re: Would more people have lived if hospitals weren't so quick to put them on ventilators?

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Would more people have lived if hospitals weren't so quick to put them on ventilators?

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Yes.

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Surely some were put on ventilators, but six months in the guidance was very clear that ventilators should not be used except in extreme cases.

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Yep, after a year, Intubated Covid pts were very few... Amazing what we learned over that year. Most covid pts were put on high flow nasal cannulas. The higher percentage pts who died had increased comorbidities as well... A lot were obese with hypertension and diabetes..

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Trump sucked sweaty Fauci balls on Covid response. That this is even a debatable point is weird AF.

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What else could he have done at the time, not trust the “experts”? Hindsight is 20/20.

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What else could he have done at the time, not trust the “experts”? Hindsight is 20/20.

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Like every other chief executive in the world, the expert you choose to trust is what makes/breaks you in the long run. Trump let the wrong guys make decisions for his administration.

That Covid was not the virus it was hyped to be is not hindsight.

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I thought they figured this out during the pandemic and stopped doing it so much, so early.

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I did not read the study but I remember in the early stages of the pandemic, hospitals were using long established protocols and did what they had been doing for years. Everyone that works in critical care knows that once a person hits the wall with acute respiratory failure, it's either intubate and ventilate or they die. Something with this disease I believe that changed the make up of the lung tissue and made it more susceptible to iatrogenic barotrauma (treatment induced damage due to pressure). It took some time to figure that out and they switched to less invasive less pressure intensive treatment such as BiPAP and CPAP. That's from memory from 4 years ago.

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Per my friend (of 40 years) "shite tons" of antibiotics were given to every covid patient in their IV drip.

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thats called - meets sepsis criteria load up the zosyn and vanc, baby!!

You missed that intubated vaxxed patients had slightly worse outcomes to the unvaxxed for Omicron.

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I get that some get to that point. The question in my OP is did we just accept a vent as the standard too early on and kill a lot of people needlessly

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For an extremely short period of time, yes. They period was a matter of weeks, and not more than between 2 and 6 when local people got to make decisions based off their own experience.


My wife and I are both physicians. We had no children and were pretty recently out of training in the beginning of the pandemic. We would come home and read for hours, listen to daily press conferences from the feds, and then found several groups of ICU docs around the country who blogged (written and video mostly) about their experience. The recommendation to intubate early (in the course of illness) came at a time where the spread wasn’t well understood, and the fear was that you would infect the whole floor with NIPPV methods (before every hospital room was rigged with a window fan blowing air out into the parking lot and sufficient PPE was acquired).
About a week in, before I had seen my first patient with it, I talked to my wife about this. I thought it was odd that we should forget roughly everything we currently knew about a pathogen and start from scratch. About a week later (still before I found this), there was a movement coming out of New Orleans ICUs to ignore the virus and treat it like any other case of ARDS, and deliver ICU care like we have over the last 20 years based on some pretty decent evidence (that VERY much changed what the previous 20 years of medicine looked like). I still actually patiently await the day for someone to parse through all the EHR data and find the guys brave enough to not prescribe antibiotics and see their outcomes vs everyone else (controversial because Zithromax is associated with better outcomes when looking at all ICU patients with pneumonias, and secondary bacterial infection isn’t unique to ventilator use, so most argue that if they’re sick enough to be in the unit, you don’t take chances and just put them on antibiotics, but I still think it will be an interesting paper in another 5-10 years when someone publishes it).

In my hospital, I did not take care of anyone intubated “early” during the course of their intubation. We, in effort to reduce our risk and our patients’ risk, adjusted our hospital care in such a way that we took turns going to the hospital so we wouldn’t walk from a COVID room to a 90 year old in the office and bring something with us (lasted a total of 5 weeks before we realized how fairly difficult it was to transmit and adjusted). My group did take care of 3 patients that I recall had been intubated “early,” and I took care of them after extubation. One of them never recovered. They were on bipap and doing poorly. I talked with the family. We withdrew care. They came to the hospital and were with them when they died. They had been ill and on borrowed time for at least 5 years already. I’m not certain that HFNC/BiPAP without intubation change his outcome other than possibly making him die sooner. The other two did generally fine.
I think the longest any of my patients were intubated was about 22 days. They lived.
Remdesivir did not seem to have a deleterious effect on any patient that I saw. We were selective in its use- COVID and the shock it caused the body created the problem you described in the OP- fluid retention, rising creatinine, and an overflow of fluid into the lungs. I saw that in a few dozen cases from the virus. Most of them were too sick to get remdesivir. Plenty that got it died. Plenty that didn’t still lived. The first time I used it, a patient made a dramatic turnaround. I didn’t see that a single other time. Early bias had us keep using it. That and a lack of anything else to use that was useful (yes, we wrote hydroxychloroquine, Zithromax, ivermectin. Same sort of observed outcomes. None of it really made a difference). I would not be surprised to see future studies continue to uphold that Remdesivir did not help. I would be surprised to find good, objective, unbiased data suggesting that it was a significantly harmful medication to give patients (based on experience). I would probably suggest the same for the others listed. I saw no dramatic improvements with any combination over another.


There was a short period (3-6 months) during either the 2/3 peak or first variant (I forget at this point) that the strongest predictor of poor outcome in my patients and group was whether they got vaccinated or not. We still saw zero “normal, healthy” people die. I have one patient that we attribute cardiomyopathy to the OG COVID. The patients who died were at least obese or old with at least one other health problem. But there was a short time where those people who got hospitalized were essentially all unvaccinated (again- it wasn’t 20-30 year old athletes or even healthy 50 year olds, and I am not commenting on vaccine policy at all. I am relaying experience. They were all unvaccinated AND unhealthy (though I know a TON of very unhealthy people who don’t think of themselves as such, sadly)).





So to answer your question:
Yes. The medical community probably caused some deaths by changing the way they treated the virus early on before there was direct experience, and we were relying on information gathered in China, relayed through state boards and state/fed press briefings. But based on the article you share and the way you ask the question, I can confidently say that it is far fewer than you are attributing to it.



And lastly, a small nugget:
Roughly 100% of people who a doctor thinks should be intubated and refuse it die.

You remember the noise cuomo made (before the widespread dissemination [even though multiple studies of antibody presence in banked blood showed it had infected folks in November of 2019]of Covid) for ventilators?

You remember how you barely heard the word ventilator in the news after that?

It’s because ventilators were killing folks. Look at the mortality rate if someone is vented with Covid.