A flashback to April 2020: we knew then that ventilators were not the answer.

https://time.com/5820556/ventilators-covid-19/

I wonder how many people did not see this article. I did not see it until about a week ago. We knew a few weeks into the pandemic that ventilators were not the answer. Gee, that does not match up to what we were told or what we did inside the ICU setting.

“ New York City emergency-medicine physician Dr. Cameron Kyle-Sidell sparked controversy when, two weeks ago, he posted a YouTube videoclaiming that ventilators may be harming COVID-19 patients more than they’re helping.” Kyle-Sidell went on to report and warn that “We are operating under a medical paradigm that is untrue,” I believe we are treating the wrong disease, and I fear that this misguided treatment will lead to a tremendous amount of harm to a great number of people in a very short time.” “Weeks later, claims from Kyle-Sidell and like-minded doctors continue to spark impassioned debate within the medical community, with some doctors moving away from the use of ventilators and others defending the current standard of care. What’s clear, though, is COVID-19 patients on ventilators aren’t doing as well as doctors would hope—and health care experts are scrambling to fix it.”.

Scrambling to fix it? I am not sure that is very true. While some brave physicians did buck the system and do it “their way” with great success, the majority of healthcare providers continued down the path of intubation and Remdesivir with zero deviation from doing the “protocol” they were told to do. Untold numbers of people died from this action. I do not know of a single ICU attending physician in my area who deviated from the Fauci/CDC protocol. They all used the ventilator remdesivir combo. It was deadly. Yet they kept pushing forward with it.

“Doctors like Kyle-Sidell (who TIME could not reach for comment) argue these numbers are so high because physicians are ventilating patients as though they have a condition called acute respiratory distress syndrome (ARDS), when they in fact have a different type of lung damage that may not respond well to mechanical ventilation. A group of European physicians submitted a letter to the American Journal of Respiratory and Critical Care Medicine, published March 30, detailing COVID-19’s discrepancies from typical ARDS and calling on doctors to avoid jumping to unnecessary mechanical ventilation. Other physicians say mechanical ventilation can help some patients, but doctors are jumping to it too quickly, potentially subjecting patients to unnecessary traumatic treatment when they could use less-invasive respiratory supports like breathing masks and nasal tubes.”

And then you have the ever dutiful “do as we are told” physicians like this dude, who replied to Dr. Kyle-Sidell’s approach in this manner: ““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.). So Dr. Hill is suggesting here that the use of ventilators is merely a lack of well trained physicians? It is due to a health care system that is failing and MOST DEFINITELY NOT the ventilator itself? Hogwash.

Then there is this blurb: “He says some doctors are intubating early because they fear that less-intensive forms of ventilation, like high-flow nasal oxygen, can aerosolize a virus, putting health care workers at risk of getting sick. “This is more theoretical fear than a real fear,” Hill says, since there’s not strong evidence that COVID-19 spreads this way.” I do believe that this was a big reason for intubation and is much more realistic than Dr. Hill wants to credit. I would bet there was some CDC/NIADH/Fauci guidance somewhere along the way that suggested this as a protective mechanism for staff.

Bottom line: the ventilator remdesivir protocol cost hundreds of thousands of people their life. It killed a colleague of mine. We failed badly.