Afterthought Nr 2 on this thread: I found myself using the term "primary source control". Why was I saying that?💡I teach my medical residents/registrars to always pursue "primary source control" of infections all the time instead of relying on antimicrobials
https://twitter.com/ToshiAkima/status/1449615105566461953
Primary source control of infection is a much more ancient, pre-antimicrobial era method of infection control. You drain the pus, debride or amputate the gangrenous limb, remove the foreign object/device/hardware/prosthesis
Even today if you don't achieve primary source control antibiotics won't be enough and you may lose your patient. Teaching point: Don't be overreliant on treating infections with pharmacological interventions
The lesson from cholera is that we should aim at primary epidemiological source control of infection first. As with antibiotics, leaky pharmacological interventions should be treated as a backup defence. We mustn't rely on vaccines as the sole means of fighting COVID
Primary source control is a hard concept for modern physicians to grasp. We're too used to magically fixing things with molecular wonderdrugs, but when it really gets bad we need to start thinking like 19th C clinicians again
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