“Panic” and Other Games People Play

Further to my previous post, Foreign Bodies and Home Truths, here’s some informed common sense from Josh Farkas (@PulmCrit), “an associate professor of Pulmonary and Critical Care Medicine at the University of Vermont”:

COVID-19

CXR & CT scan

  • The typical finding is patchy ground glass opacities […]  Over time, patchy ground glass opacities may coalesce into more dense consolidation.

lung ultrasonography

findings
  • Patchy ground-glass opacities may cause B-lines

performance
  • A patchy B-line or consolidation pattern can be seen in any pneumonia or interstitial lung disease […] Note that supine, hospitalized patients may have B-lines and consolidation

general approach to imaging

all imaging modalities are nonspecific
  • All of the above techniques (CXR, CT, sonography) are nonspecific.  Patchy ground-glass opacities may be caused by a broad range of disease processes (e.g. viral and bacterial pneumonias).  For example, right now in the United States, someone with patchy ground-glass opacities on CT scan would be much more likely to have a garden variety viral pneumonia (e.g. influenza or RSV) rather than COVID-19.

  • Imaging cannot differentiate between COVID-19 and other forms of pneumonia.

key principle: supportive care for viral pneumonia

general principle:  avoid COVID-19 exceptionalism

  • There is not yet any compelling evidence that the fundamentals of treating COVID-19 are substantially different from treating other forms of viral pneumonia (e.g. influenza).

Prof. Farkas sums up his advice in a poster:

KEEP

CALM

and

PROVIDE

USUAL

CARE

Let’s take that advice. Let’s not play any of these popular (and deadly) games:

  • Us & Them
  • They’re to Blame for It!
  • Round Them Up!
  • It’s Us or Them!
  • It’s Coming For Us!
  • We’re Doomed!
  • Let’s All Panic!

Instead, let’s be sensible and supportive of each other. That might not be quite as exciting as the seven games people play listed above. I don’t know if that will save our souls but it might just save lives. It will certainly save sanity.

Please retweet and share this post. All over the place.

man-scared

Thanks to Mohamed Mahmoud Hassan for releasing his image “Man Scared” into the Public Domain.