Previous: Wellness Programs Don't Seem to Work as Advertised
Next: Obamacare First Anniversary Update



View count:22,694
Last sync:2024-05-12 23:30
A few more patients are cured of Ebola in the US, and placebos can help kids with the cold. This is Healthcare Triage News.

For those of you who want to read more, go here:

John Green -- Executive Producer
Stan Muller -- Director, Producer
Aaron Carroll -- Writer
Mark Olsen -- Graphics
A few more patients are free of Ebola in the US, and placebos can help kids with the cold. This is Healthcare Triage News.

We can't seem to get away from Ebola in the news, and we'd be remiss if we didn't tell you what's going on. Another few patients have been declared Ebola-free in the United States, and have been released from the hospital. In fact, as of taping, only one person in the United States, a doctor in New York, is infected with Ebola.

What's remarkable is that eight of the nine people who have been treated in the United States have survived. And everyone who was picked up quickly, once they had symptoms, has survived. So why is the mortality rate so much lower here than in Africa, where mortality has hovered around 70% for this outbreak?

One reason is that we have access not to Ebola-specific drugs, but to regular old drugs that we sometimes take for granted. Patients with Ebola can get terrible secondary infections. Sometimes they need antibiotics, and we've got them in spades. Sometimes patients suffer from organ failure, their blood pressure plummets. When that happens, we have drugs and fluids and devices that can keep people alive. That matters.

Further, when things go wrong, We have scanners and tests that diagnose the issue. Other countries don't. And let's not ignore the personnel differences. We complain about the doctor shortage here in the United States, but we have about 245 doctors per 100,000 people. Liberia has 1.4. We have a whole series on international health care systems here at Healthcare Triage.

But it's important to recognize that when we talk about one versus the other, I'm mostly complaining about first world problems. Literally. Poverty, real poverty, makes a huge difference in so many ways. Ebola included.

Our second story is about treating kids with colds. Colds are awful, especially when a small child has one. They're not very very good at sucking it up, and there's so little you can do for them. Most of the over-the-counter medicines have been pulled from the shelves because they don't work, and they had lots of side effects.

People are always trying to look for help, even from complementary medicine. A study published this week in JAMA Pediatrics tried to look at just that. To the research!

It was a randomized controlled trial of an agave nectar formulation. One third of the kids got that, one third of the kids got a placebo, and one third got nothing at all. Everyone got a baseline measurement the night before they got their randomized "therapy." On the next night, kids in the trial got a single dose of their "therapy" before bedtime.

The main outcomes were cough, congestion, runny nose, and sleep. Both for the child, and for the parents. The first thing to notice that in all groups, even in the "no therapy" group, there were improvements from baseline. Even "being studied" seemed to have an effect. The second thing to notice the kids were significantly better on the agave nectar than in the "no therapy" group. But there was no difference between kids in the agave nectar group and the placebo group. The placebo group also did significantly better than the "no therapy" group.

This is why I tell parents who have kids with colds to try anything that I don't think has a harm. I include cost in the harm category. If you want to tell your child you're giving them a "special drink of warm tea," that's awesome. If you have a special moisturizer that "soothes their chest," that's great. If you want to put a little agave nectar in water and tell them it's medicine, I'm okay with that too.

Of course, in the study, the placebo effect was likely working on the parents as well as the kids. Which of them received the bigger benefit isn't clear. But the effect is there. In fact, I think the placebo effect is so important, we're gonna cover it in detail in future Healthcare Triage episodes.

But when we tell you that no medicines work for colds, we're not telling you to do nothing, we're telling you that nothing works better than placebos, you absolutely should use placebos. They work!