Thanks for the comments and feedback.
I’m not trying to start a war. And I’m not looking for credit or a pat on the back or anything. I feel fortunate to be healthy and to have an income; too many others are not as fortunate. We are (almost) all doing what we can to help society as a whole survive this. I hope that education will help prevent people from needing my services in the first place because there aren't nearly enough ICU beds to handle the influx that appears to be coming our way. I would love to be in a position where I have no patients in the ICU because everyone is healthy; my fear is that I won’t have patients because they will all be dead.
@Hieveryone
Your assertion that some of the info may be inaccurate is insulting to the researchers that have put their heart and soul into helping others. I think I can safely assume that you aren’t a researcher or scientist, and thus I will start by suggesting that you take some (or a lot of) time to learn about critical thinking and cognitive bias. If you are unable to find appropriate resources, please let the forum know, as I’m sure that many of us can point you in the right direction.
In the meantime, let me put things into terms that you might be able to comprehend. When your car has mechanical issues, you go to a mechanic, not a hairstylist. That’s because the mechanic is an expert on the topic of concern. Similarly, you trust scientists and physicians to speak about science and medicine. Come to think about it, you should look up what the scientific method is as well, and then read about how and why scientific articles are reviewed and sometimes retracted. Don’t forget to pay attention to what happens to the scientist(s) whose article gets retracted - from what I understand, it can be very unpleasant, and often career-limiting, if not career-ending. Perhaps then you will realize that it is very difficult for scientists to propagate inaccuracies over an extended period, as
everything is subject to peer-review and validation. To this end, physicians (at least, all the ones I know and trust) generally demonstrate a fair bit of skepticism when any new/novel information arises, especially if it doesn’t make sense physiologically.
To your second assertion, you are correct - the information I presented was incomplete. As I clearly stated, the references indicated were taken from my journal feeds
from the day I wrote the post. Last I checked, there were over 50,000 open-access journal articles regarding COVID. I made what I thought was a reasonable assumption that you didn’t want a summary of every one of them. I’d be happy to send you a list if you wish, or you can search for yourself
here. If you are actually attending an institution of higher learning that cares about education, then you should be able to access even more through the institutional subscriptions. As you surely have peer-reviewed evidence to back up your assertions, I would welcome the opportunity to review anything that you feel is relevant.
Your final assertion was that I had espoused a one-sided view of the virus. In reality, I do not and can not have a fixed viewpoint; my role as a clinician and teacher requires that I remain open to having my mind changed as evidence changes. I truly have no horse in this race. My one and only concern is that those people I am in contact with (physically or virtually) are as healthy as possible. I apologize if that offends your sensibilities. Actually, no. I take that back. I don’t care if it offends your sensibilities, because, as you have said, it’s my right to think and do what I want, and I will always do what's best for the people that entrust me with their care. I have been given this privilege, and I take this very seriously.
Let me close with a few miscellaneous comments:
- I have spent a fair bit of time reviewing and responding to the prior posts, particularly yours. This is time that I could have spent inpatient care, doing paperwork, or otherwise earning income. More importantly, it is also time that I could have spent with my family, whom I care about very much. Do you think that I would have spent this time if I didn’t believe that correcting inaccuracies through education would be helpful?
- The word “doctor” stems from the Latin word for teacher. My role isn’t to tell people what to do; my role is to educate them on why they should do it. To do this, I need to understand first.
- Einstein (who was relatively intelligent, I believe) once said, “Once you stop learning, you start dying.” A closed mind is incapable of learning.
- A recent study suggested that the majority of inaccurate perceptions held by people aged 18-45 arise as a result of misplaced trust in postings on Facebook, Twitter, and other social media.
- There are numerous posts from front-line healthcare workers around the world who have had a close-up view of the effects that this virus can have, and there is an increasing number who will (or already do) suffer from PTSD because of what they saw. Imagine having to look someone in the eyes and tell them that they are going to die alone because the damage is too severe and irreversible, and the regulations don't allow visitors. Now imagine having to do that every day, or even twice a day. Now take it further and imagine that the next person you have to tell is a previously-healthy recent university graduate who likely contracted the virus from a single indiscretion when he went to a party to celebrate his graduation. And then tell it to the parents who tried to stop him from going, but gave in because "it's just one time, he's been really careful otherwise..."
- No physician wants to be in a position where they have to tell a family that I can't put their parent/grandparent/relative on a ventilator because we don't have enough. The goal of flattening the curve is to prevent this from becoming an issue. If your family member is given this news (and despite our disparate views, I truly hope that nobody close to you ever has to be told this), how will you feel about having contributed to the spread of the virus?
Looking forward to your comments and having the opportunity to review your references (as requested above).
@bunnspecial
You are completely correct. Moderation and reasonability are paramount. Unfortunately, there appears to be an inability to comprehend this fact. Either that, or there is an unwillingness to accept it. We are human beings; we need social contact. It is reasonable to go out as long as the appropriate precautions are taken, not only for our own protection but for the protection of those around us.
@dwfaust
The evidence regarding the efficacy of masks is clear
when they are used correctly. Unfortunately, many people don't wear them correctly. I was able to Google a couple of references regarding the evidence, as well as the reason for the "flip-flop" regarding masks:
With regards to a mask impacting your breathing, this shouldn't normally be an issue unless you have underlying respiratory issues (best assessed in person by the appropriate physicians.) Studies have been done with N95 masks, which are typically more restrictive than cloth masks or medical procedure masks. In general, airflow should be sufficient to ensure adequate oxygenation. Having said this, there is certainly a subset of patients in whom masks do compromise the ability to breathe. For these patients, it is even more important for others to be wearing their masks in order to minimize the risk of transmission. If you are unable to wear a mask for medical reasons, then the ideal situation would be to avoid going to places where close contact is likely (more than 6ft is advised, though evidence suggests that particles may be propelled over 13 feet - see reference 37 in the second article linked above). Since this is difficult if not impossible for most people, it would be best to minimize going to such places, especially since any underlying pulmonary disease would put you at greater risk for complications and death should you be unfortunate enough to become infected. In an ideal world, you wouldn't be harassed for being unable to wear a mask. On the other hand, if someone is using a dubious medical issue to avoid wearing a mask, then I would point them to my response above.
tl;dr -
- this virus kills - for a disturbing visualization, see here
- in WW II, there were about 400,000 US combatants killed over about 4 years; COVID has killed over 40% as many in about 15% of the time
- this virus is going to leave a lasting impact on all of us, whether physically, mentally, economically, or a combination of all of these
- the effects may not be seen for many years, so initial recovery from a "mild" (i.e. non-hospitalized) infection does not imply a return to normal
- masks work - use them
- we learned to use condoms because of HIV; I'd argue that masks are less uncomfortable and inconvenient
- social distancing works - please do it whenever possible
- wash your hands (hand sanitizer is not as good as a 20-second soapy wash)
- get used to this, because it's going to be a while before we get anywhere close to "normal" again
- a vaccine that I would trust is likely not going to be available for another six months or more, and even then, it is going to be difficult to make enough for everybody and to get it to everybody (one article I read suggested that a major stumbling block could end up being whether we can make enough glass vials ...)
(Sorry for the long rant - I am too tired to go back and edit...)
www.google.co.uk
