Regain humane beyond clinical support: priorities in a time of pandemic

Abstract

© Author(s) (or their employer(s)) 2021. No commercial reuse. See rights and permissions. Published by BMJ. It is extraordinary to observe the efforts of the scientific community in seeking treatments against SARSCoV-2 over the past year. We have witnessed the development of trials to evaluate the efficacy of both older antimalarial drugs and brand novel monoclonal antibodies, often with conflicting results. We have observed remarkable attempts to identify optimal dosing of anticoagulant drugs to counteract the SARSCoV-2 thrombophilic trigger, still with unsatisfactory findings. We have noted several attempts to resolve doubts regarding the best technique and timing of noninvasive ventilation, yet unclear. We have read curious homemanagement protocols, rich in antibiotics and steroids, but without proofs of benefit. We have been spectators of neverending television debates on the efficacy and economic impact of lockdown and protective masks, with supporters on both sides often lacking scientific evidence. We have long heard arguments about the best type of nasopharyngeal swab, without ever pointing out the limitations of any diagnostic test, in terms of sensitivity and specificity. Only recently the first guideline of the European Respiratory Society has come to our rescue, collecting, with an enormous effort, the evidence known so far, humbly presenting itself as the ‘starting point’ to address a disease still largely unknown. Evidence that we all need, but that, during a so rapidly changing situation, risks being ‘out of date’ with each passing day. It is quite clear that a pandemic with a new disease raises the level of uncertainty well beyond tolerable limits.