Doctors are moving treatments away from ventilators as most people that ended up on ventilators died anyway.
Dyson claims that UK government has advised them that they no longer need the ventilator they were asked to develop.
New York now claims they had enough ventilators to get through the peak of their crisis.
Ford’s 50,000 ventilators they are making won’t be done until July.
So, was this an overhype of a medical need? Was this people lighting their hair on fire and raising an alarm that wasn’t as bad as everyone claimed.
We had good reason to predict that covid-19 would, like similar diseases, require ventilators in serious cases. Given the rate of spread, those ventilators would be needed as soon as possible.
Turns out, the prediction was wrong. That doesn’t mean prioritizing ventilators was the wrong decision, given what we knew at the time. That’s the nature of proactive measures - sometimes you get it wrong and effort is wasted.
It’s important to consider the timing of the ventilator need. It was happening when this was all beginning. The typical treatment for patients having breathing problems is to put them on a ventilator. Doctors are going to use the treatment which they feel has the best chance of success. They’re not going to start doing experiments in alternative treatments when someone is critically ill unless there’s a really good reason. Now that this has gone on for a while, doctors are able to see if ventilators are having the kind of success they expect. Since lots of patients are dying even on a ventilator, they are stepping back and looking into alternative treatments. But they didn’t know that at the beginning, so I would consider the call for ventilators at that time to be justified.
On this specific point, Dyson hadn’t developed anything near an approved product. Airbus, Rolls-Royce (and I think Ford UK) each replicated the production line of an existing approved design, and provided the extra production capacity that way.
The city of New York got through their crisis with about 9,000 ventilators. The City of New Orleans made an appeal for 5,000 ventilators from the Federal government. New York metro area is about 17x larger than the New Orleans metro area. There was mass hysteria on the news a month ago about New Orleans not getting their request fulfilled. They ended up receiving 750, and the Louisiana governor now says they have sufficient supply.
In crisis, creating hysteria over lack of supplies, that are not founded in facts but artificial pleas and cries, ultimately wastes time, resources, and diverts supplies to the wrong areas.
Turns out a lot of the problem was busted blood vessels, not mucus. That and erroneous SPO2 readings. Docs didn’t know those until recently. Sounds like CPAPS and BiPaps are the coming craze.
A nurse friend on FB said something in a comment the other day that when this began, a ventilator was the first response. As noted above, even those on ventilators tended to die. So now a ventilator is much farther down the list of treatment options.
Since we didn’t know how treatments would work, it was reasonable to assume that we would need a great number of ventilators. Now that it has not shown to be a very effective treatment, we don’t need as many.
So was the ventilator crisis overhyped? No, it was not. The medical community just learned what is, and what is not effective. If things had gone another way, we very well would be in an actual ventilator crisis.
Estimating need when you’re in the middle of an exponential curve is not easy. Neither is establishing a just-in-time manufacturing and distribution system for ventilators. It’s neither “overhyped” nor “hysteria.”
I’m a programmer, and I was a programmer working when Y2K happened.
There was a lot of press, and a lot of speculation about what could happen.
And a lot didn’t happen…
Because programmers were brought in to every company for the sole reason of finding what could go wrong, and fixing it before it did go wrong.
And the reason why the programmers were brought in was because of the press and the speculation, so the people who didn’t know anything about programming were convinced to spend money to get people who did know something about programming to make sure that any potential bugs were fixed before they became real bugs.
And since then, dozens of armchair quarterbacks who don’t have experience working in the software industry, who’s only experience of Y2K is that they were alive at the time (and some people not even then) have written about how the whole Y2K thing was over-hyped and overblown.
They are wrong.
So when someone comes along and says that the need for ventilators was overblown or over-hyped…
Unless you can give me your credentials - that you work in a hospital and have been dealing with Covid-19 in an area that has been hard hit… I’m going to think that you’re just another armchair quarterback second-guessing the people who really know what they’re doing without a real clue about what might have happened.
When the ventilator crisis was first mentioned no one expected governments to shut the economies down. But they did and thus the truly enormous spikes in cases didn’t happen–Italy is one country where they did have a ventilator crisis.
I’m also in the software biz and also came to the same conclusion. Y2K is a perfect analogue for the current situation – if any outcome turns out to be better than predicted, it’s because an army of people worked their asses off to make sure it turned out well.
Also, I think also ignoring what the local governments and hospitals were able to pull out of the supply chain and warehouses. Just a WAG, but that was probably not an insignificant number.
That and thank whoever you might believe in that NY appears to be the exception and not the rule (fingers crossed). I’m in the original epicenter in Seattle, and we only have about 6,000 cases now. Just imagine if we had more than one New York level outbreak? And think about all the medical personnel from around the country that are in NY now helping keep it all together thru the surge.
Yeah, this. New York predicted a need for 30,000 ventilators at a time when Trump was still trying to dismiss this as “just like the flu”. If it had been allowed to grow unchecked, they probably would have needed that many.
That they still needed about 1/3 that number, even with the shutdowns they eventually had, suggests that the original estimate was probably pretty accurate. They didn’t need all 30,000 because the other actions had the desired effect - but there was no way to know ahead of time that those actions would be taken, or exactly how effective they’d be.
Especially when the effectiveness of your own actions on that exponential curve are uncertain. If the virus had turned out to be more contagious or people had been less conscientious in following rules, that number of ventilators might well have been needed.
When deciding on whether you’ll err on the side of too little or too much, it’s a good idea to think of the cost of getting it wrong for either possibility. If you err on the side of more and end up getting 20% too many ventilators, how bad is it? If you err on the side of less and end up having 80% of the ventilators you need, how bad is it?
Ventilators were hyped the same way the military is hyped. We have a huge standing military and arsenal. Some people complain about the waste, but most Americans believe that having too much military is better than too little. Helps them sleep better at night, despite the high costs.
I think one thing that has frustrated me over the past several weeks is that our leaders talk about this being a “war” (calling doctors and nurses “warriors” and the like) but we don’t have the resources we would have in an actual war. And we haven’t collectively adopted a “war” mentality despite the rhetoric. Sure, we’ve been bunked down for a few weeks. But reopening businesses right now like is like having a picnic out on the battlefield with mortar shells raining down on you just because you want some fresh air. And you aren’t even wearing a helmet! If this is really a war, it’s one that we aren’t going to win unless we change our attitudes.
Throughout the crisis around the ventilators, I kept wondering who would run all the new ones. Don’t ventilators require operators with significant training? I would assume at least a respiratory therapist would be in charge at some level. How many machines can be overseen by an RT? I wondered if we might end up with an even greater shortage of trained personnel.
I have no medical training at this level, so just guessing here.
Do doctors actually think some patients were harmed by ventilators, in the sense that they would have had better chance of recovery without the ventilator?
It seems like you understand just fine. At the time the requests were based on the best information available. That information WAS the facts, and not at all artificial like you’re suggesting. The actual need for ventilators changed for all the reasons you mentioned (plus the lockdowns), not all of which could have been predicted at the time.
It’s always a bit distressing to see catastrophe averted, and then have people say that it means the danger was “overhyped”.
If it turns out that the measures taken made it faster to flatten the curve than we expected, that’s reason for relief. It’s not evidence though that anyone should have expected it was obviously going to be that “easy”. The danger now is that people will feel this was not as bad, and not listen to warnings about the possibility that a second wave will be the real bad one, because after all “they” were “wrong” about the first one.
That *was *discussed as a concern during the ramp-up.