A critical-care physician told The Wall Street Journal that patients sick from the China-originated novel coronavirus last spring were put under “risky sedation” and placed on ventilators “[n]ot for the patients’ benefit,” but in an effort to potentially stop the virus from spreading to staff and other patients.
Other less risky methods of breathing support could potentially result in a patient “spray[ing] dangerous amounts of virus into the air,” the physician argued.
“We were intubating sick patients very early. Not for the patients’ benefit, but in order to control the epidemic and to save other patients,” said Dr. Theodore Iwashyna, a critical-care physician at University of Michigan and Department of Veterans Affairs hospitals in Ann Arbor. “That felt awful.”
The shocking comment was picked up by founder of Rational Guard and lockdown critic Justin Hart.
“What happened to ‘do no harm,’” he questioned. “This article makes me sick.”
Hart’s comment is in reference to the one of the promises in the Hippocratic Oath doctors are sworn to practice: “first, do no harm.”
— Justin Hart (@justin_hart) December 21, 2020
The Journal elaborated on Dr. Iwashyna’s remarks: “Last spring, doctors put patients on ventilators partly to limit contagion at a time when it was less clear how the virus spread, when protective masks and gowns were in short supply. Doctors could have employed other kinds of breathing support devices that don’t require risky sedation, but early reports suggested patients using them could spray dangerous amounts of virus into the air, said Theodore Iwashyna.”
According to the critical-care physician, doctors and nurses at the time “feared the virus would spread through hospitals.”
“Ventilators can injure lungs by causing too much strain as the machines force in air,” the Journal noted. “They deliver air and oxygen through a throat tube, which the body typically fights.”
“We’ve got gag reflexes that are pretty hard to go away, precisely to avoid things going into our lungs,” Iwashyna explained.
Moreover, early COVID patients were looked in on fewer times than normal — again in an attempt to “slow the spread” within the hospital — and therefore given stronger sedatives. Research suggests stronger sedatives are riskier for patients.
“As a safety precaution, doctors and hospitals limited the access of health-care workers to coronavirus patients on ventilators, giving them fewer opportunities to check on them,” the Journal noted. “That meant patients required more powerful sedatives to keep them from pulling out throat tubes. Sedation increases risk for delirium, research suggests, and delirium increases the likelihood of long-term confusion and death.”
The high risk to patients was ultimately all for naught, per the Journal. Research showed that “alternative devices to ventilators, such as delivering oxygen through nasal tubes, weren’t as risky to caretakers as believed,” the Journal said.
Treatment now mostly looks like it did pre-pandemic: “Doctors hold off longer before placing patients on ventilators. Patients get less powerful sedatives, with doctors checking more frequently to see if they can halt the drugs entirely and dialing back how much air ventilators push into patients’ lungs with each breath.”
“Let us go back to basics,” said Dr. Eduardo Oliveira, executive medical director for critical-care services for AdventHealth Central Florida. “The less you deviate from it, the better.”
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