk people can continue working. We can’t treat everyone as “high risk” because then the high risk won’t get the extra attention and care they deserve. In our approach to controlling coronavirus we made no distinction between teenagers partying on beaches in Florida and debilitated, frail residents living in congested nursing homes in NYC. Our uniform approach was neither scientific nor safe.

COVID-19 is a virus which unmasks our social and economic fault lines.

[…]

I consider that people who criticize me with valid scientific arguments are my greatest benefactors. But the outrage propagated by social media is a force of its own, and destroys any intelligent discourse, civil or uncivil. Once the outrage gets going, platforms for academic discourse censor and the discourse just doesn’t happen. I was unable to publish my essay about nosocomial spread of COVID-19 in nursing homes and hospitals. I submitted to many outlets. I suspect the editors feared social media backlash against my raising an uncomfortable issue. Fear isn’t healthy for science.

People of any age with the following conditions are at increased risk of severe illness from COVID-19:

• Chronic kidney disease
• COPD (chronic obstructive pulmonary disease)
• Immunocompromised state (weakened immune system) from solid organ transplant
• Obesity (body mass index [BMI] of 30 or higher)
• Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
• Sickle cell disease
• Type 2 diabetes mellitus

For more click here.

Update April 28, 2020: https://www.usatoday.com/story/news/factcheck/2020/04/24/fact-check-medicare-hospitals-paid-more-covid-19-patients-coronavirus/3000638001/

“… if it’s a straightforward, garden-variety pneumonia that a person is admitted to the hospital for – if they’re Medicare – typically, the diagnosis-related group lump sum payment would be $5,000. But if it’s COVID-19 pneumonia, then it’s $13,000, and if that COVID-19 pneumonia patient ends up on a ventilator, it goes up to $39,000.”

– Scott Jensen

UPDATE July 8, 2020:

My concern is that we cannot understand this disease unless proper statistics are recorded w/o fear of potential professional repercussions.