If you are new to this site,

1. Read the comments on the public page (opening  and reading all the tabs in the language of your choice)
2. Read this page, then
3. Go to COVID Academy and follow the instructions
4. Therafter browse the link in the top right menu of this page as are added or as they become active

If you find something horribly upsetting of just wrong on this or any other part of the site, reach out to me through the contact page of www.Saineville.com

TRUTHS

• COVID-19 is a bad thing.
• COVID-19 or something worse was inevitable.
  In theory we could have prevented or delayed this event, but not easily, and it’s water over the dam.
• COVID-19 or something worse will happen again!
  We need to learn as much as we can about this disease, about preparedness, about managing health care systems, about collaboration, and about humanity.
• There is a silver lining of COVID-19 (there is always is a silver lining).
  We will sacrifice a lot for this virus. And learn a lot …… if we pay attention.
• There is no cure or known effective medicines for the treatment of COVID-19 (as of April 1, 2020).
  The only effective prevention is education and promotion of what I call “Pandemic Hygiene” (see below).
• Wherever possible, patients and health care workers should be treated within randomized control trials (RCTs).
  This is the fastest way to discover what works and what doesn’t. We dont have the time or the resources for undisciplined clinical choice. Don’t mistake random care for randomized care.
• There is a place for compassionate non-evidence based care.
  It will be difficult to resist throwing heroic and unproven treatments at young previously healthy patients who are crashing.We do this all the time in critical care medicine, often invoking noble motives “We shall leave no stone unturned in the care of the patient”, or justifications, “We have nothing to loose, the patient will otherwise die”. In the context of a pandemic those arguments carry less weight. You have a lot to lose! Namely resources like ventilators, medications, PPE, and human resources which are very limited, and which are put at risk by the act of providing care. Heroic resources applied to an unsaveable patient cannot be taken back, and in resource challenged settings, will reduce the quality of care and the outcomes of all patients.This is the ugly and unpalatable truth of disaster medicine. One of the first things clinicians need to learn is to recognize a sick and potentially unstable patient. One of the first things you need to learn in disaster medicine is to recognize an unsaveable patient.The reality of resource limits hits hard and fast, and it becomes rapidly clear that rigour and evidence based practice is the most compassionate care. This is where physicians learn to make very hard choices, and at that point compassion, which is heart driven not evidence driven, is about the only tool you have. In the end this is what will get us through the long days to come and the longer nights to follow.