Ask him why he downvoted me. I'm really curious what guideline he thinks I violated.
I certainly don't think your original post violated HN policy by any means, but that isn't the threshold for downvoting on HN as far as I understand.
I downvoted because the material in question isn't inline with how the majority of us are thinking about this disease. It creates a false controversy. To be fair, much of what he's describing is the pathophysiology of diffuse alveolar damage (the correlate of ARDS), but simultaneously he's saying it's not ARDS. Even in this video he seemingly felt compelled to walk back his high altitude pulmonary edema comments from a prior video.
I am not going to be replying further in this thread, but since things got off the rails a bit and my downvote was a part of that, I did want to try to explain my views of the content.
That may be true. But that is what makes this important. The current protocols aren't working. This guy is a doctor on the front lines. Gattinoni, whom he references, is an expert in ventilation. This is not a crackpot conspiracy like 5G towers and I'm sick of seeing it dismissed like it is.
I have watched all his videos and I have never seem him say it is HAPE. My recollection is he said it was similar to HAPE.
Gattanoni states:
However, the patients with Covid-19 pneumonia, fulfilling the Berlin criteria of ARDS, present an atypical form of the syndrome. Indeed, the primary characteristics we are observing (confirmed by colleagues in other hospitals), is the dissociation between their relatively well preserved lung mechanics and the severity of hypoxemia.
I am not referring to my own history. I often read downvoted comments and sometimes upvote them.
If people could indicate a reason for the downvote, it would probably help the whole situation.
The fact that this guy is a doctor... does not help your case. It makes it worse... if this were another lay person that downvoted cuz they thought it was off-topic, I would be ok with that.... But it sounds like this is another doctor, that disagrees with the doctor I linked to.
Sure that's controversial, but the controversy is perennial. People have been making exactly the same arguments about it for a dozen years now, and that's just on HN—the debate goes back well before that. Different takes are possible. HN has its take. It's stable, we're not going to change it, and in my opinion it works relatively well. Moreover, the problems with it are not the problems that the users who post complaints about it are complaining about.
When more is known about covid-19 I plan to come back to this thread and see who was right. If Dr Cameron Kyle-Sidell was wrong, totally off-base, on the wrong track... then maybe you're right... maybe this system does work "relatively well"
That said, some of the best comments are ones that carry an argument that most people would disagree with, but are worded persuasively and/or informatively enough that they attract upvotes. It's difficult to achieve but well worth aiming for.
Outside of encouraging that, I'm not sure what else dang is meant to do. Discussion platforms that try to enforce policies like requiring explanations for any downvotes don't seem to have substantially better quality discussions.