VIRAL NEWS – James Cook Critical Care Covid-19 Updates from Around the Internet

Volume 3 – 16th March 2020

KEY RESOURCES: Public Health England: Coronavirus tracker: https://www.arcgis.com/apps/opsdashboard/index.html#/f94c3c90da5b4e9f9a0b19484dd4bb14 (desktop version) https://www.arcgis.com/apps/opsdashboard/index.html#/ae5dda8f86814ae99dde905d2a9070ae (mobile version) Coronavirus Infection Prevention: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control Coronavirus Case Definition and initial management – can change rapidly: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-initial-investigation-of-possible-cases/investigation-and-initial-clinical-management-of-possible-cases-of-wuhan-novel-coronavirus-wn-cov-infection

Resources The joint societies Covid-19 Website has launched.

https://icmanaesthesiacovid-19.org/

I’d like to draw your attention to this statement:

Pleasebeawarethatthisisafast-evolvingsituationandclinicalandpublicadvicemaychange.Informationherewillbeupdatedandchangedasappropriatesopleasecheckforthelatestversion.

Remember this for all sources of information: Things are changing fast. Just because the advice changes it doesn’t mean it was wrong: The facts will change and the advice changes with it. The biggest enemy is fear leading to rumour leading to more fear.

Lung Ultrasound Andy Hyde has put together an exceptional presentation on lung ultrasound which is now the modality of choice in Critically Ill Patients – it is attached to this email. We will offer seminars in Lung, pleural and thoracic USS soon – it isn’t hard, you can use any probe and you can learn it. Radiology Just a reminder: profound hypoxia is possible with relatively little in terms of CXR Changes. If the GIF doesn’t work for you, the CT shows very small patchy infiltrates that wouldn’t usually imply the 100% oxygen this patient is on.

Lung CT: Don’t expect huge numbers of our own CTs to start appearing in the medical literature! The Royal College of Radiologists have put out the following statement:

• “Our view is that there is no current role for CT in the diagnostic assessment of patients with suspected coronavirus infection in the UK.”

• CT does have a well-established role in the assessment of patients presenting with severe respiratory distress and will still be used

Research Lots of us, our patients and our colleagues have been asking about Inflammatory Bowel Disease and Covid-19. The Lancet have a resource here: https://www.thelancet.com/journals/langas/article/PIIS2468-1253(20)30076-5/fulltext BEWARE FAKE NEWS A long thread appeared on Twitter from an Attending (=consultant. . . ish) neurologist in the USA, purporting to be the situation in Seattle. “An intensivist colleague told me. . . .” Fast forward twelve hours, thousands of retweets and lots of comment, this appeared:

The retraction has roughly 2% of the shares of the nonsense it retracted. Think before you tweet. It takes ten times as much work to dispel bovine excrement as it does to create it. Don’t believe anything that starts “I’ve heard that. . . “ even if it comes from a doctor. Anyone can make a scary graph from Excel in ten minutes.