Read on Twitter
1/n I have debated posting this for some time because I am not a fan of controversy and am aware of the implications of raising even valid concerns. I can only share my concerns and unfortunately have no answers, just questions. Time may never make this Covid-19 situation
2/n clear. An anecdote that troubles me on many levels: A friend of mine became ill with no known ill contacts. He tested neg for Covid-19 and improved after 5 days. He again tested neg before returning to work. Several days later he decompensated and was admitted to a
3/n local hospital. Again tested neg and was discharged. Discharge Dx: "Pneumonia due to Covid-19." Nobody knows why he received this diagnosis. Did they assume 3 serial false neg tests? As I researched online I found this letter. I have no idea of the validity but in itself
4/n it raised great concerns about our state of science on testing. (I would recommend reading the letter & the following comments). It is entirely possible that these scientists merely have an axe to grind. https://cormandrostenreview.com/retraction-request-letter-to-eurosurveillance-editorial-board/
5/n I am troubled that I have not seen any scientists refuting or confirming their complaints on social media or in the press. I am also stunned that they claim that the foundational study was published a day after receipt...very concerning for the peer review process.
6/n My dilemma as a practicing doc is that it is very difficult to give practical advice to my patients on the value of testing in many situations. I recommend "Universal Precautions" because of testing irregularities. For instance Elon Musk had 4 tests on the same day
7/n (Two Positive and 2 negative). This is very concerning to me as a doc because we use one test to determine treatment and quarantine. Also 77 NFL players tested Pos at one facility but all neg on re-testing. This combined with reports that 78% of patients testing positive are
8/n completely asymptomatic. I don't see clear reports on what percentage will go on to be symptomatic. This has huge social implications. The problem is that if we test people w/ a common cold but they have a false Pos Covid test, we will call it Covid 19. This will affect
9/n mortality rates significantly. True cases may actually have a higher mortality rate than we are quoting at this point. We also have to weigh in the social consequences of our response as per this article: https://edition.cnn.com/2020/11/28/asia/japan-suicide-women-covid-dst-intl-hnk/index.html
10/n Clearly this information makes giving appropriate advice if a co-worker or asymptomatic friend tests pos. In order to weight the odds, we have to understand the prevalence in the population which is nearly impossible. We also have to consider the significant cost of repeat
11/n testing. I have friends who have tested over 10 times "just to be safe." We are clearly in challenging times and hopefully we will have more clarity soon. I'm trained not to order a test unless it will alter my management. I wish I could have a better answer but for now
12/n I, like you, wait for experts in the field to guide us. Both sides of the covid arguments have to drop the emotions & work together to find meaningful answers in this challenging time. For now it is "use sound judgment, universal precautions, and respect Covid-19
13/n and make yourself as metabolically healthy as possible to give yourself the best chance of a positive outcome." Sorry, no clear answers and I welcome thoughtful feedback from those with a clearer picture.
