[wastoute]

Well i only moonlighted in ERs but I spent plenty of time “visiting” ERs over some 20 years and was the OIC of an Army ER. Patients who come in blue and gasping for breath do generally get intubated straight away. I’ve done it myself, many times. It’s called “Respiratory Failure”. Obviously, I’m not seeing these patients but it sounds like the are decompensating quickly. Ok’d have to be pretty damn confident you knew what you were doing not to.

Now we are hearing they are holding off. Why? Because 80 or 90% just die in hours and the vent doesn’t help anyway? I don’t know, but maybe it’s a possibility. Maybe the people actually doing it have decided to stop tubing these people because the outcome is so miserable.

MomMD is still working, she is seeing these patients. Depressing was the word I’m pretty sure she used. “Nothing seems to work.” But you gotta remember they aren’t fixing cars. You can’t just throw things at these patients hoping they will work. That’s Institutional level panic behavior. There is data that will answer the question and we ain’t getting it.

[meatloaf]

Check out this study.

https://chemrxiv.org/articles/COVID-19_Disease_ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin/11938173

[grey_whiskers]

Problem with intubation (paraphrasing from memory as I type) is that some of the alveoli are full of mucus/fluid, some are ruptured, some are intact. But the damage is diffuses, so not limited to just the lowest lobes or just one lung.

So the initial thought is, the people are hypoxic, crank up the O₂ pressure. But that causes further damage to the non-intact alveoli.

This paper is consistent with the clinical findings, that the malaria drugs don't work if the disease has progressed too far: it doesn't combat cytokine storm, but the hydroxychloroquine acts as an ionophore to get the zinc into the cell, where it inhibits viral replication: so if the disease is too far gone, cutting the viral count is a fool's errand.

The idea of red blood infusion *with* hydroxychloroquine /zinc (to prevent the new blood cells from getting infected) is a novel treatment. Won't necessarily repair the lungs though.

[Mom MD]

I didn’t say nothing seems to work just be someone else. I did say there is no one magic bullet. We are also not seeing an 80% death rate on vents. people are coming off, but some rather slowly

[reasonisfaith]

“80 or 90% just die in hours”

Where’s the study proving this percentage?

Where’s the study proving anything you say, ever in your life?