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Wendy madan perkins's avatar

Dr Zach Bush mentioned, at least 20 months ago, that this looked like cyanide poisoning…very interesting. Thanks Walter Xxxxxxxxxxxxxxx 💖👩🏼‍🌾🎨🦋

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Pinktelegirl's avatar

Back in March 2020, before we had functioning PCR swabs (thanks to CDC failure) and used CT to help diagnose covid, I said "this is not ARDS". I am a physician, 11 years as an intensivist, worked in 2009 during H1N1. Had multiple young people in my ICU, esp young men. Put peeps on ECMO. It was a mess. But, after treating ARDS for 11 years, when covid happened, I said the bilat ground glass opacities are NOT normal ARDS. I couldn't find anyone at my hospital to agree with me in a 2 minute conversation (MD attention spans are dismal). Got a twitter account and tried communicating with radiologists at UW, who also just disregarded me, saying it's ARDS. I kept saying it looks similar, but it's too "perfect" - meaning too diffuse, bilateral and homogenous. Clinical presentation completely different. "happy hypoxia" - never saw a "happy H1N1" case.

The term cytokine "storm" also was inappropriate ... since it takes 8 days - 2 weeks to "storm", which isn't exactly a storm. The cytokine storm we saw with H1N1 was a storm - rapid, early onset. I think by misnaming it, we anchored on all the wrong physiology of ARDS and cytokine storm, as seen in H1N1 and other flus. If your base of knowledge is wrong, everything you learn is a sandcastle on the beach......

Fast forward 2 years and we are finally getting explanations that explain the diffuse, fibrotic pictures we saw on CT.

Anecdotally, I am seeing higher pulm art pressures on ECHOs of my patients. Time will tell. I have long watched PAP because I have special interest in PE treatment. Also have seen coronary vasculitis in adults, on echo, like what we see in kawasaki kids.

I too have lost friends over my opinion on covid. I never imagined I would lose friends because I thought the CT looked a little off!!! But our paths diverged early on and remain separate. We need creative people to prevent us from getting anchored on the wrong treatment paths.

Thankfully I have found wonderful, imaginary friends online, like Walter, that have kept me sane.

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