Link to evidence that lots of people need oxygen concentrators but not ventilators?
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Replying to @s_r_constantin
Chinese reports + American interviews of front line doctors collected by project open air https://drive.google.com/folderview?id=1D1_C_Bng3zqw2IDZmo3jYZDZDLNYm0tq … Interviewed doctors seem inconsistent about how much care those on oxygen need, but consistent that there's two scenarios: oxygen and intubation.
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Replying to @gallabytes
That’s not the relevant consideration for whether *home* oxygen is useful for a large # of patients. In fact the interviews you linked are not consistent with that story.
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Replying to @s_r_constantin @gallabytes
“When respiratory failure occurs it is FAST. It may be happening about 7-10 days from symptom onset, but very rapid from the time of hospital admission. Common scenario is: Admit the patient on 1 liter of oxygen by nasal canula (a very little bit.)”
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Replying to @s_r_constantin @gallabytes
“Twelve hours later the patient needs more help with a device that pushes oxygenated air into their nose/mouth and down their airway into their lungs (NPPV, think like a CPAP machine). Twelve to 24 hours later they are intubated, on a ventilator, turned onto their bellies”
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Replying to @s_r_constantin @gallabytes
In a scenario like this, there’s only a 12-hour window where a patient needs oxygen but doesn’t need ICU-level care. In which case, home availability of oxygen doesn’t free up that many medical resources.
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Replying to @s_r_constantin @gallabytes
The world where home oxygen masks are still useful is one in which many patients a.) need oxygen, b.) will get *better* and not need hospitalization if they get oxygen; c.) will eventually need hospitalization if they get no early treatment.
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Replying to @s_r_constantin @gallabytes
I still don’t know how common that scenario is. Ie how much better is oxygen treatment for mild pneumonia than no treatment?
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Replying to @s_r_constantin @gallabytes
In a world where oxygen for mild pneumonia doesn’t prevent progression to ARDS, then home oxygen improves quality of life for mild cases but doesn’t take pressure off the medical system or prevent many deaths.
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Replying to @s_r_constantin
this makes sense - I'm not sure how we would test - hospitals seem to keep giving oxygen while patients are hospitalized until shortly before discharge, but that doesn't necessarily mean it's working.
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This is a straightforward lit review check, also look for how it works in SARS, MERS, and vanilla influenza. On my to-do list but I’m busy today so if you find out first lmk.
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