New guidlelines are to NOT use ventilators if at all possible

[Scott Downey]

Simply they also can kill you if the virus does not and once on the ventilator, death rates jump high.
Dealing with the cytokine storm using immuno suppresive drugs, one of which is Actemra or Chloroquine, etc... is more important. Because if you can shut that down, likely you wont need the ventilator. And the ventilator can tear up your lungs.

Analysis urges less reliance on ventilators for coronavirus patients - STAT

He ran marathons and was fit. So why did Covid-19 almost kill him? - STAT

And I notice the governor's demanding so many ventilators now dont need them.
So they are learning how to not put people on ventilators, and that is a good thing. Oxygen to the nose or the inflated oxygen helmets are better choices, and stopping the cytokine storm.

 

[RighteousnessTemperance&]

This isn’t surprising, given the low success rate and the unknowns surrounding the virus. High-tech or more expensive isn’t always the best answer. Could this help significantly flatten the curve?

 

[Gold Dragon]

Simply they also can kill you if the virus does not and once on the ventilator, death rates jump high.
Dealing with the cytokine storm using immuno suppresive drugs, one of which is Actemra or Chloroquine, etc... is more important. Because if you can shut that down, likely you wont need the ventilator. And the ventilator can tear up your lungs.

Analysis urges less reliance on ventilators for coronavirus patients - STAT

He ran marathons and was fit. So why did Covid-19 almost kill him? - STAT

What medical qualifications do you have to give dangerous medical advice that is not stated in either of the articles you posted or in the research paper quoted by the first article. And there is nothing new about the idea of avoiding ventilator use if possible. Ventilators are always a last resort.

Maybe if you understood what you were reading, you would realize that the risk of barotrauma (pressure related trauma) from ventilators has been known for decades and settings have been optimized through decades of research and experience with ventilators to avoid this. The study referenced in the first article was a very useful resource on what are the optimal conditions and ventilator settings to minimize barotrauma based on the unique characteristics of covid19. It is definitely not telling people to avoid ventilators.

The second article is a case study of a single case where an experimental drug was used and fortunately he recovered, maybe due to the drug. The patient was young and fit and likely fit the profile of someone who normally would recover from covid19 without medications or ventilators.

 

[Gold Dragon]

This is in the conclusion of the study referenced in the first article.

http://www.ajtmh.org/docserver/full...est&checksum=8573FDA901E2EC8B448AF4AC64F2F640

Patients with fatigue and at risk for exhaustion because of respiratory distress do require invasive ventilation. In these patients, lung protective ventilation is essential, for which limiting the PEEP level on the ventilator may be important. This might reduce the currently very high case fatality rate of more than 50% in invasively ventilated COVID-19 patients

The 50% fatality rate is from how severe the disease is by the time you need ventilators. If you didn’t use ventilators the fatality rate would be close to 100% in this group. With ventilator settings more customized to covid19 patients we may be able to get that fatality rate down to something like 30-40%.

 

[Gold Dragon]

Scott Downey, please change the title and content of the OP because if it causes one person to avoid a ventilator when their doctor tells them they need it, that person will die when they had a 50% chance or better of living.

The referenced articles are fine to include and are useful. But your comments about ventilators are wrong and dangerously misleading.

 

[Scott Downey]

The study also revealed that the overwhelming majority of patients who were on ventilators eventually died, and those who did more often had diabetes. And many people have at least one of these diseases, high blood pressure, obesity, diabetes. IMO, any study results where they pump you full of chloroquine when your already almost dead are bogus, which are the emergency quidelines the FDA has authorized for it's use. Common sense make way for medical politics. Many people have an extreme interest in seeing treatments fail for this virus, for politics, and for vaccines which they can make a lot of money on. It is why you hear the lock downs must continue or get more extreme until a vaccine is approved ( Bill Gates). Every possible death is now a corona virus death, the 5yr old girl died of meningitis but she also had a covid infection, but you dont hear that, what you hear is death was caused by covid virus.

Nearly all NY coronavirus patients suffered underlying health issue, study finds

A new study by a medical journal revealed that most of the people in New York City who were hospitalized due to coronavirus had one or more underlying health issues.

Health records from 5,700 patients hospitalized within the Northwell Health system -- which housed the most patients in the country throughout the pandemic -- showed that 94 percent of patients had more than one disease other than COVID-19, according to the Journal of the American Medical Association (JAMA).

NYC TO HOST MACY'S ANNUAL FOURTH OF JULY FIREWORKS DESPITE CORONAVIRUS

Data taken from March to early April showed that the median age of patients was 63 years old and 53 percent of all coronavirus patients suffered from hypertension, the most prevalent of the ailments among patients.

In addition, 42 percent of coronavirus patients who had body mass index (BMI) data on file suffered from obesity while 32 percent of all patients suffered from diabetes.

The study also revealed that the overwhelming majority of patients who were on ventilators eventually died, and those who did more often had diabetes.

 

[Gold Dragon]

The study also revealed that the overwhelming majority of patients who were on ventilators eventually died, and those who did more often had diabetes. And many people have at least one of these diseases, high blood pressure, obesity, diabetes. IMO, any study results where they pump you full of chloroquine when your already almost dead are bogus, which are the emergency quidelines the FDA has authorized for it's use. Common sense make way for medical politics. Many people have an extreme interest in seeing treatments fail for this virus, for politics, and for vaccines which they can make a lot of money on. It is why you hear the lock downs must continue or get more extreme until a vaccine is approved ( Bill Gates). Every possible death is now a corona virus death, the 5yr old girl died of meningitis but she also had a covid infection, but you dont hear that, what you hear is death was caused by covid virus.

Nearly all NY coronavirus patients suffered underlying health issue, study finds

A new study by a medical journal revealed that most of the people in New York City who were hospitalized due to coronavirus had one or more underlying health issues.

Health records from 5,700 patients hospitalized within the Northwell Health system -- which housed the most patients in the country throughout the pandemic -- showed that 94 percent of patients had more than one disease other than COVID-19, according to the Journal of the American Medical Association (JAMA).

NYC TO HOST MACY'S ANNUAL FOURTH OF JULY FIREWORKS DESPITE CORONAVIRUS

Data taken from March to early April showed that the median age of patients was 63 years old and 53 percent of all coronavirus patients suffered from hypertension, the most prevalent of the ailments among patients.

In addition, 42 percent of coronavirus patients who had body mass index (BMI) data on file suffered from obesity while 32 percent of all patients suffered from diabetes.

The study also revealed that the overwhelming majority of patients who were on ventilators eventually died, and those who did more often had diabetes.

Yes it has been known for about 3 months now that hypertension, diabetes and obesity are risk factors for death when you have covid19. We have treatments that manage hypertension and diabetes and if managed well, those people live very long lives. Covid19 shortened their lives. Obesity doesn’t kill people but the diabetes and heart disease you develop from obesity does. Covid19 shortened their lives.

Yes many people with covid19 on ventilators die. Because they are in the critical stages of disease. Without the ventilator almost all will die. With the ventilator some live.

Please change your irresponsible, dangerous and completely false statements about ventilators in your opening post and thread title.

 

[Scott Downey]

Again!! Some people think I make up stuff. Everything is published and freely available to read for yourself.
Researchers To Doctors: Stop Putting COVID-19 Patients On Invasive Ventilators


A paper recently published by The American Society of Tropical Medicine and Hygiene adds further support to recent CDC guidelines for minimizing the use of invasive ventilators. As physicians had been voicing concern that doctors were being too eager to put patients on invasive ventilation and may be doing more harm than good, the investigators looked into outcomes of intubated patients vs. non-intubated patients experiencing hypoxia. Unlike with other forms of pneumonia, they found that COVID-19 patients were unusually damaged by invasive ventilation but also able to tolerate higher levels of anoxia -- to the point that one doctor recalls having to tell patients to get off their cellphones so that they could be intubated. The recommendation is that guidelines be adjusted to discourage invasive ventilation unless a patient is physically struggling to breathe, rather than relying strictly on oxygen levels; otherwise, the use of non-invasive ventilation, such as CPAP and BiPAP, should be encouraged. When invasive ventilation is used, oxygen levels should be minimized in order to reduce the risk of damaging healthy tissue.
Researchers To Doctors: Stop Putting COVID-19 Patients On Invasive Ventilators - Slashdot

 

[Scott Downey]

People who try to intimidate other posters should be warned then banned, IMO.

 

[Scott Downey]

Nearly all Covid-19 patients put on ventilators in New York's largest health system died, study finds
https://www.cnn.com/2020/04/22/health/coronavirus-ventilator-patients-die/index.html
Nearly all coronavirus patients who needed ventilators in New York's largest health system to help them breathe died, a study found.

Overall, about 20% of Covid-19 patients treated at Northwell Health died, and 88% of those placed on ventilators died, according to the study. A ventilator is a device that forces air into the lungs of patients who cannot breathe on their own because of severe pneumonia or acute respiratory distress syndrome.
Other, smaller reports have indicated that patients who need ventilation are unlikely to survive.


Hospitals consider changes to do-not-resuscitate situations amid coronavirus pandemic
Just 12% of the patients in the study needed ventilators, Dr. Safiya Richardson at the Feinstein Institutes for Medical Research, Northwell Health, and colleagues found.

The facts put to silence the wise critics, but the foolish ones prattle on.

 

[Gold Dragon]

Again!! Some people think I make up stuff. Everything is published and freely available to read for yourself

The articles you are posting are correct. But you are misinterpreting what they are saying and have taken their reports too far.

Yes the paper says that some patients are being put on the ventilator too early.

Yes it also says that ventilators can damage the lungs if the wrong settings are used.

But you did not read the actual paper to see that the second point is not the reason for the first point. That connection was made by you.

The reason the paper recommends some patients should not be put on the ventilator so early is because ventilators are in short supply and should be saved for when the patients really need then, when they are physically tiring instead of simply when hypoxia shows which is something covid19 patients seem to tolerate well but in other diseases we start thinking about ventilating pretty early. Yes intubation too early can be causing more harm than good because intubation is an overall dangerous process with many risks but also because ventilators are a rare resource and should be reserved for those who really need it. But this information is actually not that new and was already reported anecdotally in critical care circles quite a long time ago. So while some places may have been intubating earlier than they needed to, most had the right criteria that was not primarily hypoxia based. This paper just formalized that finding.

The second point about damage to the lungs is about when you already have to intubate, what are the best settings to minimize lung damage. This is a subtle thing and requires balance because too much pressure does damage the lungs but too little and you are not delivering enough oxygen support. The paper is making recommendations about pressure settings to try and improve the 50% death rate (because of how severe covid19 is for these patients) once you get put on ventilators by optimizing them better. It is not saying that ventilators are killing people.

You have incorrectly connected the two points and implied that ventilation overall is damaging to the lungs and is the cause of death. That is incorrect and not stated in any of the articles you quoted.


I recommend you read the actual paper if you can understand any of it.

Respiratory Support in Novel Coronavirus Disease (COVID-19) Patients, with a Focus on Resource-Limited Settings | The American Journal of Tropical Medicine and Hygiene

 

[Gold Dragon]

People who try to intimidate other posters should be warned then banned, IMO.

You are intimidated by the word please?

When you are dangerously misrepresenting the truth (unintentionally through ignorance) in a way that will directly cause people to die, should I just stay silent?

 

[Scott Downey]

CNN changed their text, here is Bloomburg reiterating 9 in 10 died on ventilators. I should have known, CNN would not be trustworthy. I am posting this so in the future people can see that.

New Study Shows Nearly 9 in 10 Covid-19 Patients on Ventilators Don’t Make It
A giant study that examined outcomes for more than 2,600 patients found an extraordinarily high 88% death rate among Covid-19 patients in the New York City area who had to be placed on mechanical devices to help them breathe.



The study, published in the Journal of the American Medical Association, is one of the largest reviews published to date of Covid-19 patients hospitalized in the U.S. The researchers examined outcomes for coronavirus patients who were admitted between March 1 and April 4 to 12 hospitals in New York City and Long Island that are part of the Northwell Health system.



Overall, the researchers reported that 553 patients died, or 21%. But among the 12% of very sick patients that needed ventilators to breathe, the death rate rose to 88%. The rate was particularly awful for patients over 65 who were placed on a machine, with just 3% of those patients surviving, according to the results. Men had a higher mortality rate than women.

 

[InTheLight]

CNN changed their text, here is Bloomburg reiterating 9 in 10 died on ventilators. I should have known, CNN would not be trustworthy. I am posting this so in the future people can see that.

New Study Shows Nearly 9 in 10 Covid-19 Patients on Ventilators Don’t Make It
A giant study that examined outcomes for more than 2,600 patients found an extraordinarily high 88% death rate among Covid-19 patients in the New York City area who had to be placed on mechanical devices to help them breathe.



The study, published in the Journal of the American Medical Association, is one of the largest reviews published to date of Covid-19 patients hospitalized in the U.S. The researchers examined outcomes for coronavirus patients who were admitted between March 1 and April 4 to 12 hospitals in New York City and Long Island that are part of the Northwell Health system.



Overall, the researchers reported that 553 patients died, or 21%. But among the 12% of very sick patients that needed ventilators to breathe, the death rate rose to 88%. The rate was particularly awful for patients over 65 who were placed on a machine, with just 3% of those patients surviving, according to the results. Men had a higher mortality rate than women.

I'm not sure I'm understanding the point you are making here. Are you saying the ventilators are killing people?

So what are you suggesting the doctors should do?

Not put patients on ventilators because they are going to die anyway?

Or what?

 

[Scott Downey]

I'm not sure I'm understanding the point you are making here. Are you saying the ventilators are killing people?

So what are you suggesting the doctors should do?

Not put patients on ventilators because they are going to die anyway?

Or what?

The info is laid out in these links.
Ventilators are overused for Covid-19 patients, doctors say - STAT
Analysis urges less reliance on ventilators for coronavirus patients - STAT
He ran marathons and was fit. So why did Covid-19 almost kill him? - STAT
Nearly all NY coronavirus patients suffered underlying health issue, study finds
Researchers To Doctors: Stop Putting COVID-19 Patients On Invasive Ventilators - Slashdot

Quote:
Unlike with other forms of pneumonia, they found that COVID-19 patients were unusually damaged by invasive ventilation but also able to tolerate higher levels of anoxia -- to the point that one doctor recalls having to tell patients to get off their cellphones so that they could be intubated.

The doctors doing that as patients are on their phones is damning evidence they were being overused, especially seeing 9 in 10 ended up dying after going on the ventilator, the cure worse than the sickness. Everyone can make their own conclusions about this.

 

[RighteousnessTemperance&]

Scott Downey, please change the title and content of the OP because if it causes one person to avoid a ventilator when their doctor tells them they need it, that person will die when they had a 50% chance or better of living.

The referenced articles are fine to include and are useful. But your comments about ventilators are wrong and dangerously misleading.

NYC is coming morbidly close to your 100% death rate. Care to explain why NYC would have 1.76X the ventilator death rate of your 50%?

 

[Gold Dragon]

NYC is coming morbidly close to your 100% death rate. Care to explain why NYC would have 1.76X the ventilator death rate of your 50%?

I suggest reading the articles posted by Scott Downey and not his conclusions about those articles which are false.

Ventilators are overused for Covid-19 patients, doctors say - STAT
Analysis urges less reliance on ventilators for coronavirus patients - STAT
Researchers To Doctors: Stop Putting COVID-19 Patients On Invasive Ventilators - Slashdo

The bottom 2 articles reference this article in the AJTMH about too early ventilator use which also is where the 50% recovery stat is from.

Respiratory Support in Novel Coronavirus Disease (COVID-19) Patients, with a Focus on Resource-Limited Settings | The American Journal of Tropical Medicine and Hygiene

The presence of only hypoxemia should in general not trigger intubation because hypoxemia is often remarkably well tolerated. Patients with fatigue and at risk for exhaustion, because of respiratory distress, will require invasive ventilation. In these patients, lung protective ventilation is essential.

If you read the article, the reason they advise avoiding ventilators in just hypoxia is so that it can be saved for those who really need it. The hypoxia criteria is commonly used in other conditions needing ventilators but a unique characteristic of covid19 means it can be relaxed. This characteristic was already widely known for a while so while some places may have been ventilating with hypoxia only criteria, this was not the default everywhere.

And they also propose a ventilator strategy that will help reduce that 50% mortality.

This ventilation strategy might reduce the currently very high case fatality rate of more than 50% in invasively ventilated COVID-19 patients.

That 50% is a commonly cited figure in places where icu’s and hospitals are not overrun (I think the paper specifically cites a JAMA article about Seattle patients). But if you can imagine, if your health system is strained and ventilators need to be rationed for only the worst cases or people are getting ventilators too late, your death rate on ventilator goes up. So NY, Wuhan, Italy all have very high death rates on ventilators.

None of these articles are saying that ventilators are killing people. They are saying that ventilators need to be used more efficiently in terms of when we start them and what settings we use once we start them because of unique characteristics of covid19.

Yes the process of intubation and ventilation can cause harm that is why it is used as a last resort. Intubation is a high risk procedure Ventilators when used at the wrong settings can worsen the situation. But it is covid19 that is killing the patient and would do so faster for the patients legitimately needing ventilation if they didn’t get it. The ventilator gives the patient a chance to recover. It doesn’t cure you but buys you time that you wouldn’t have without it.

 

[Calminian]

Scott Downey, please change the title and content of the OP because if it causes one person to avoid a ventilator when their doctor tells them they need it, that person will die when they had a 50% chance or better of living.

The referenced articles are fine to include and are useful. But your comments about ventilators are wrong and dangerously misleading.

Oh palease. This is so silly the way you guys react to posts. Just like the MSM thinking Trump liking HQC means people will try to take it without a prescription. Get off the high horse.

Some doctors much more qualified than you today just revealed that you have about a 20% chance of surviving a ventilator. Meanwhile, a Nevada Governor with Trump Derangement Syndrome, has prevented doctors from prescribing HQC out of a hospital setting early on in the disease progression when it's crucial. The doctors are suing him.

Mentioning that ventilators are not as effective as we once thought is true. TDS, on the other hand, is deadly.

 

[Gold Dragon]

Some doctors much more qualified than you today just revealed that you have about a 20% chance of surviving a ventilator.

If you mean surviving covid19 on a ventilator, yes that is true in some areas because of how severe the disease is by the time you need a ventilator.

Read the articles Scott Downey referenced. Here are some relevant quotes if you are too lazy to. They do not say what he is saying about ventilators.

Ventilators are overused for Covid-19 patients, doctors say - STAT

None of this means that ventilators are not necessary in the Covid-19 crisis, or that hospitals are wrong to fear running out.

Analysis urges less reliance on ventilators for coronavirus patients - STAT

If a Covid-19 patient is clearly struggling to breathe, then invasive ventilation makes sense, wrote Marcus Schultz of Amsterdam University Medical Centers and his colleagues.

Slashdot

The recommendation is that guidelines be adjusted to discourage invasive ventilation unless a patient is physically struggling to breathe, rather than relying strictly on oxygen levels;

Respiratory Support in Novel Coronavirus Disease (COVID-19) Patients, with a Focus on Resource-Limited Settings | The American Journal of Tropical Medicine and Hygiene

Patients with fatigue and at risk for exhaustion, because of respiratory distress, will require invasive ventilation. In these patients, lung protective ventilation is essential.