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The thing is generally for lung treatment doctors follow a path of escalation, start with less invasive methods like oxygen and progress to ventilators. With co

The thing is generally for lung treatment doctors follow a path of escalation, start with less invasive methods like oxygen and progress to ventilators. With covid 19 there have been several reports from doctors that skipping this and putting the patient directly on ventilators directly significantly improves survival. Doesn't that contradict what you are suggesting.

DoreenMichele 7y ago
Source? I cited my source, above. What you're saying is news to me. Without a source, I can only reply based on general life experience that most doctors are lazy and quick to prescribe drugs and surgery (or similar intervention -- in this case, ventilators) in place of trying to insist on educating patients and taking more low tech, often labor-intensive approaches instead. I have seen all the handouts saying if you have allergies and respiratory problems, your first line of defense should be things like having wood floors at home instead of carpeting. Not once has a doctor ever sat me down and had a meaty discussion with me about my decor choices or similar. It's always been, at best, "Which drug is your favorite?"
- Kliment 7y ago
  The Chinese recommendations document ( Handbook of COVID-19 Prevention and Treatment available from https://covid-19.alibabacloud.com/ https://covid-19.alibabacloud.com/ ) suggests oxygen early on, and not keeping patients on noninvasive ventilation for long before moving on to invasive, or skipping noninvasive altogether (intubating earlier rather than later) gives better outcomes. I suspect this is what the parent post is referencing. However, this applies to hospitalized patients in intensive care. High flow oxygen is the best way to prevent them from reaching that stage. What you're talking about is a much earlier stage of treatment, in order to prevent the need for hospitalization. Once a patient has reached the invasive ventilation stage their chances of recovery have already dropped massively, but at that stage the outcomes with invasive ventilation are significantly better than without. That said, all the emergency hospitals with capacities in the thousands being built are designed to get as many patients as possible on oxygen early on, as this definitely prevents many deaths. Their ventilator patient capacity is significantly lower - the bulk of them (as used in China, Spain, Italy) are just endless rows of beds and oxygen plumbing, to relieve the ICUs and isolation wards from people who just need oxygen and isolation and allow them to be used to only treat critical patients.
  - DoreenMichele 7y ago
    Thanks for that. I have really serious lung problems and spent years homeless. While homeless, I used to just stand outside my tent and cough up massive amounts of fluid and gunk so I could breathe when I laid down to sleep. Based on my experiences with my incurable lung disorder, I'm fairly confident we could be doing more with non-invasive techniques even at fairly advanced stages.
    - toyg 7y ago
      I understand your perspective but you’re relying on anecdata, not data.
      - DoreenMichele 7y ago
        FWIW, my anecdata includes a 32 year old son with the same diagnosis who still lives with me and our diagnosis (for a congenital condition) dates to May-June 2001, nearly 19 years ago. But, yes, first-hand personal experience and anecdata are roughly synonymous, though the first one lacks the generally dismissive implications of the second.
        Kliment 7y ago
        I believe the parent poster's implication was not that your experience is invalid, but that it doesn't reliably transfer to covid patients (where the complication leading to death is fibrosis of the lungs, which incidentally explains the very high death rate of advanced stage disease, ventilator or not).
  - jlokier 7y ago
    > at that stage the outcomes with invasive ventilation are significantly better than without You are responding to a thread that has this in it: >> If it's any comfort, the death rate is so high with ventilators (80%+, which is bad even for ventilators) How can both statements be true at the same time? Or is the 80%+ incorrect?

DoreenMichele 7y ago

Source? I cited my source, above. What you're saying is news to me. Without a source, I can only reply based on general life experience that most doctors are lazy and quick to prescribe drugs and surgery (or similar intervention -- in this case, ventilators) in place of trying to insist on educating patients and taking more low tech, often labor-intensive approaches instead. I have seen all the handouts saying if you have allergies and respiratory problems, your first line of defense should be things like having wood floors at home instead of carpeting. Not once has a doctor ever sat me down and had a meaty discussion with me about my decor choices or similar. It's always been, at best, "Which drug is your favorite?"

Kliment 7y ago
The Chinese recommendations document ( Handbook of COVID-19 Prevention and Treatment available from https://covid-19.alibabacloud.com/ https://covid-19.alibabacloud.com/ ) suggests oxygen early on, and not keeping patients on noninvasive ventilation for long before moving on to invasive, or skipping noninvasive altogether (intubating earlier rather than later) gives better outcomes. I suspect this is what the parent post is referencing. However, this applies to hospitalized patients in intensive care. High flow oxygen is the best way to prevent them from reaching that stage. What you're talking about is a much earlier stage of treatment, in order to prevent the need for hospitalization. Once a patient has reached the invasive ventilation stage their chances of recovery have already dropped massively, but at that stage the outcomes with invasive ventilation are significantly better than without. That said, all the emergency hospitals with capacities in the thousands being built are designed to get as many patients as possible on oxygen early on, as this definitely prevents many deaths. Their ventilator patient capacity is significantly lower - the bulk of them (as used in China, Spain, Italy) are just endless rows of beds and oxygen plumbing, to relieve the ICUs and isolation wards from people who just need oxygen and isolation and allow them to be used to only treat critical patients.
- DoreenMichele 7y ago
  Thanks for that. I have really serious lung problems and spent years homeless. While homeless, I used to just stand outside my tent and cough up massive amounts of fluid and gunk so I could breathe when I laid down to sleep. Based on my experiences with my incurable lung disorder, I'm fairly confident we could be doing more with non-invasive techniques even at fairly advanced stages.
  - toyg 7y ago
    I understand your perspective but you’re relying on anecdata, not data.
    - DoreenMichele 7y ago
      FWIW, my anecdata includes a 32 year old son with the same diagnosis who still lives with me and our diagnosis (for a congenital condition) dates to May-June 2001, nearly 19 years ago. But, yes, first-hand personal experience and anecdata are roughly synonymous, though the first one lacks the generally dismissive implications of the second.
      - Kliment 7y ago
        I believe the parent poster's implication was not that your experience is invalid, but that it doesn't reliably transfer to covid patients (where the complication leading to death is fibrosis of the lungs, which incidentally explains the very high death rate of advanced stage disease, ventilator or not).
- jlokier 7y ago
  > at that stage the outcomes with invasive ventilation are significantly better than without You are responding to a thread that has this in it: >> If it's any comfort, the death rate is so high with ventilators (80%+, which is bad even for ventilators) How can both statements be true at the same time? Or is the 80%+ incorrect?