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Dr Mike Yeadon's avatar

I remain distressed that few to no noisy physicians have emphasised to the general public that sedation, intubation and mechanical ventilation are inappropriate treatments for patients who are conscious, breathing through an unobstructed airway (the opposite of such as a near fatal asthma attack) and have no injury to their chest (such as can occur in stab wounds, other causes of pneumothorax & crush injury).

If such patients had a low and falling blood oxygen saturation, the appropriate treatment would be an oxygen mask or nasal cannula so that they breathe from air enriched with oxygen to some extent.

The mechanical ventilation story was pushed very heavily where I was in UK, early in 2020, to the extent you could not have failed to be impressed by it. There was talk of a need to immediately close the gap between capacity and need, with something like 20,000 ventilators.

Recall the absurd situation where vacuum cleaner and vehicle manufacturers were being spoken of as potential sources for jury-rigged ventilators.

These machines, when used appropriately (eg surgery accompanied by deep anaesthesia, after head injury or poisoning, where the respiratory reflexes are blunted, severe burns and other conditions where injury is so severe than medically-induced coma is a humanitarian decision) is life-saving.

It’s a complicated piece of machinery and anyone with the first knowledge of them immediately realises that rapid production of ventilators is camel through the eye of a needle style impossibility. Not even close. Furthermore, it’s a discipline all of its own to know how best to “fly” the patient and recognise early if things are turning bad. So even if there really had been a need for all these machines (there definitely wasn’t), the lead time for producing those kinds of numbers would be, I suspect, in the years not months. And we’d still lack the skilled staff to use them.

I could write a long essay on how the knowing misapplication of mechanical ventilation to helpless patients in hospital is murder.

It’s long past the time when regular doctors, but at least pulmonologists, critical care specialists and consultants broadly in general medicine should be setting into the record views along these lines, providing they’re correct.

WHY are they not doing so? Those who know that wrongdoing was everywhere have an obligation to share what they know in order to reduce the risk that it’ll happen again.

I think it’s highly likely to happen again because the advantages to the perpetrators of doing so are strong, particularly in the context of respiratory illnesses.

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TNK's avatar

It takes only a slight disruption in care, routine, and attention to throw fragile elderly folks (and some fragile younger folks) over the edge. The disruption in Spring 20 was far from slight. The US specializes during normal times in keeping these people barely alive, matrix-like, for extended periods so they can keep feeding the machine. So wherever these folks already were, many succumbed. The ones that actually made it alive to hospitals already had their death sentence signed upon admission. Its not hard to see why many would die immediately after the insane measures were implemented. I have seen no evidence that hospitals did anything beyond covering their asses. Workers had been propagandized to believe their own lives were in grave danger. Sick fragile folks were an easy sacrifice.

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