Puscast: Oct 1 - 15, 2020.

·26 min·2 clips

The IDSA sent me a pen celebrating my COVID work while their journal service has been down for a month.

The bulldog gets blamed first. The host opens on the first two weeks of October 2020, points listeners to the references at his site, then wanders straight into a rant about a professional society buying symbolic clutter. The IDSA COVID-45 response lapel pen gets no mercy. He treats it as a tiny case study in bad priorities: postage, carbon footprint, and people who needed masks more than pins. Then the papers arrive. A COVID pneumothorax study gets respect, but the host keeps tapping the same warning sign: ventilated elderly men were already very sick. Association is easy to spot here. Causation is the slippery bit. Steroids come off better. Hydrocortisone sounds interesting but thin because the trial stopped early, so dexamethasone is the practical pick for now. Wuhan corticosteroid data gets a hard squint, especially when set beside randomized evidence and a JAMA meta-analysis pointing to lower 28-day all-cause mortality. The take is plain enough: steroids are the COVID treatment here that actually belongs on the useful shelf. Remdesivir gets a colder pass. The WHO study makes it look weak, though the host leaves room for a timing problem. If an antiviral has to land within a day or two of symptoms, asymptomatic early infection makes the whole plan ugly. Then probiotics, somehow, get their moment. For trichomonas and BV, adding them to metronidazole raises cure rates enough that the host sounds almost annoyed to be impressed. The close returns to the usual ritual: papers, references, clinical sign-off, and a dry nod toward Jeff.

As heard by us

A sharp October literature review where steroid evidence, antiviral timing, and probiotics share space with complaints about wasteful medical swag.

The Puscast turns the first two weeks of October 2020 into a bracing infectious disease roundup, opening with irritation over an IDSA lapel pin and a New England Journal of Medicine mouse pad before moving into COVID treatment evidence.

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Why you'd press play

Press play when you want steroid evidence, remdesivir doubts, and a surprise case for probiotics with bite.

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