In a jaw-dropping article published by The Wall Street Journal – ‘Hospitals Retreat From Early Covid Treatment and Return to Basics’ – physicians admit to ventilating patients who did not need it as a step in their protocol – get this – not as a treatment that was likely to benefit the patient, but rather as a fruitless and callous way of attempting to stop the spread of covid-19.
Last spring, with less known about the disease, doctors often pre-emptively put patients on ventilators or gave powerful sedatives largely abandoned in recent years. The aim was to save the seriously ill and protect hospital staff from Covid-19.
Now hospital treatment for the most critically ill looks more like it did before the pandemic. Doctors hold off longer before placing patients on ventilators. Patients get less powerful sedatives, with doctors checking more frequently to see if they can halt the drugs entirely and dialling back how much air ventilators push into patients’ lungs with each breath.
“We were intubating sick patients very early. Not for the patient’s benefit, but to control the epidemic and to save other patients,” Dr. Iwashyna said “That felt awful.”
Yes, euthanising humans is illegal. Especially for the benefit of other patients. It should feel awful.
Last spring, doctors put patients on ventilators partly to limit contagion at a time when it was less clear how the virus spread when protective masks and gowns were in short supply. Doctors could have employed other kinds of breathing support devices that don’t require risky sedation, but early reports suggested patients using them could spray dangerous amounts of virus into the air, said Theodore Iwashyna, a critical-care physician at University of Michigan and Department of Veterans Affairs hospitals in Ann Arbor, Mich.
Subsequent research found the alternative devices to ventilators, such as delivering oxygen through nasal tubes, weren’t as risky to caretakers as believed. Doctors also gained experience with covid-19 patients, learning to spot signs of who might suddenly turn seriously ill, some said.
The WSJ article describes a study conducted that now allows doctors to predict who needs a ventilator and who does not:
It found more doctors now follow the pre-pandemic protocols, which have reduced the number of deaths and shortened the time patients spend on ventilators, HCA’s chief medical officer said.
Before the pandemic, between about 30% to more than 40% of ventilator patients died, according to research. Numbers were sharply higher in the pandemic’s early hot spot in Wuhan, China. As the pandemic grew, hospitals in the US reported death rates in some cases of about 50% for ventilated covid-19 patients.