Does it help putting people who have coronavirus on ventilators versus letting them struggle on? Strictly speaking, claims Matt Strauss, no one knows whether those who survive their time on a ventilator may have survived anyway.
Conversely, Dr. Strauss, a critical care physician, notes that also unknown is whether some would-be survivor died because he was on a ventilator.
Matt Strauss, the former medical director of the critical care unit at Guelph General Hospital in Canada, is now an assistant professor of medicine at Queen’s University. Dr. Strauss continues:
Ventilators, Toilet Paper Hysteria
I fear the current clamor reminds me of nothing so much as the panic buyers of toilet paper stampeding over each other in early March. When the history of the COVID-19 pandemic in the Western world is written, I do not believe ‘massive ramp-up of ventilator manufacturing,’ will be credited with our deliverance.
Ventilators do not cure any disease. They can fill your lungs with air when you find yourself unable to do so yourself. They are associated with lung diseases in the public’s consciousness, but this is not in fact (ventilators’) most common or most appropriate application.
With COVID-19, the preliminary outcome data is rather dismal, notes Dr. Strauss. Last week the New England Journal of Medicine published a case series of very ill COVID-19 patients in Seattle with data up to March 23:
Of the 20 patients who went on a ventilator, only four had so far escaped the hospital alive. Nine had died. Three remained in suspended animation, going on three or four weeks of ventilation. Four escaped the ventilator but remained in hospital.
No Randomized Control Trial
There has never been a placebo randomized control trial of putting people on ventilators versus letting them struggle on.
At least two-thirds of attempts to stave off death by using ventilators will fail in the short term, writes Dr. Strauss in Spetctator.us
Of the remaining third, we do not know how many will be successful in the medium or long term. This doesn’t quite seem like a convincing rationale to shut down the economy, redirect previous manufacturing output towards ventilators and suspend civil liberties to give us more time for the attempt.
And those bemoaning the government’s failure to demand more and more ventilators should pause for a moment and ask themselves whether that is really the right solution.