Statements like this confuse me. Are you concerned about toxicity? I doubt young, non-comorbid patients in the ICU w/ severe hypoxemia are the ones benefiting from this drug.Ill probably still pull it out for younger people or people with no comorbidities who have a good shot at meaningful recovery but as a universal therapy for everyone who walks in the door requiring O2 I think it should die since it seems likely that it offers no benefit at large.
Statements like this confuse me. Are you concerned about toxicity? I doubt young, non-comorbid patients in the ICU w/ severe hypoxemia are the ones benefiting from this drug.
Given that remdesivir really lacks any empirical backing, we're back to theoretical concerns. So I would say that our dear leader was the perfect candidate--old+risk factors and treated very early in the course.
Kudos to those of you with the balls to stop using it. My hospitals were full-steam ahead on hydroxychloroquine, so I don't foresee any changes to our protocols. Not a bad time to buy stock in Gilead, imho.
Sorry to be pedantic, but your two statements are incongruous. (I agree with the second, but your first one was illogical).It is overall system cost--we cant afford to give a drug that costs 2.5k for everybody who walks in the door with this. If we admit 5% of the 8 million cases in the USA that is spending 1 billion dollars in healthcare money on a single drug that has shown no benefit. That is ridiculous.
Thankfully I have worked in a hospital that did not buy in to plaquenil and will hopefully stop using this routinely as well.
Sorry to be pedantic, but your two statements are incongruous. (I agree with the second, but your first one was illogical).
From a cost-benefit perspective, throwing the kitchen sink at someone on death's door is silly. A 30 year old on ecmo has far worse prognosis than a 74 year old w/ transient desaturation. Plus, based on everything we think we know about this disease, this drug is highly unlikely to offer anything to the former, but may result in modest benefit for the latter.
It seems like you think I have a far less sophisticated understanding of cost-benefit analysis than I possess. But going back to my first question, why would you think a young patient in the ICU would be the best candidate for this drug?
Why do you say that?
You are missing the lack of comorbidities part. I'm not saying every obese young person in the icu should qualify, but rather the ones who might have a high viral load causing them to get sick where this might actually do something as opposed to it being a function of the immune system.
Why do you think the low risk 75 year old who is going to be fine needs a 2.5k drug?
What I do with the vent, fluid management, sedation, etc have 100x more impact than the new tamilfu.