COVID-19 learning online: 1) What *is* a ventilator?? 2) Eric Topol on treatments, comorbidities, what next?

One thing that will be recorded in the history of the unfolding coronavirus story is how people are using social media – for better or worse – to answer questions that never seemed important. Warning: the internet has scammers and idiots. Think carefully. Do not listen to people if you don’t know where they get their information.

Here are two examples, from good sources.

1. Understanding ventilators: Everyone’s talking about the shortage of ventilators. The super-active patient advocate Grace Cordovano tweeted a request for consumer-friendly information on what a ventilator is, how it works, etc. An hour later P. F. Anderson responded with a perfect answer. Five minutes, simple, clearly worded, accurate, exquisitely well illustrated.
2. Potential medications and other rumors: You’ve probably heard that most deaths are among people with pre-existing conditions, and that various treatments are being considered. These and other rumors are discussed in this 21 minute interview (plus transcript, for fast skimming) with the great Dr Eric Topol on Medscape. Topics:
   1. Pre-existing conditions (“comorbidities”): rumors from Italy say 99% of deaths had pre-existing conditions, e.g. 75% hypertension. Topol explains why he’s a little incredulous, and which conditions make sense. (Conversely, it does make sense that COPD would be a problem for a lung disease!)
   2. “Two drug classes that have been put into confusion mode … ACE inhibitors and NSAIDS. … there are no data to support either harm or benefit.” (There’s speculation, perhaps theory, but not a shred of evidence, he says.)
   3. Rumors from China about whether blood type matters. (It’s not like it’s something we could choose to do differently…)
   4. Do we really need to flatten the curve? The hospitals near me aren’t backed up. Is this a hoax? (“It will double every couple to few days. So just roll this out for another 10 days, which is how long it will take to be like Italy.”)
   5. Why test people who don’t have symptoms?? (“We would do as many millions of tests possible to see where our hot zones are going to emerge before they do. And the tests are cheap. They’re easy. We were not prepared. …”)
   6. Digital tracking, location services, privacy. “This would not be the time for privacy concerns. Normally that’s a biggie for me. But right now we’re facing perhaps the worst crisis in public health that we’ll ever see in our lifetime.” [I agree with him on that.]
   7. Don’t let up – keep doing what works. South Korea: “So they have contained this, but even then, John, we’re starting to see that pick up again with more cases after they had shown a flattened curve. So we aren’t learning the lessons here about taking this seriously.”
   8. “Everyone’s an armchair infectious disease doctor, an epidemiologist with no training”: “It’s kind of good. If everyone did convert to become a citizen scientist, that would help, because that means they’re tuning in to what’s going on.” ERIC BABY! I LOVE YOU!
   9. “Non-shedders”: Seriously, read this. What’s going on here?
   10. At-home testing: Um, see what you think… but drive-throughs…
   11. What should we do? “Other than increased testing, what would you do? Not what should we have done, but what can we do today?”

Again, that interview is here.