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”:
CXR & CT scan
The typical finding is patchy ground glass opacities […] Over time, patchy ground glass opacities may coalesce into more dense consolidation.
Patchy ground-glass opacities may cause B-lines
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:
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.
Thanks to Mohamed Mahmoud Hassan for releasing his image “Man Scared” into the Public Domain.