Allow me a brief thread that will first cause you some anxiety but then reassure you. I will preface this with my credentials. I have been an intensive care physician for 15 years now. Long enough have gained a fair amount of experience in these matters.
It is inherent in our nature to look for answers. It is also natural for us to seek the easiest way to accomplish a task. I’m not an evolutionary biologist but it makes sense to me to expend the least amount of effort to survive.
We have a tendency to seek simple solutions to complex problems. A perfect example: vitamins. A multi billion đź’µ industry based on only the scantest of evidence. In some clinical circumstances they are beneficial, sometimes life saving but in most cases the make expensive pee.
This recently came to light with vitamin C in the ICU. I’ve treated a lot of bad infections in my time. It involves a lot of work in the unit. Tracking and controlling the source, choosing the right therapeutic agents, managing the complications and supporting the patient.
Out of the blue some isolated work coming out of a single hospital was showing incredible results in septic patients who received a cocktail of vitamins C and steroids.The success rate of this therapy was unlike anything we had ever seen. I went to one of his talks. Listened.
He was a good and kind physician. He truly was impassioned about his work and wanted us to follow suit. He even told us that if we did not use vitamin C we were letting our patients die. That stung. Could the entire medical community really have missed something this fundamental?
Some started using Vitamin C quoting the oft heard mantra, “What have I got to lose?” Others sat down and designed studies to see if the effect was real. They were boring, plodding well thought out studies. The media wasn’t interested.
And though the final results are not out yet, this incredible effect hasn’t been reproduced. It appears that when you have a new weapon in your arsenal and refocus your attention at a problem, the general care get a lot better. And that’s what makes the difference.
All that tough, complex, backbreaking work in the background needs to be accounted for to see if the effect of the treatment is real. To see if it has benefit. To make sure it’s not harmful. And that takes time. And waiting is hard.
And so with #covid19 there are many unproven therapies out there. Some with more evidence than others. Some being toted by well intentioned physicians, politicians, journalists and celebrities. Some not so well intentioned.
You can follow @drdagly.
Tip: mention @twtextapp on a Twitter thread with the keyword “unroll” to get a link to it.

Latest Threads Unrolled: