Fox News Doc: It's Time For COVID-19 Patients To 'Come Off' Ventilators And Either Survive Or Die

[babylonsister]

https://crooksandliars.com/2020/04/fox-news-doc-its-time-covid-19-patients?fbclid=IwAR3MG0ECYJYkG8aK_apbQIjdmMcmpV3iXaNFXwwq4T1M81-46MyMHB9gY5c

4/05/20 8:23am
Fox News Doc: It's Time For COVID-19 Patients To 'Come Off' Ventilators And Either Survive Or Die
Fox News medical contributor Dr. Nicole Saphier on Sunday said COVID-19 patients would soon need to be removed from ventilators even if they cannot breathe on their own.
By David


Fox News medical contributor Dr. Nicole Saphier on Sunday said COVID-19 patients would soon need to be removed from ventilators even if they cannot breathe on their own.

"There's going to be more deaths this coming week," Saphier said on Fox & Friends. "The reason I try and explain that to people is although our rates of hospitalization are going down, that is a good thing."

"But we're going to start seeing more deaths," she continued. "Because the people that are having to be in the ICU on the ventilators, they are being kept on the ventilators from anywhere one to four weeks."

Saphier argued that "at some point, they will have to come off the ventilators."

"And they're either going to survive or they're either going to die," she added. "Some of the mortality rates coming out of China are ranging from 60 to 90% of people on the ventilators [who die]. Thankfully, here in the United States, that number varies."

[democrattotheend]

1. This isn't terribly different from what Cuomo said last week

He pointed out that the longer someone stays on a ventilator, the less likely they are to recover. Seemed to be setting the stage for limiting time on ventilators. While not appealing, limiting time on ventilators seems like a better option than instituting a blanket rule that nobody over a certain age gets one, as they did in Italy and Spain.

[dawg day]

7. Or maybe we could just build and distribute more ventilators.

Somehow we have ceased being the United States of America, able to mobilize quickly and get things done.

Maybe it just takes an FDR. Maybe it just takes not-Trump.

[Tweedy]

28. Sadly, yes

And we needed to start building in December.

April is preferable to May.

We could be churning out N95 masks, though, right now today.

[Igel]

32. It's one way of acknowledging reality.

If you have 100 people on life support indefinitely with virtually no chance of recovery, it's a problem.

It's bad enough when they're vegetative or in a coma. When they're conscious and can't hardly move, have to be catheterized and intubated, it's hell. https://epmonthly.com/article/post-intubation-sedation-the-tube-is-in-now-what/ Think of what that would be from the patient's perspective, not the ER doctor's.

It would also be hell to have to tell somebody whose conscious that the odds are close to zero they'd ever breathe without the machine, so the option is they stay intubated, taking an ICU bed, for the rest of their lives, possibly in pain, or they're removed and they live or die.

Worse is when there are limited resources. It's why some states have end-of-life options for hospitals. TX allows this: If a hospital determines that a patient will not recover and is just using resources, whether or not they can pay, they can be disconnected. If the family can arrange for alternative treatment in another hospital, great.

I'm not sure the alternative is appealing. Let's say that NYC has all the ventilators that Cuomo wants in use--30k patients. 90% don't come off. That's 27,000 people. On ventilators. Where do you put the 27,000 people? Giant warehouses of people with hard tubes down their bronchial tubes, unable to talk, sedated or doped because the tubes hurt, not mobile? And you keep them there for years, with visitation rights for their families? Farm them out for families to manage?

Reality bites.

[thucythucy]

42. As someone in the disability community comments like this scare the shit out of me.

I know and have known people who use ventilators and are catheterized. Some of them have MS, some have one or another form of muscular dystrophy. You can be on a ventilator and be mobile. In fact all the people I've known on ventilators also used power wheelchairs. The intubation you see in an ICU is meant to be temporary, the more permanent forms of intubation can often be better managed. So we're not necessarily talking about "warehouses of people." I hope and expect that many people--even those left with permanent impairments--will be able to resume life in the community--with the proper supports. To start switching off people in the expectation that their life from now on will be an unending misery would be absolutely tragic.

As for "limited resources," this society CHOOSES to limit those resources, and what's happening now is only the most recent, horrific example of this. Somehow, when it's a bank bailout or another war or a couple three nuclear powered aircraft carriers the resources are never ever "limited." We stockpile tens of thousands of nuclear weapons, but having an adequate supply of ventilators, PPEs, or even fucking face masks is somehow beyond us.

And we also have the ability to provide in-home care for people with even the most severe disabilities. Many states have independent living programs that provide just these sorts of assistance. It's not rocket science. It has and can done. I know spinal cord injured quadriplegics who are able to live in the community and even hold down full time jobs--given the support they need. We just have to decide as a society that providing this assistance is as big a priority as building giant sports stadiums or giving tax breaks to billionaires.

I understand what you're saying, and no one wants people to suffer unnecessarily. But that decision should be left to the individual or their proxy. To have doctors switching off someone's life because that person "is just using resources" is absolutely frightening to people like me.

If at the end of the day there remains a significant population of people who need to be on ventilators for the rest of their lives as a result of this illness, we should expend some effort in figuring out how we can assist them in coping with this, should they decide that's what they want. We should be able to come up with options between "giant warehouses" and "pull the plug."

Sorry to rant, but I felt I had to get that off my chest.

Best wishes, and please stay safe.

[blitzen]

2. "Rates of hospitalization going down"? Yeah, right. n/t

[Tweedy]

29. Where? I wonder

I think only Seattle has reduced hospitalization numbers at this point.

[mzmolly]

3. Yet they claim the 'pro-life' banner.

[gibraltar72]

4. Maybe it's just me but I liked Dr. Kervorkian better.

He was following his patients wishes.

[underpants]

5. Fox was kind of forced to get some doctor ANY doctor on air.

They're early coverage ma open them up to lawsuits from what I've read.

[dawg day]

6. The lengths they will go to for the sake of defending Trump for his criminal lack of action

"See, if everyone on a ventilator would just get off and die, there would be plenty of ventilators for the rest of us!"

[blogslut]

8. I don't want to defend anything from Fox news

But, isn't it true that the longer a patient is on a ventilator, the more likely that person with have permanent lung damage?

[babylonsister]

10. Yes, I think you're right, but it seems

rather barbaric to me to yank them off ventilators and let them basically strangle for lack of oxygen.

[blogslut]

18. I understand

Blogslut jr was born 3 months premature and, at the time, I didn't understand why the doctors and nurses were so insistent to take my baby off a ventilator until the reasons why were explained to me.

[madville]

11. The reports I have seen said 60-90 percent don't recover

after long term ventilator use, the mortality rate is very high.

[madville]

9. The majority who require ventilators don't survive

Here is a Washington Post article from a couple of days ago:

The dark side of ventilators: Those hooked up for long periods face difficult recoveries https://www.washingtonpost.com/health/2020/04/03/coronavirus-survivors-recovery/

At some point they have to be taken off the ventilator (it's not a long term care solution) and the majority don't make it. The question is, how long do you dedicate a ventilator to someone who is likely to die once taken off of it?

[janterry]

14. It's also a harrowing way to linger and then die

It's very invasive

[davekriss]

36. Sad story

My dad used to occasionally tell my brother and I that he did not want to live with a bunch of tubes shoved down his throat, dependent on machines to live.

Then he got cancer and eventually found himself in just that situation. Most of the time he was in an induced coma, but when we’d visit they woke him up. He was restrained because, otherwise, he’d tear out the tubes.

My brother and I flew in from out of state. He welcomed our visits, clearly. But when we’d leave, he made expressions to me that I interpreted as, ‘get these f*ing pipes out of me’. I’d shout at him (he was nearly totally deaf), ‘one more day, dad, just one more day. They want to test your ability to breath on your own’. This went on for weeks.

The doctors, always the optimists, said they can try this or that (which they did, including highly invasive surgery). One day a nurse pulled my aside and told me to end it, that we (all of us) were only making him suffer. I objected, saying Dr X wanted to try procedure Y. She said the doctors are always optimistic, they always want to save lives. But, she said, she’d seen this play out so many times and she was certain my dad would not improve. A few days later he passed due to heart failure.

It hit me weeks later that my father, a lifelong atheist and a reality-based, tough-as-nails NYC kid, was asking me to end it. We talked about this situation over the years and he wanted to end it even if it meant death.

That was 7 years ago and I still live with that guilt. It was our selfishness, our desire not to lose our dad that blinded us to his wishes and thus prolonged his suffering.

(Karma: I now have the same incurable cancer.)

[janterry]

40. I'm so sorry

Don't shoulder that guilt, though. If you can - put it down.

Whatever happened is really over. Your father is not suffering today.

The MD's gave you hope and you made a choice out of love and hope. Your tough as nails father would appreciate your love, I think.

I'm also sorry to hear about your diagnosis. I hope you live long, with love and hope
even if it is incurable

[rustysgurl]

12. I guess they should just go ahead and die ...

... and decrease the "surplus population." SMH

[procon]

13. She must have taken the Hippocratic oath at Trump University.

This fits in with the Republicans view of the weak and sick, "just hurry up and die".

[Zoonart]

15. WTAF... What ever happened to "first do no harm"?

[procon]

27. Trump U replaced it with; "get your own first, to hell with everyone else." nt

[LakeArenal]

16. WWJD???

[CousinIT]

17. Odd she didn't mention that because of TRUMP hospitals don't have enough ventilators

Because THAT is the crux of all this.

[janterry]

19. Here's a good article about ventilation

https://www.nytimes.com/2020/04/04/opinion/coronavirus-ventilators.html
(well worth reading the whole thing, imo - but here's a part of it)


Nobody can tolerate being ventilated like this without sedation. Covid-19 patients are put into a medically induced coma before being placed on a ventilator. They do not suffer, but they cannot talk to us and they cannot tell us how much of this care they want.

Eventually, all the efforts of health care workers may not be enough, and the body begins to collapse. No matter how loved, how vital or how needed a person is, even the most modern technology isn’t always enough. Death, while typically painless, is no less final.

Even among the Covid-19 patients who are ventilated and then discharged from the intensive care unit, some have died within days from heart damage.

Even before Covid-19, for those lucky enough to leave the hospital alive after suffering acute respiratory distress syndrome, recovery can take months or years. The amount of sedation needed for Covid 19 patients can cause profound complications, damaging muscles and nerves, making it hard for those who survive to walk, move or even think as well as they did before they became ill. Many spend most of their recovery time in a rehabilitation center, and older patients often never go home. They live out their days bed bound, at higher risk of recurrent infections, bed sores and trips back to the hospital.

All this does not mean we shouldn’t use ventilators to try to save people. It just means we have to ask ourselves some serious questions: What do I value about my life? If I will die if I am not put in a medical coma and placed on a ventilator, do I want that life support? If I do choose to be placed on a ventilator, how far do I want to go? Do I want to continue on the machine if my kidneys shut down? Do I want tubes feeding me so I can stay on the ventilator for weeks?

[davekriss]

37. See post #36 (my post)

This really is difficult. Everyone: write a living will that makes your wishes clear before (if) you find yourself in this situation. It will help those who love you a great deal.

[Me.]

20. Add Another Couple Of Million To That Lawsuit

[sop]

21. FOX News supported keeping Terri Schiavo on life support for seven years.

The highly publicized and prolonged legal challenges, not allowing Schiavo to die a natural death, as per her husband's wishes, were supported by Republican politicians, rightwing christian preachers and even George W. Bush. FOX News endlessly flogged the whole sordid affair for years.

[Mariana]

38. She was breathing on her own.

That would be their argument, that it's a completely different situation because she was breathing on her own.

[sop]

46. It's the lengths Republicans will go to keep people alive when it serves their right to life agenda,

not the method of keeping people alive. Keeping Schiavo alive provided a useful symbol for the christian right, and it got a lot of Republicans elected. In contrast, blue state governors demanding respirators from Trump's personal stash to keep C-19 victims alive only underscores this administration's bungling of the pandemic response, and will cost them votes.

[tblue37]

43. Remember Bill Frist diagnosing her from afar? nt

[GeorgeGist]

22. When people take infectious disease advice ...

from a friggin Radiologist, they deserve what they get.

[ismnotwasm]

23. I can tell you as of right now covid-19 positive patients cannot be organ donors

The tragedies build upon themselves. Battlefield triage who do you take off the ventilator? The 65 year old father of two, or the 27 year old heroin addict? Which life has more inherent worth? Who decides?

This is fucked up

[ret5hd]

35. The answer is obvious...the 65 yr old father probably has good insurance!

[DEbluedude]

24. "And they're either going to survive or they're either going to die," ...

Real genius. Stable, I would say.

[mr_lebowski]

26. Her credentials are tremendous, many say the best credentials they've ever seen

How else to come up with such sage analysis, as you've quoted there?

I mean that's ... that's crazy insightful shit right there.

Another good one is the one about how in Jyna the death rate is between 60% and 90% ... but it's DIFFERENT in Merika.

Here, it VARIES, you see?

[DBoon]

25. down in the pits of hell, Doctor Mengele is thrilled

[SWBTATTReg]

30. Screw faux news and everything they touch. I wouldn't ever, ever do what they suggest,

and by the way, why in the world are people paying attention to this scumbag doctor on faux?

Personal medical decisions should be left up to the families of victims and no one else. Period. Unless they have something in writing should they come down w/ an illness (do not resituate / perform far reaching live saving methods should one pass or die).

There are technologies such as 'iron lungs' etc. out there, so don't write these people off so easily. What idiots.

[ffr]

31. Are they talking this way to their core voters, just die already?

I'm mean, to the KGOP's voter base. The Russians will never get another Russian elected again. It'll just be a blue way from here on out.

Fux Noise is so far right, as in spherically speaking, they're damning their political aspirations to the ash heap of history.

[Under The Radar]

33. Wait a minute? Explain that Pro-life logic to me once again

[still_one]

39. Fuck Fox News. How long one should remain on a ventilator is between a physician and their family,

not from some doctor on a network that for months was pushing how this was a hoax

For those in this thread who are spewing those on a ventilator won’t survive perhaps should explain why there are people who have been on ventilators who not only overcame the disease, but are donating their plasma to hopefully help those fighting this through their antibodies

[tblue37]

41. They don't even try to hide it anymore. nt

[hack89]

44. Happens every day in America

Very sick people can't stay on life support forever. We had to make that decision with both my dad and mother in law.

[thucythucy]

45. I find this sort of discussion absolutely terrifying.

I know and love people with severe disabilities, some of them on ventilators.

To say "at some point, they will have to come off the ventilators" is only true because we have a shortage of ventilators, which is entirely the fault of this fucked up administration. People can live for years being ventilated, and when done outside the context of an ICU it can be managed. One of my friends with muscular dystrophy was on a vent for more than two decades. He used a power wheelchair to get around. He had a wife, an apartment, a job he loved. He also had support from his local independent living center.

Sometimes I feel as though the disability rights movement never happened. Certainly, to imply, as this doctor does, that we should just start switching off the vents and see what happens--that kind of callousness scares the shit out of me.