So yes, dexamethasone appears to save lives, but without more...

So yes, dexamethasone appears to save lives, but without more details, it is hard to measure its clinical impact. Remember remdesivir, the first drug shown to be effective in treating COVID-19 did not affect outcomes, it lowered hospital length of stay, which is of great value in not overwhelming the health systems carrying capacity, but is more like Tamiflu than a “cure.” What is most interesting in the press release is how they chose to describe dexamethasone’s benefit, a third – 33%, and a fifth – 20%. Pretty impressive numbers, but they illustrate the relative improvement. Those same results can be expressed in other ways. For example, those results, when described in absolute terms, show a 12% improvement for patients on ventilators and a 5% absolute improvement for those patients receiving supplemental oxygen. For patients on a ventilator, eight patients must be treated to save one life; for those receiving supplemental oxygen, you need to treat 25 patients. To be fair, the press release provided those numbers, but the media seems to be ignoring them. A moment of reflection will tell you that when it comes to COVID-19 and getting your attention, 33% sounds a lot bigger, than 12%. From a clinical perspective, the good news is that dexamethasone might be a useful tool in the therapeutic toolbox, mainly because it’s use is well understand it is widely available, and cheap. Cheap is good when the NNT is high. It will be life-saving for a precious few, and there is value in that, but it is just one step in a long therapeutic journey, not the great leap forward that the media headlines would have us believe.