the remdesivir story continues to unfold in a genuinely weird way. before going further, let's not forget the "compassionate use" trial in NEJM which claimed success because everyone didn't die (which, in retrospect, is *definitely* hot garbage) (rant 1/4)
https://twitter.com/PulmCrit/status/1248912063013040128?s=20
the NIH guidelines now recommend remdesivir for anyone with COVID-19 who is hospitalized with a saturation <94%. these recommendations are broader than the NIAID trial inclusion criteria- so even if the trial is very positive, this still seems like an over-reach (#rantorial 2/4) 
the SCCM just released a statement promoting remdesivir, even though the NIAID trial remains unpublished. never mind about RCTs! the new approach to evaluating drugs is really good retrospective data sharing. cool, cool, cool. (#3/4)
(sccm.org/Blog/May-2020/…)
(sccm.org/Blog/May-2020/…)
to show how well this approach works, the SCCM blog uses the Marini/Gattinoni model of "CARDS" as a success story. however, this H/L non-ARDS nonsense has largely been discredited & should be a *cautionary* tale of why we need to slow down and focus more on the evidence (4/4)
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