Tag Archives: disseminated intravascular coagulation

Coronavirus: new treatments, trials and NHS best practice in Scotland

I have written an open letter to the Scottish Government, which I have quoted below, edited for clarity and additional reference links.

Hi,
Which of you are aware and which of you are unaware of the following coronavirus pandemic reports?

In the medical news,
COVID-19: Could a clot-busting drug help save the lives of patients on ventilators?

in medical science journals,
Is There a Role for Tissue Plasminogen Activator (tPA) as a Novel Treatment for Refractory COVID-19 Associated Acute Respiratory Distress Syndrome (ARDS)?: Journal of Trauma and Acute Care Surgery  – See also attached PDF

Tissue Plasminogen Activator (tPA) Treatment for COVID-19 Associated Acute Respiratory Distress Syndrome (ARDS): A Case Series: Journal of Thrombosis and Haemostasis  – See also attached PDF

and on American TV News?

Deathly Ill Coronavirus Patients Could Be Saved By Heart Attack And Stroke Drug

I seek information about whether these recent reports have been acted upon in a timely way by yourselves in the Scottish Government and by NHS Scotland?

I wish to know if the NHS has instituted blood-clotting (coagulation) tests for coronavirus patients admitted to NHS hospitals, to monitor intensively whether patients’ blood clotting response has been seriously harmed by the coronavirus disease and by how much and whether this requires specific targeted treatment to normalise the patient’s blood clotting response?

Secondly, I wish to know for those patients whose blood clotting response is found to be abnormal, either generally or in specific organs, such as lungs, kidneys and heart, affecting organ function, whether appropriate blood-clot busting drugs, such as Tissue Plasminogen Activator (tPA) are being administered, on a trial basis or generally, to treat blood-clotting problems whether in the manner suggested in the Journal of Trauma and Acute Care Surgery paper linked to and appended namely,

“we believe an initial approach might be to administer 25mg of tPA over 2 hours followed by a 25mg tPA infusion administered over the subsequent 22 hours, with a dose not to exceed 0.9 mg/kg. The same exclusion criteria currently in place for stroke and MI treatment could be used, with responders maintained for some period of time on a heparin infusion after completion of the tPA treatment.”

or otherwise?

Can Members of Parliaments (MSPs & MPs), the Press and the People assume that your lack of a speedy reply to me and your lack of full disclosure and informative answers to my questions by publishing the answers to them reflects badly on your performance as ministers and officials and is illustrative of your failure of leadership?

Can we therefore assume that your ability starts and finishes at mismanaging the NHS Scotland as a devolved identical copy of NHS UK so that, to be sure, if and when the UK NHS run from Westminster and Whitehall, London, England approves trials and approves a new treatment for coronavirus disease only then will you finally direct the NHS in Scotland to follow UK NHS practice, parrot fashion, but that meantime under your devolved misgovernment, no Scottish government ordered clinical trials of new treatments for coronavirus will be entertained in Scotland, because that would be to show real initiative, uncharacteristic of plodding puppets of the UK who have no initiative and leadership ability to speak of?

Finally, Jason Leitch seems to be performing in the role of Scottish government public health education spokesman so then who is doing the job he is allegedly paid for – “National Clinical Director” or “Clinical Director, Healthcare Quality and Strategy”?

Who is directing the NHS in Scotland to adopt best practice in the clinical treatment of hospitalised patients suffering coronavirus disease? Who is directing clinical trials of new treatments in Scotland?

If Jason is busy parading himself around the media studios to speak to the common people, telling us, for example, how, where and when to exercise then why is his job title not accurately descriptive of the role he is actually doing and clearly prefers to do?

If one is truly a “National Clinical Director” then surely one’s job is to direct the nation’s clinics in a medically scientific fashion, so as to defeat this coronavirus pandemic?

But Jason seems to be far too busy with media appearances coaching the people in our behaviour to find any time to direct the nation’s clinics other than in a hand-waving way, leaving the clinics to their own devices or to detailed direction from the UK government in London.

If one speaks to the public about health matters on behalf of the government then one’s job description is accurately described as a “Scottish Government Public Health Spokesperson”, is it not?

Is the Scottish government actually employing anyone who is directing the NHS hospital clinics in Scotland, directing the quality and strategy of health care so as to fight this pandemic successfully, saving most lives and if so, who is employed in that role? What is their name and what directions is he or she issuing to the Scottish NHS clinics as regards the best international medical practice and clinical trials?

Where should we look, when I or any member of the public, want to look through the list of directions issued to the clinics of the NHS in Scotland, to see if blood-clotting issues are being treated appropriately or whether that’s a neglected issue in Scotland because the orders from London say nothing about “blood-clotting” so far so that’s not yet on the Scottish government’s radar, being more of a poodle of the UK than an actual “government”?

Yours sincerely,

LATEST NEWS

16th April 2020, Stat: Blood clots in severe Covid-19 patients leave clinicians with clues about the illness — but no proven treatments

21st April 2020, NBC I-Team: Blood Clots Closely Associated with COVID-19 Deaths, Research Says

22nd April 2020, Washington Post:  A mysterious blood-clotting complication is killing coronavirus patients

CNN: Doctors try to untangle why they’re seeing ‘unprecedented’ blood clotting among Covid-19 patients

23rd April 2020, Daily Mail: Coronavirus is causing blood clots and sudden strokes in otherwise healthy patients in their 30s and 40s, doctors report

2nd May 2020, The Guardian: ‘Happy hypoxia’: unusual coronavirus effect baffles doctors

16th May 2020, Telegraph: Blood-thinning drugs can help save Covid-19 patients’ lives

5th June 2020, ITV News: ‘Lifesaving’ device trialled for potential coronavirus patients without key symptoms

16th June 2020, BBC: Coronavirus: Dexamethasone proves first life-saving drug

3rd July 2020, POZ: “No one needs to die from Covid any more.”

MATH+ Hospital Treatment Protocol for Covid-19 – V5 (2020-7-14)

MATH+ Protocol – Downloads & Translations

Frontline COVID-19 Critical Care Alliance www.covid19criticalcare.com

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