Correlation equals Causation and other news

[IMGASMD]

Joe Rogan and Elon Musk discuss the dangers of ventilators.

Joe Rogan: "Like 80% of the people they put on ventilators died."

Elon Musk: "This is what actually damaged the lungs, not Covid. The cure is worse than the disease."

---

Members don't see this ad.

 

[nimbus]

Dr. Rogan and Dr. Musk should start treating sick patients together.

 

[midazzoler]

 

[coffeebythelake]

I dont understand how people think Elon Musk is a genius. He isn't. And this is just another example of how dumb he is.

 

[2Fast2Des]

I dont understand how people think Elon Musk is a genius. He isn't. And this is just another example of how dumb he is.

All he had to do was keep his mouth shut and pump out cars and spaceships and take his stock to the moon. Instead he felt the need to speak and buy Twatter/X and now my Tesla stock is still -11% after being up by like 40% during its prime. Thank God I didn't listen to the *****s who said to keep buying more shares as the prices kept plummeting

He's got too much money, way too many things he's involved in, and probably losing his mind from the lack of sleep, so he can say or do whatever he feels without any accountability

 

[PainDrain]

Joe Rogan and Elon Musk discuss the dangers of ventilators.

Joe Rogan: "Like 80% of the people they put on ventilators died."

Elon Musk: "This is what actually damaged the lungs, not Covid. The cure is worse than the disease."

Wtf. This is so ridiculous and it’s one of several reasons I stopped listening to Rogan. He twists and manipulates things to favor his view. He claims to be this apolitical person interviewing interesting people but he is far from a neutral observer.

 

[PpfSuxTube]

Wtf. This is so ridiculous and it’s one of several reasons I stopped listening to Rogan. He twists and manipulates things to favor his view. He claims to be this apolitical person interviewing interesting people but he is far from a neutral observer.

He's a tinfoil hat wearing idiot. At one point he had a good show but now not really...

 

[dchz]

Wtf. This is so ridiculous and it’s one of several reasons I stopped listening to Rogan. He twists and manipulates things to favor his view. He claims to be this apolitical person interviewing interesting people but he is far from a neutral observer.

I never bought he was neutral so I never listened to him.

But recently I stopped listening to NPR up first because it was way too left leaning for a supposedly neutral news source. Steve Innskeep doesn't even try to hide his bias anymore.

I substituted Reuters world News instead, which is really just US news half of the time.

 

[Arch Guillotti]

Wtf. This is so ridiculous and it’s one of several reasons I stopped listening to Rogan. He twists and manipulates things to favor his view. He claims to be this apolitical person interviewing interesting people but he is far from a neutral observer.

He’s not apolitical. He’s an idiot.

 

[psychbender]

I've noticed that everyone that confuses correlation and causation ends up dead... just saying.

 

[nimbus]

I've noticed that everyone that confuses correlation and causation ends up dead... just saying.

Well played

 

[abolt18]

I've noticed that everyone that confuses correlation and causation ends up dead... just saying.

Statistics is a dangerous game!

 

[midazzoler]

Joe and Elon both survived through the day yesterday. By their ventilator logic their survival correlates to their immortality.

 

[GravelRider]

I listened to Joe Rogan early on because he was a decent interviewer and he had interesting people on his show. Lately he’s veered into this right wing conspiracy theory swamp. Joe Rogan and Elon Musk are idiots and great examples of what is wrong with our current moment in society. We elevate the voices of non-experts and conspiracy theories. Just wait until A.I. lays waste to humanity with the dumbing of the homo sapien mind…

However, he’s not entirely wrong. Ventilator induced alveolar trauma in ARDS and other such lung pathologies is a fairly well-known problem. Early on in the initial Covid wave, we were intubating everyone early, but later there was a push to avoid intubation for as long as possible. It’s a shame how they framed the discussion because there is a legitimate academic point there. Instead they use it to push conspiracy theories.

 

[chessknt]

I listened to Joe Rogan early on because he was a decent interviewer and he had interesting people on his show. Lately he’s veered into this right wing conspiracy theory swamp. Joe Rogan and Elon Musk are idiots and great examples of what is wrong with our current moment in society. We elevate the voices of non-experts and conspiracy theories. Just wait until A.I. lays waste to humanity with the dumbing of the homo sapien mind…

However, he’s not entirely wrong. Ventilator induced alveolar trauma in ARDS and other such lung pathologies is a fairly well-known problem. Early on in the initial Covid wave, we were intubating everyone early, but later there was a push to avoid intubation for as long as possible. It’s a shame how they framed the discussion because there is a legitimate academic point there. Instead they use it to push conspiracy theories.

Dude intubating later or earlier didn't matter at all-by the time they needed to be intubated their lungs were beyond ****ed and it is impossible to blame the ventilator.

 

[GravelRider]

Dude intubating later or earlier didn't matter at all-by the time they needed to be intubated their lungs were beyond ****ed and it is impossible to blame the ventilator.

That’s fine and not the point. The point is that there is plenty of medical literature and medical opinion articles out there that can support what these idiots say. Also, the last time I delved into critical care literature (which was a while ago), ARDS protocols are a thing because frankly ventilators aren’t great for lungs…especially sick lungs. We’ve created entire protocol driven ventilator management to try and minimize the damage ventilators do while lungs heal themselves. You and I both understand that ventilators are the best choice we have for supporting people with severe acute lung pathology despite their shortcomings. This is why it’s dangerous when people who are not experts talk like they are…facts are left out and half-truths are misconstrued.

 

[Radetzky]

I’m yet to come across these ventilator “protocols” that everybody keeps talking about.

 

[Beeftenderloin]

I’m yet to come across these ventilator “protocols” that everybody keeps talking about.

It’s all things that we take for granted today but was cutting edge 10-15-20 years ago. Low Vt ventilation using 4-8cc/kg IBW, keeping Pplat<30, driving pressure under 15 (if you pay attention to it), using relatively higher PEEP and positioning/proning to facilitate an open/recruited lung. It’s not so much a protocol per se, it’s more just current standard of care for ICU vent management.

 

[coffeebythelake]

I’m yet to come across these ventilator “protocols” that everybody keeps talking about.

ARDSnet protocol that everyone seems to be doing for every patient including the non ARDS, non critically ill

 

[chessknt]

It’s all things that we take for granted today but was cutting edge 10-15-20 years ago. Low Vt ventilation using 4-8cc/kg IBW, keeping Pplat<30, driving pressure under 15 (if you pay attention to it), using relatively higher PEEP and positioning/proning to facilitate an open/recruited lung. It’s not so much a protocol per se, it’s more just current standard of care for ICU vent management.

Exactly. These were violated in a lot of covid patients because their lungs were so heavily damaged it wasn't possible to keep them 'alive' without doing so (ie pplat 30 volumes were mid double digits) but in the end they just died anyways. Well meaning people would force these people to breath 50-60/minute on 100% hfno for a week with minimal to no po intake waiting to intubate until they collapsed with exhaustion thinking it was somehow helping them, but they died just as much as the ones that got intubated on the first day that happened. Then lay people with no comprehension at all concluded the ventilator killed people because the unifying factor was people didn't die from covid unless a ventilator was involved. Had some people tell me they wouldn't let me kill them with a ventilator and I told them that meant no CPR too but they always changed their mind when it came to the exhaustion point.

 

[coffeebythelake]

Exactly. These were violated in a lot of covid patients because their lungs were so heavily damaged it wasn't possible to keep them 'alive' without doing so (ie pplat 30 volumes were mid double digits) but in the end they just died anyways. Well meaning people would force these people to breath 50-60/minute on 100% hfno for a week with minimal to no po intake waiting to intubate until they collapsed with exhaustion thinking it was somehow helping them, but they died just as much as the ones that got intubated on the first day that happened. Then lay people with no comprehension at all concluded the ventilator killed people because the unifying factor was people didn't die from covid unless a ventilator was involved. Had some people tell me they wouldn't let me kill them with a ventilator and I told them that meant no CPR too but they always changed their mind when it came to the exhaustion point.

In summary: the sickest patients get intubated and they died.

 

[IlDestriero]

In the first go around with Covid, and I know as I was an early adopter and got really hammered (though fortunately I stayed out of the hosptial) they were intubating everyone very early. Partly I think because that secured their airway and they didn’t have real PPE. Nobody was going on HFNC or bipap. That proved to be a problem and early research suggested that it was increasing mortality. We were looking at Europe as they were a few weeks ahead of us, and remember we were making it up as we went using bad data as well sometimes. Ultimately I called around to friends in a few different area hospitals to make sure if I went in I wouldn’t be immediately tubed and sedated. 2 we’re still doing that, one wasn’t. So that was the plan.
So yes, those that got the vent were already circling the drain, and most died. From Covid, clots, pneumonia, ARDS and multi organ failure, etc. However, some of those, especially in the first few months, and even later if the backwards non evidence based places, could have probably been salvaged.

 

[Radetzky]

It’s all things that we take for granted today but was cutting edge 10-15-20 years ago. Low Vt ventilation using 4-8cc/kg IBW, keeping Pplat<30, driving pressure under 15 (if you pay attention to it), using relatively higher PEEP and positioning/proning to facilitate an open/recruited lung. It’s not so much a protocol per se, it’s more just current standard of care for ICU vent management.

Yeah my point was the only thing here that’s protocolised is the tidal volume. The rest is subject to a good degree of judgement still

 

[PpfSuxTube]

Dude intubating later or earlier didn't matter at all-by the time they needed to be intubated their lungs were beyond ****ed and it is impossible to blame the ventilator.

Well that's really not true at all or leaves out significant detail.

What Rogan and tesla fail to specify is what each term means.
And this is very important.

Early vs very early intubation imply quite a different burden of lung pathology as we now realise.

"Very early" then yes they are probably correct.
"Early" then no they're probably not correct.

I'm not sure what phase "needed to be intubated" implies but probably somewhere between early and late and in that case, no that's probably not correct to say that intubating them was more harm than good...

 

[chessknt]

My point was that there never was (and still is not) any quality evidence that time to ventilation had any impact on outcomes (mortality). This correlates to what people were seeing in ICUs--most died like dogs on the vent whether they got there on day 9 or day 2 of hospitalization. There isn't even a coherent definition of what early intubation even means. The theory being floated was that the PPV would hasten their ards but the reality is that it didn't matter. Leaving then to suffer in a state of near failure for days was inhumane.

It all goes back to the point where people who don't know should refrain from comment.