A patient with COVID-19, the illness caused by the coronavirus, wears a snorkeling mask converted into a ventilator in Paris on April 1.
REUTERS/Benoit Tessier/File Photo
Some doctors are trying to reduce their reliance on ventilators for some coronavirus patients as the death rate for patients using the machines is abnormally high.
New York officials say 80% of coronavirus patients who used ventilators in the city have died, the Associated Press reported. Unusually high death rates have also been recorded elsewhere in the world.
Ventilators are typically only used for the worst-affected patients and there are no drugs to help treat coronavirus, so this could explain the higher death rate.
But doctors also say that ventilators can be damaging to the lungs, and while it may be an effective way to treat other respiratory illnesses, some are now looking for alternative treatments.
There is still a global ventilator shortage, with doctors and healthcare systems calling for more to be urgently made or bought to treat the worst-affected patients.
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Some doctors are trying to use ventilators less frequently as some areas report high death rates amid coronavirus patients who have to use them.
Ventilators are machines used to bring oxygen into peoples’ lungs, and are typically only used for patients worst affected by respiratory diseases.
Some 40% to 50% of patients with severe respiratory issues die while on ventilators, the Associated Press (AP) reported, citing experts.
New York City has reported that 80% of its coronavirus patients who were put on ventilators had ultimately died, the AP reported, citing state and city officials. It is the worst-affected state in the US.
There have also been reports of unusually high death rates among patients on ventilators elsewhere in the US, China, and the UK, the AP reported.
Workers make ventilators at a plant in Barcelona, Spain, on Tuesday.
Europa Press News/Europa Press via Getty Images
Putting a patient on a ventilator is an extreme step saved for the most-affected patients, who typically already have the highest chance of dying from respiratory failure.
The higher death rate could be a direct result of this, as well as the fact that there are so far no drugs that can help fight the coronavirus.
Ventilators could be causing further harm to COVID-19 patients, some doctors warn
Some doctors are also concerned that ventilators could actually be further harming certain coronavirus patients as the treatment is always hard on lungs, the AP reported.
Dr. Tiffany Osborn, a critical care specialist at Washington University School of Medicine, told NPR on April 1 that ventilators can actually damage patients’ lungs.
“The ventilator itself can do damage to the lung tissue based on how much pressure is required to help oxygen get processed by the lungs,” she said.
Dr. Negin Hajizadeh, a pulmonary critical care doctor at New York’s Hofstra/Northwell School of Medicine, also told NPR that while ventilators work well for people suffering from diseases like pneumonia, they don’t necessarily for coronavirus patients.
She said that most coronavirus patients in her hospital system have ultimately not recovered despite being given a ventilator.
She added that the coronavirus does a lot more damage to the lungs than illnesses like the flu, as “there is fluid and other toxic chemical cytokines, we call them, raging throughout the lung tissue.”
Medical workers wearing personal protective equipment wheel bodies to a refrigerated trailer serving as a makeshift morgue at Wyckoff Heights Medical Center in New York City on Monday.
Dr. Eddy Fan, an expert on respiratory treatment at Toronto General Hospital, told the AP: “We know that mechanical ventilation is not benign.”
“One of the most important findings in the last few decades is that medical ventilation can worsen lung injury — so we have to be careful how we use it.”
Doctors are trying to find other solutions and reduce their reliance on ventilators
The lack of treatment options for coronavirus patients have caused most of the world to turn to ventilators for the worst-affected patients.
But the high death rates among ventilator users have prompted some doctors to find alternatives, and reduce the reliance on ventilators, the AP reported.
Dr. Joseph Habboushe, an emergency medicine doctor in Manhattan, told the AP that it had been routine in the city to place particularly ill coronavirus patients on ventilators until a few weeks ago. Now other treatments are increasingly being tried.
“If we’re able to make them better without incubating them, they are more likely to have a better outcome — we think,” he said.
A GE worker in Massachusetts takes part in protest on Tuesday demanding that the company use the workforce to produce ventilators and calling for more safety measures.
According to the AP, doctors are trying things like: putting patients in different positions to try and get oxygen into different parts of their lungs, giving patients oxygen through nose tubes, and adding nitric oxide to oxygen treatments to try and increase blood flow.
New York State Health Commissioner Dr. Howard Zucker said Wednesday that officials are examining other treatments that could be used before ventilation, but said “that’s all experimental,” the AP reported.
The global ventilator shortage
The global shortage of ventilators has become one of the big stories of the pandemic, as doctors around the world are desperately trying to treat patients.
UK private companies are making them amid a shortage in the health service, but they will likely not be made before the virus peaks in the country.
In Italy, doctors had to decide which patients were more likely to survive in order to decide who they would give a ventilator, and have turned patients away due to the ventilator shortage.
In Spain, police asked people to donate snorkels so that their parts could be used to build makeshift ventilators.
The police in Madrid on Monday asked people to donate full-face snorkel masks that could be used as makeshift ventilators for COVID-19 patients.
And in the US, New York Gov. Andrew Cuomo has decried a ventilator shortage in the state, while states say they have had to battle the federal government for new ones and enlisted private companies to fix broken ventilators received from the federal stockpile.
Multiple countries have also accused the US of seizing their orders of medical equipment, including ventilators, though the Trump administration denies this.
Some of the world’s biggest manufacturers have also pivoted to starting making ventilators, including Foxconn, the world’s biggest iPhone maker, and Ford, GM, and Tesla.
And employees in some US companies, including GE, have protested, calling on their employers to get them to make ventilators.
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