You must have missed that. To answer this: — Benkei

You have missed this:

There was a sentence in the article that stated that greater access to hospitalization was another reason for their low death rate, but there were no supporting facts for that. That statement is common sense, but it's contradicted by the article I cited where they showed those receiving hospitalization in New York had a very low rate of survival. — Hanover

I didn't miss it because it's not what I referred to. It's not greater acces but earlier access and your article doesn't prove the opposite at all because it doesn't go into when people are admitted into the hospital and the severity of their symptoms at the time.

it's contradicted by the article I cited where they showed those receiving hospitalization in New York had a very low rate of survival. — Hanover

Receiving hospitalization or mechanical ventilation?

That statement is common sense, but it's contradicted by the article I cited where they showed those receiving hospitalization in New York had a very low rate of survival. — Hanover

Your article says:

Overall, about 20% of Covid-19 patients treated at Northwell Health died, and 88% of those placed on ventilators died

It's not greater acces but earlier access and your article doesn't prove the opposite at all because it doesn't go into when people are admitted into the hospital and the severity of their symptoms at the time. — Benkei

What they say is:
“When I have an early diagnosis and can treat patients early — for example put them on a ventilator before they deteriorate — the chance of survival is much higher,” Professor Kräusslich said.

First of all, this isn't science. This is a clinician giving his general assessment based upon what it feels like on the ground. Second, it's entirely possible he's treating patients who were never going to deteriorate anyway, so he's providing unneeded treatment. What standard does he have to show that a particular patient was one of the rare ones who was going to exhibit serious symptoms and so he therefore ventilated prior to their being critical? Has the protocol of random testing in order to obtain early diagnosis and then immediate hospitalization with ventilation been tested against another protocol?
And has any of this analysis been tested against a better cross-section of people other than the German population so that we can screen for populations that happen not to be in their 40s and in generally good health?

This outcry for ventilators is as absurd as the outcry for choloroquine, but for some reason we accept that ventilators are appropriate treatment because it's just the norm, and then we pass all sorts of policy to assure there are plenty of ventilators for everyone.

Receiving hospitalization or mechanical ventilation? — frank

Either. What scientifically valid study shows that ventilation or hospitalization is an effective treatment for covid 19? If you're going to treat an illness in any way, by ventilation, by offering oxygen, giving an IV, or petting them on the head, you're going to have to show statistically that those things make any sort of difference.

Overall, about 20% of Covid-19 patients treated at Northwell Health died, and 88% of those placed on ventilators died

Right, and this can mean all sorts of things, including ventilators do nothing, ventilators kill, or that ventilators increase your chance of survival by some negligible amount. It's certainly not sufficient scientific evidence that ventilation is a statistically likely way to improve one's chances to survive.

ventilation, by offering oxygen, giving an IV, or petting them on the head, you're going to have to show statistically that those things make any sort of difference. — Hanover

I'll pass that along. I don't think they realized that.

Are you seriously suggesting that there's no evidence that a machine which demonstrably keeps failing lungs working facilitates recovery of people with respiratory failure?

I'll pass that along. I don't think they realized that. — frank

If you're going to appeal to authority, you're going to have to cite to the authority, which are the actual studies. Simply suggesting that they must know where the studies are and they must be relying upon them because they are too sophisticated to have done otherwise isn't a proper appeal to authority. It's just a blind trust in the system.

This is a clinician giving his general assessment based upon what it feels like on the ground. Second, it's entirely possible he's treating patients who were never going to deteriorate anyway, so he's providing unneeded treatment. What standard does he have to show that a particular patient was one of the rare ones who was going to exhibit serious symptoms and so he therefore ventilated prior to their being critical? Has the protocol of random testing in order to obtain early diagnosis and then immediate hospitalization with ventilation been tested against another protocol?
And has any of this analysis been tested against a better cross-section of people other than the German population so that we can screen for populations that happen not to be in their 40s and in generally good health? — Hanover

This is based on existing protocol which is science based. Try again.

Are you seriously suggesting that there's no evidence that a machine which demonstrably keeps failing lungs working facilitates recovery of people with respiratory failure? — fdrake

That's what the evidence is in fact showing. Google this "do ventilators help covid patients"

This is based on existing protocol which is science based. Try again. — Benkei

Really? Because it's the existing protocol, it must be based upon good science? It's just a tautology? Maybe show me the study you're referencing instead of just repeating that's what everyone happens to be doing.

Medicine isn't research based for the most part. Some of it is. The rest is literally like what's happening now: Americans calling Germans asking what they're doing.

The ventilator isn't therapeutic, btw, it's a way of keeping a person alive so that some other therapy can work.

That's what the evidence is in fact showing. Google this "do ventilators help covid patients" — Hanover

Ok.

The question: "Do people who are put on ventilators tend to die?" is not...
the question "Do ventilators preserve the life of those patients and aid recovery?" is not...
the question: "Did putting someone on a ventilator kill them?"

A world where there are ventilators has a lot less deaths due to respiratory failure than one which has no ventilators. It's not like ventilators are a covid specific thing, they're for respiratory failure.

Medicine isn't research based for the most part. — frank

If you're going to concede the point that medicine isn't scientifically based, but that it's just based upon anecdotal cases and general feel, then we should all step back from accepting these medical opinions as any sort of gospel and perhaps reconsider our reliance upon them when forming public policy.

and perhaps reconsider our reliance upon them when forming public policy. — Hanover

What's the alternative?

A world where there are ventilators has a lot less deaths due to respiratory failure than one which has no ventilators. It's not like ventilators are a covid specific thing, they're for respiratory failure. — fdrake

Well of course. Use respirators where they ought be used, but maybe not for covid. If they don't work for those patients and they possibly hasten their death, then let's not get in such a frenzy to make sure they are plentiful enough for covid patients.

What's the alternative? — frank

Not relying upon them.

Well of course. Use respirators where they ought be used, but maybe not for covid. If they don't work for those patients and they possibly hasten their death, then let's not get in such a frenzy to make sure they are plentiful enough for covid patients. — Hanover

President Hanover issues a decree where patients currently on ventilators stop using them due to inconclusive evidence that they do not help.

Almost everyone currently on a ventilator dies.

Huh.

Not relying upon them. — Hanover

Who should we rely on to advise us on public health issues?

May I just remind us that we "practice" medicine?
Science based evidence, controlled trials, double blind studies: what ever word you choose to use doesn't change the fact that it is not medical "answers". Our health care providers are simply the instruments that medicine is "practiced" through.
I am not going to appeal to the "higher power" or God for authority but I do believe that
"The power that made the body can heal the body."
Whether it is the power acquired by education by our Doctors who treat presenting symptoms or the scientists in the lab working to find treatments, cures, vaccines....it still applies.

@Hanover

Would we stop using defibrillators if we found out they only worked 20% of the time? If your heart's not beating, without intervention, you die. If you can't breathe, without intervention, you die.

By the way, the worldwide figure for survival of those on ventilators is closer to 50% than 80%, e.g.: https://www.atsjournals.org/doi/pdf/10.1164/ajrccm/140.2_Pt_2.S8

Ventilators may not be as effective as thought re COVID, depending on the type of patient. What's the solution to that? Ans = More research so better decisions can be made on which COVID patients should be prioristised on ventilators (as per the link above) if there's a shortage thereof, not a broad stop to ventilation. And you have no justification for using this to hammer medical science. If someone can't breathe, doctors aren't going to sit around and watch them die, they're going to do everything they can to get oxygen into their lungs because that is the only hope they have of saving them.

@Hanover

https://www.evidence.nhs.uk/search?q=guidelines+on+ventilated+patient

Almost everyone currently on a ventilator dies. — fdrake

The treatment protocol is fluid at best but there is emeging correlation between when a COVID 19 patient is vented and the survival rate.
I am not sure when we will confirm causation but until then we are grasping at any possible way of treating the COVID 19 patients.

Would we stop using defibrillators if we found out they only worked 20% of the time? — Baden

If they killed people, we'd stop using them.

You're making the Trump argument by the way. Let's try this medication, it seems like it works from what folks have told me, it's been around a long time, and why not, it's safe for most people.

The reason this matters is because we've shut down the world's economies to be sure we had plenty of beds and ventilators and it might be all those beds and ventilators aren't really making a difference.

So, to the extent we say "why not give them a try?" the "why not" is because there is a massive price to pay if we're wrong. And maybe we were.

President Hanover issues a decree where patients currently on ventilators stop using them due to inconclusive evidence that they do not help. — fdrake

President Fdrake issues a decree that we quarantine the world so that the spread of covid will not exceed the number of ventilators based upon no evidence that ventilators increase the survival of covid patients.

Huh?

COVID-19 patients present with a condition similar to ARDS. There's only one piece of research that backs up the associated ARDS protocol. That research shows improved outcomes vs previous strategies.

If they killed people, we'd stop using them. — Hanover

I'm kinda curious as to why you think ventilators are killing people. Nothing in the article you posted suggests this.

People with more severe reactions are more likely to receive a ventilator, and they're also more likely to die as a result of the virus.

The treatment protocol is fluid at best but there is emeging correlation between when a COVID 19 patient is vented and the survival rate. — ArguingWAristotleTiff

People on ventilators tend to die. Having a high death rate due to respiratory failures while on ventilators is not so surprising. This is fully consistent with them helping people survive; if someone who needs a ventilator to breath did not have a ventilator, they would die.

If there are indicators that certain COVID patients would be at a higher risk of death from being ventilated, in the case of respiratory failure, that would be a good incentive not to ventilate them.

Consider what options are being weighed; someone's lungs are not working, they would choke to death with a good chance without the ventilator. The alternative; do not use ventilators on people choking to death due to inconclusive evidence, with no proposed mechanism, which is being given undue weight because people are misinterpreting statistics.