Just how difficult it is to understand the best treatment for COVID-19 pneumonia

www.ncbi.nlm.nih.gov

Coronavirus disease 2019 (COVID-19) pneumonia is an evolving disease. We will focus on the development of its pathophysiologic characteristics over time, and how these time-related changes determine modifications in treatment. In the emergency department: ...

My first disclaimer is that pulmonology and critical care medicine are not my specialty. I am formally trained in Pediatrics with a subspecialty in Sports Medicine (all ages). That said, this article from about 5 months ago caught my interest because it takes a comprehensive look at the pathophysiology of COVID-19 pneumonia with new eyes and fresh perspective. It exposes many of our misconceptions about what we once thought was happening in the lungs of the afflicted, to where we are now in our understanding. Granted, this is complex information and is best suited for medical professionals (physicians, ICU nurses, perfusionists, RT's, etc) but can be understood if you have had basic college level biology and physiology. What should you take from this paper. 1) understanding about this disease is evolving as it is different from diseases we that seem similar on the face but are really quite different. 2) treatment and what will work and what will harm vary greatly depending on the patients station through the course of the illness. 3) learning about how to best treat this disease is an ongoing process and we currently do not have all the answers. What is the relevance to SAV? Answer: There is no way on earth that any untrained family member, like we typically see in these SAV cases, could possibly even be able to scratch the surface of the complexity of the management of severe COVID-19 disease. The best physicians in the business are learning every week what works and what doesn't and the jury is still out, and will be for sometime. While I have sent patients to the hospital and to the ICU with this disease I do not manage them nor do I try and second guess my intensivist colleagues who do. I truly know that their hearts and minds are in the right place and that they are doing everything within their power to heal and save my patients and return them to their families. However, as we can see from this paper, not everybody is going to respond to the treatments we have, nor can we currently save everybody. The keys to the lock box on this have not yet been made. Family members and the general public need to see just how complex caring for this disease is, what goes on behind the scenes at developing and modifying the best treatments to date are complex and extremely difficult. Nobody I practice with in our health care system is willingly out to harm patients. We want them all to go home to their families even if they were not vaccinated, even if they are victims of misinformation and even if we do not agree with them socially and politically. We leave our bias at the door, do the best jobs we can, often with little rest or sleep and sincerely hope for better days to come. I hope we do have some pulmonologists and intensivists on this forum who can critically comment on the materiel in this paper. I would be most interested in hearing your thoughts and experiences...