Never forget that the lab leak was a “conspiracy theory” that the New York Times’ head Covid reporter called “racist.” If you think I’ll tire of recalling this, my friends, you are wrong.

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[–]weavilsatemyface 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (34 children)

Username checks out.

[–]ActuallyNot 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (33 children)

Remember the context: in the early months of the pandemic, hospitals were literally forcing patients into ventilators even if they could still breathe without assistance, in order to protect the medical staff from Covid infection, knowing full well that intubation is a very dangerous procedure that will kill many of those patients. (Especially when hospitals failed to treat the secondary bacterial pneumonia when it invariably occurred.) It completely failed to protect the staff, or keep the patients alive, but that was the policy.

You might still need to link me to this policy. None of your links suggest that this was the case.

[–]weavilsatemyface 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (32 children)

You might still need to link me to this policy.

As I'm sure you are fully aware, hospitals do not generally make their internal policies public.

But we have whistleblowers and survivors reporting preemptive intubation, doctors publicly resigning because they disagree with that preemptive intubation, other doctors writing scientific papers arguing either for or against preemptive early intubation, and professional associations recommending preemptive intubation. I'm sure you can join the dots.

There's skepticism, and then there's refusal to believe that the sun exists because you can't lick it.

[–]ActuallyNot 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (31 children)

As I'm sure you are fully aware, hospitals do not generally make their internal policies public.

So when you say "[H]ospitals were literally forcing patients into ventilators even if they could still breathe without assistance, in order to protect the medical staff from Covid infection, knowing full well that intubation is a very dangerous procedure that will kill many of those patients. (Especially when hospitals failed to treat the secondary bacterial pneumonia when it invariably occurred.) It completely failed to protect the staff, or keep the patients alive, but that was the policy."

So you claim to know about the existence and contents of this policy with respect to at least some hospitals.

How?

But we have whistleblowers and survivors reporting preemptive intubation

That only shows that it occurred in some cases. A sensible assumption that was only shown to be erroneous as data became available would be that intubation would be critical in patients with oxygenation levels that are known to be harmful in other contexts.

doctors publicly resigning because they disagree with that preemptive intubation

That's at least indicative of some issue. Can you link me to some of these public resignations?

There's skepticism, and then there's refusal to believe that the sun exists because you can't lick it.

You've claimed that a policy exists and that hospitals don't make such policies public. What I'm asking for is the evidence that you have to make that claim.

[–]weavilsatemyface 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (30 children)

I don't think you're arguing in good faith at this point. I've already linked to evidence of this policy, and I know you've seen it because you replied to that post.

[–]ActuallyNot 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (29 children)

I don't think you're arguing in good faith at this point.

Oh, FFS. If there never was a policy of intubating patients who could breathe normally for the sole purpose of protecting hospital staff, just say so.

There's no need to get all ad hominem.

I've already linked to evidence of this policy, and I know you've seen it because you replied to that post.

I've responded to that post.

I agree that there is evidence that there a change in when and whether intubation was a good idea. However this is all about the outcomes for the patient.

I don't agree that any of your links suggest that people would be intubated if their breathing and oxygenation levels were normal, solely for the protection of hospital staff.

[–]weavilsatemyface 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (28 children)

I don't agree that any of your links suggest that people would be intubated if their breathing and oxygenation levels were normal, solely for the protection of hospital staff.

If I said, or gave you the impression, that hospitals were intubating people with normal oxygen levels and no Covid symptoms, then I apologise for misleading you. That's not what I intended to say. Of course they were intubating people in the ICU with reduced oxygen levels. But they were doing it early when patients were showing only slightly reduced oxygen, often not in distress, and often in preference to trying non-invasive ventilation first. And they did this explicitly because they feared that non-invasive ventilation would spread the disease to staff and other patients.

To be clear: there were also many cases were patients had dangerously low oxygen, and were in distress. Even in those cases, invasive mechanical ventilation may not always be appropriate.

[–]ActuallyNot 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (27 children)

But they were doing it early when patients were showing only slightly reduced oxygen, often not in distress, and often in preference to trying non-invasive ventilation first.

Not quite. They were often not in distress, but this was anomalous: Their oxygenation levels were dangerously low.

And they did this explicitly because they feared that non-invasive ventilation would spread the disease to staff and other patients.

I don't agree that any of your links suggest that that was anything more than a minor consideration in the decision to intubate early.

[–]weavilsatemyface 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (26 children)

this was anomalous: Their oxygenation levels were dangerously low.

No, it was not dangerously low. 30% oxygen is dangerously low. 70% is not.

I don't agree that any of your links suggest that that was anything more than a minor consideration in the decision to intubate early.

The links explicitly say that that early intubation was done to protect staff. Doctors and nurses who were there on the front lines say that early intubation was done to protect staff. Major media outlets say early intubation was done to protect staff. Articles in scientific journals say early intubation was done to protect staff. Professional medical associations recommended early intubation to protect staff. But you know better.

Denial is not just a river in Egypt.

[–]ActuallyNot 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (25 children)

30% oxygen is dangerously low. 70% is not.

30% or 70% of what?

Normal arterial blood oxygen saturation levels in humans are 97–100 percent. If the level is below 90 percent, it is considered low and called hypoxemia. Arterial blood oxygen levels below 80 percent may compromise organ function, such as the brain and heart, and should be promptly addressed.

If we're talking oxygen saturation, 95% is low. 80% is dangerous. 30% is off the charts rapidly dying.

The links explicitly say that that early intubation was done to protect staff.

Misleading at best.

"Early intubation should be considered to prevent the additional risk to staff of emergency intubation and to avoid prolonged use of high flow nasal oxygen or non‐invasive ventilation."

This is not explicitly to protect staff. It's to avoid emergency intubation (which poses additional risk to staff) and to avoid prolonged use of nasal oxygen or an NIV mask.