(A true story, which might have a happy ending) Once upon a time there was a city which was struck by a terrible plague. Many died – and even more lost friends and relatives that they loved. Almost everyone found it harder to pay the bills but especially people who didn’t earn much to begin with. People working in bars and restaurants, theatres and concert halls. All those places – in fact – that made life worth living for everyone else….
Welcome to the Plague Pit – issue number 37. I’ve written before about COVID-19 research. I tried to use specific papers to outline briefly some general concepts like literature searches, impact factors, the peer-review process, publication bias, research fraud, systematic vs narrative reviews and meta-analysis (https://plaguepit.com/publications/). Last week, I also had a quick go at prospective vs retrospective cohort studies, multivariate regression and observational vs randomised controlled trials (https://plaguepit.com/risk/). I had hoped that would just about cover things. As time…
Welcome to the Plague Pit – issue number 33. In the middle of the COVID-19 pandemic, perhaps it’s odd to talk of ‘disasters coming in threes’. But this week has felt a bit like that. First – I went to a safety meeting about a young patient who had an unexpected catastrophic outcome after routine minor surgery. I was involved in the patient’s care. Then, yesterday, a colleague told me about his own unsuccessful attempts to resuscitate a hospital patient…
Welcome to The Plague Pit – issue number 30. The COVID-19 death rate is falling in the UK and the US, and rising in many other countries. As the pandemic plays out globally, we are learning more and more about the disease. According to one major database of academic literature, 3,406 relevant new papers were published last week alone. That makes more than 23,000 this year. A few of these may go on to influence the way we manage the…
Welcome to The Plague Pit – issue number 27. Yesterday, regular operating lists started at my hospital for the first time in nearly three months. As the newsreaders keep telling us, it’s not over yet. But if a graph can look beautiful, I think this one does. People are still dying, though. A month ago I went to ICU to hear from the hospital’s pathologists. They were presenting the results from our first two COVID-19 post mortems. About twenty people…
Welcome to The Plague Pit – issue number 24 Most of what I have written in The Plague Pit so far concerns doctors. What we think, what we do, what we wear – and so on. For this issue, I’d like to start instead with some first-hand accounts of the ICU experience from recovered COVID patients. I think these paint a striking picture of how extraordinarily unpleasant intensive care, and its aftermath, can be. I’ve written before about patient confidentiality….
This week is a bit of a mixed bag – and perhaps not as long a piece as it could have been, what with all the COVID-19 news. For those who feel a bit short-changed and want something more to read, I’ve added a few interesting bits to the Military Intelligence page: a paper on COVID in children, a video on COVID and blood clots, another video giving a two minute overview of ICU. Step down….and step back up I’ve…
Welcome to The Plague Pit – issue 17 I’ve written a lot about oxygen so far. Given that COVID-19 is first a disease of the respiratory system, that seems fair. In issue 13 (Physiology and Hairstyles), I talked about how COVID-19 increases the work of breathing, even as it decreases the amount of oxygen getting into the blood from the lungs. The relationship between breathing and oxygen is even more complicated, though. As the work of breathing goes up, so…
Welcome to The Plague Pit – issue number 16. From: The Daily Telegraph 08.05.20 ‘SIR – The Prime Minister has said that he went through “litres and litres” of oxygen during his treatment in intensive care at St Thomas’s Hospital and did not need to be connected to a respirator. In his video tribute when he left the hospital, he especially thanked two nurses, Jenny McGee and Luis Pitarma. Mr Pitarma is a senior nurse and a specialist in the…
Welcome to the Plague Pit – issue number 13 A few weeks ago, I said I’d write about what happens to seriously ill COVID-19 patients. These are the ones with lungs so badly affected by the disease that they require help from a mechanical ventilator to get the oxygen they need to survive. The way that oxygen normally gets into the body, and what happens to it when it gets there, is the domain of physiologists. It all starts with…