Why ventilators may not be working as well as doctors had hoped

But Dr. David Hill, a pulmonary and critical care physician who treats COVID-19 patients in Waterbury, Conn., says arguments against COVID-19 ventilation have been over-simplified. It may be less that ventilators aren’t the proper treatment for coronavirus, and more that they’re not a panacea for a pandemic that has pushed the health care system to its breaking point, Hill argues.

“You have really sick people, [while] the people who have the best training are in short supply and ventilator management is not simple,” Hill says. If a dedicated lung specialist were available for each patient, he believes, outcomes would probably be better. They could make the subtle adjustments required for effective long-term ventilation, or try less-invasive options and only move to intubation when absolutely necessary. But with many hospitals nearly at capacity, last resorts can become first resorts.

High ventilator mortality rates in New York City suggest “a health care system failing, and not a ventilator hurting people,” Hill says. (He says telehealth consultations with pulmonology experts could provide stop-gap support for emergency-room doctors.)

Few doctors are saying COVID-19 patients should never be ventilated, but there is a growing subset that thinks it’s happening too quickly.

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