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Nida Qadir, MD

19 Jul, 5 tweets, 2 min read

https://twitter.com/weselymd/status/1417098498974142468

Important questions about the type of ethical decision-making that needs to happen when resources become scarce - a situation no one wants to be in, but I worry may again become inevitable as #COVID19 cases continue to rise.

https://twitter.com/weselymd/status/1417098498974142468

Should #vaccinated patients be prioritized over unvaccinated, all else being equal? I don’t think so, no matter how frustrating this is. Many unvaccinated are victims of misinformation. Also, if we did this, then where else do we draw lines related to personal health behaviors?

What about HCWs? When we were making our crisis standards of care document, there were discussions about the ethics of giving HCWs a tie breaker, all other things being equal. The rationale was that if they got better, they could go back to work & help others, maximizing benefit.

However, I agree w/ Dr. Ely that this may not be realistic considering how long it can take to recover. Some may be back in months, some in years, and some never. But what if said HCW got COVID while caring for COVID patients?

We have to grapple with some incredibly difficult questions as the pandemic continues. Many thoughtful people have widely differing views. Take the poll, if you haven’t already.

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Nida Qadir, MD

@NidaQadirMD

20 Jul

@CNN

Thanks @CNN for sharing this story on @UCLAHealth's collaboration with @LAOpera! In this program, opera performers lead #COVID19 survivors through breathing and singing workshops - it's an innovative (and fun!) adjunct to pulmonary rehab.

cnn.com/2021/07/18/us/…

What does #opera have to do with pulmonary rehab? Well, would it be surprising to know that some of the work we do in pulmonary rehab is quite similar to the #breathing exercises opera singers do? The opera stars just happen to be doing them on an elite level.

For example, diaphragmatic breathing, which we use as a technique to help increase tidal volume, is also used by singers to increase endurance and help them sing longer on a single breath.

Read 5 tweets

Nida Qadir, MD

@NidaQadirMD

25 Feb

@UCLAHealth

Honored to present at combined medicine & surgery grand rounds @UCLAHealth today & a privilege to highlight the incredible work done by the UCLA #COVID19 front line. Also packed in a review of the evidence basis for COVID therapeutics & discussed COVID recovery.

A lot to cover, and admittedly, I haven’t been that nervous about a presentation in a long time. I’ll share some slides here, starting with a summary of #COVID19 therapeutics.

Reviewing the body of evidence is always a task, even if the last time you did it was a week ago. You’ll get >100,000 results in PubMed if you search for #COVID19. In one year, there are about as many results for COVID as there are for influenza over 30 years 😳

Read 12 tweets

Nida Qadir, MD

@NidaQadirMD

20 Nov 20

@bmj_latest

Just published in @bmj_latest, an update to our @WHO living guideline on drugs for #COVID19 – this update focuses on #remdesivir & was informed by the results of 4 trials w/7,333 participants – ACTT-1, SOLIDARITY, Spinner (JAMA), & Wang (Lancet). tinyurl.com/y4svlcyn

Summary: based on currently available data, there is insufficient evidence that #remdesivir improves patient-important outcomes ➡️ thus, a conditional (weak) recommendation against the use of remdesivir in hospitalized patients with #COVID19.

A conditional, or weak, recommendation against #remdesivir means that, based on current data, the undesirable effects probably outweigh the desirable effects, but substantial uncertainty exists. With this in mind, we very much felt that trials of remdesivir should continue.

Read 8 tweets

Nida Qadir, MD

@NidaQadirMD

6 Oct 20

#CCCF2020 Brian Kavanaugh Controversies - #COVID19: #ARDS or not? What we really addressed - not so much "is it ARDS?" but rather, "does it matter?" So happy to have been a part of this, but man, I still have so much to say! My take on the ? – yes, it matters - to an extent 🧵 1/

Pre-intubation management: YES, but not because it substantially changes methods of support, or the criteria used for #intubation. It matters because categorizing patients as having #ARDS has value. 2/

If we use the Berlin definition, patients on Venturi masks or arguably #HFNC don’t actually meet criteria for #ARDS because they’re not on PEEP >/= 5. The natural history of ARDS though almost certainly begins prior to the use of mechanical ventilation (invasive or not). 3/

Read 13 tweets

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