Si rischia di più con #COVID19 o con AstraZeneca?
Sempre di più con #COVID19 anche per soggetti a basso rischio;
il beneficio del vaccino aumenta quanto maggiore è il rischio da COVID19.

Grazie a @alex_freeman per le bellissime infografiche. Paragone rischi benefici AstraZeneca per diverse fasce di età in una popolazione a basso rischio di esposizione.

Per descrivere le pratiche di prescrizione di farmaci a casa non in linea con evidenza scientifica viene in mente la frase di Voltaire:
"L'arte della medicina consiste nel distrarre il paziente mentre la natura opera la guarigione" Ma andrebbe aggiunto "Primum Non Nocere" 1/6 Sono molto pericolose le affermazioni di colleghi che parlano di maggior mortalità in ospedale rispetto a chi si cura a casa, a causa delle cure ospedaliere.
E' un esempio di selection bias, che chi fa il nostro mestiere dovrebbe conoscere bene.
2/6

Every extra bed we have opened this year has been made thanks to the effort of an entire hospital.
Thanks to: specialists, trainees, nurses, students, physiotherapists, technicians, cleaning staff, research staff, IT services, clinical engineering, procurement, management 1/7 and certainly I have forgotten someone but I thank you anyway. Each of us worked differently. We reinvented ourselves.
Each of us has worked flexibly in tasks that are not part of their regular job. All together for one big goal: to give a bed to those who need it. 2/7

Ogni letto in più che abbiamo aperto quest'anno è stato fatto grazie allo sforzo di un intero ospedale.
Grazie a tutti: specialisti, specializzandi, infermieri, studenti, fisioterapisti, ausiliari, tecnici, personale delle pulizie, personale di ricerca 1/10 servizi informatici, ingegneria clinica, ufficio acquisti, direzione sanitaria, operativa, generale e sicuramente ho dimenticato qualcuno che però ringrazio lo stesso. Ognuno di noi ha lavorato in modo diverso. Ci siamo reinventati. 2/10

1/5 Association is not causality.
Recently there have been some headlines about low vitamin D levels and #COVID19. This has led some experts to recommend vitamin D. We have to be careful about jumping from association to causality. Vitamin D is linked to sunlight exposure. 2/5 The skin makes vitamin D from cholesterol when it's exposed to sunlight. We don't know but it could be that higher vitamin D levels are a proxy of an outdoor lifestyle, which could be the reason for a decrease risk of getting #COVID19 for instance.

"On small numbers and large problems"
Imagine that in a given country every day, every 100000 people we admit to an ICU bed 1 patient with pneumonia requiring invasive mechanical ventilation. 1 per 100000 seems a small number, right? Ok, now imagine that the average stay for this patient (taking into account who survives and who unfortunately does not) is 10 days. It means that we need roughly 1 x 10 = 10 beds in order to be able to admit 1 patient and discharge another one each day.

1/6 If someone is promising you the release of anti COVID therapies I remind everyone that specific therapies are not there yet. Research has helped us a lot to understand what works and what doesn't. 2/6 We will soon know the result of new therapies, but for the moment there are no specific therapies.
For now, for those who can be treated at home, there are symptomatic therapies such as aspirin and paracetamol.

1/5 The tension between scare mongers and deniers shows that we are not very good in explaining uncertainty and the balance between risk of harm and benefit to people. Most events in human life and medicine do not occur with 100% certainty. 2/5 Actually, if there is one certain thing about #COVID19, it is that we have to learn to live with a degree of uncertainty. Reaching zero risk is simply not possible, and even if a vaccine becomes available, it will be unlikely that it will be 100% effective.

Abstract Winning Session #lives2018 @ESICM great to see high quality research from our younger members @ESICM