Should We Ration ICU Beds and Ventilators to #Coronavirus #COVID19 Patients?

Artist’s rendition of Coronavirus

Previously I shared with you some data from two hospitals in Wuhan, China, regarding their experience with COVID-19 as of Jan 31, 2020.

Something led me back to that study and on closer review I found shocking numbers. The report outlines their experience with 191 hospitalized patients. 137 were eventually discharged. 54 died.

Here’s the shocker: Of the 54 who died, 32 required mechanical ventilation. Of those 32, 31 died. That’s a 97% mortality rate if you end up on a ventilator in China.

I readily admit I know nothing about the quality of medical care anywhere in China. Nor do I know if we can trust the data coming out of China.

If a therapeutic modality has a 97% failure rate, that’s awfully close to being futile. Physicians have no obligation to offer futile “therapy” to patients. Before the U.S. ramps up production of an extra several hundred thousand ventilators,  maybe we need to re-think that. What I don’t know offhand is, what is the Italian experience with COVID-19 patients on ventilators. If it’s just as poor as China’s, should we even be offering ventilators to patients? Don’t forget, every ventilator patient takes up an ICU bed and ventilator that might be needed for a patient—maybe you or someone you love—with a much higher survival rate.

I’ve heard anecdotal reports of U.S. COVID-19 patients getting off ventilators alive and walking out of the hospital. But anecdotes are not hard data. Italy has a lot of experience with this issue. What are their survival rates after intubation and mechanical ventilation? Or ECMO? I’ll let you know when I find out. If you know now, please leave a comment below.

The time may come in the very near future that physicians have to tell 80-year-old patients with heart failure and COPD (chronic obstructive pulmonary disease) and now COVID-19 that we won’t put them on a mechanical ventilator because their chance of survival is zero, or no ventilator is available. Sad.

Anxiously awaiting more data.

Steve Parker, M.D.

PS: Of the three Chinese patients given ECMO, all died.

Steve Parker MD, Advanced Mediterranean Diet

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One response to “Should We Ration ICU Beds and Ventilators to #Coronavirus #COVID19 Patients?

  1. Pingback: Once Again, I Ask WHO Is to Get the Limited Ventilators?  #coronavirus  #COVID19 | Advanced Mediterranean Diet