Despite the best of intentions, many health care practitioners are sharing their opinions concerning COVID-19 on social and news media based on anecdotal evidence. When dealing with an illness that we still don't fully understand, it is irresponsible to introduce information that hasn't been proven through rigorous testing using the scientific method into the national dialogue.
One video by an emergency department physician uploaded to social media and propagated through news media claimed that the major route of infection for coronavirus was through contact and less so by airborne transmission. Since this video was posted, we have indeed learned that airborne transmission via respiratory droplets is a predominant route of transmission.
Another video by an intensive care unit physician, also featured by a major news outlet, encouraged coronavirus patients to stay in a prone position in order to improve their breathing. It is true that prone positioning will improve breathing. In a prone position, the force of gravity will aid expansion of the chest wall. There will be a shift in the distribution of ventilation and perfusion throughout the lungs. Areas that were not being adequately perfused and ventilated now will be. This will reverse areas of atelectasis and consequently improve total lung capacity. In addition to this, prone positioning aids drainage and expulsion of respiratory sputum.
That being said, prone positioning should only be promoted in a supervised setting because it very likely will only delay the need for intubation. While the patient is prone, he/she will feel fine. However, when the patient gets back up, he/she will become hypoxic again. Promoting this technique in an unsupervised setting will only delay people from seeking medical attention when they really do need it. This delay likely will cost lives.
Finally, many doctors have been making the rounds on news shows to promote the drug hydroxychloroquine for use in coronavirus patients. There is preliminary evidence to show that the drug has some benefit for coronavirus patients and the Food and Drug Administration has given emergency approval for off-label use of this drug for COVID-19 patients. But it is irresponsible to promote the drug on a national platform until it has undergone formal randomized controlled testing. This will only further increase demand for the drug, lead to shortages, and promote black market alternatives. The decision to prescribe hydroxychloroquine is a matter that should be decided solely by the patient and her/his physician, and that physician's judgement should be based solely on scientific methodology and what is best for the patient. Doctors on news shows should not be trying to influence the national discourse by politicizing an inadequately proven drug.
As health care practitioners, we all have a responsibility to be judicious with the information we share and the potential repercussions that giving this advice on a national level will produce. Do not share advice until you have checked the scientific veracity of it. Please be prepared to cite the evidence when you do so. And please do factor in considerations about whether patients will realistically be able to perform certain techniques outside of a supervised setting.
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Funding Information
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