Aug 2, 2023Liked by Alasdair Munro

I remember being told by a wise paediatrician early in my training ‘it’s not the needle in the haystack, it’s the piece of hay that turns into the needle, we are looking for’. I love the concept of reducing the size of the mountain of hay to make it easier to fine the needle!

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Yes this is absolutely right!

This is nicely captured in what I consider a seminal text - "Sick kids look sick" (https://doi.org/10.1016/j.annemergmed.2014.11.012).

It was written in response to this study which found 1/5 kids aged 30d - 5y who were diagnosed with sepsis or meningitis had been diagnosed with a minor infectious ailment in the preceding 5 days (https://doi.org/10.1016/j.annemergmed.2014.10.022).

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Sep 28, 2022Liked by Alasdair Munro

Thanks Alastair. This is such a crucial point. In many ways the fundamental challenge of first world paediatric emergency care, and frequently discussed in a reductionist way that emphasises hindsight bias and ignores the trade off on the healthy population.

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Great post. There are actually a lot of parallels with suicide risk prediction in psychiatry (another low frequency but catastrophic event) - https://open.substack.com/pub/rationalpsychiatry/p/the-hard-problem-of-suicide-prediction

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Severe covid itself is a type of iatrogenically induced sepsis.

Immunological Mechanisms Explaining the Role of Vaccines, IgE, Mast Cells, Histamine, Elevating Ferritin, IL-6, D-dimer, VEGF Levels in COVID-19 and Dengue, Potential Treatments Such as Mast Cell Stabilizers, Antihistamines: Predictions and Confirmations


Sepsis is iatrogenic. Dirty vaccines contaminated with thousands of bacterial antigens cause IgE mediated sensitization to numerous bacterial antigens. So an infection can turn into an allergic reaction (sepsis). So as Dr. Paul Marik has shown, antihistamines (Vitamin C is the one he prefers) work in sepsis. So as always, identify and address the root cause for any good solution. Stop sickening kids using dirty vaccines. Sepsis problem solved.

Vaccines and Biologics injury table based on mechanistic evidence – Feb 2020 Covering over 125 conditions


Aeroallergen contamination of multi-dose and reconstituted vaccine vials cause the development of asthma, gastrointestinal diseases and proves vaccine makers and vaccine safety regulators are incompetent


Influenza vaccines and dengue-like disease


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