Well that's the big question.
The fact that the public is even involved in formulating solutions to the technical and medical response to the pandemic shows how desperate the situation is quickly becoming. If there are a million COVID-19 patients in the USA that need ventilators, a lot of people will die. No one knows who would have pulled through without a ventilator, or who will be killed by a bad improvised ventilator design.
The big question is: will things get desperate enough that lives will be risked on, what could likely be, often fatal, speculative treatments and devices?
Doctors are completely unaccustomed to making these kinds of decisions and judgment calls. They normally operate in an environment where they must adhere to a consensus standard of care supported by empirical medical evidence. They must use equipment that has the proper regulatory approvals. If they don't, they risk exposing themselves to liability and losing their license to practice medicine.
Now we are in a situation where there is simply going to be not enough resources for all of the patients that require respirators, which is a consensus standard of care of supportive therapy for Covid-19. Furthermore, we don't even have sufficient personal protective equipment for the doctors so that they can treat patients safely.
In this situation, the only feasible solution is to prevent infections by minimizing contact between individuals. It is clear that if no more respirators become available, and PPE product is not significantly increased, the likelihood of one being able to obtain life saving care is quite slim once these resources are exhausted.
So what to do? We can try to create improvised devices. It probably won't be known if they are safe and effective until they are tried on patients, and the results will be the patient survives or not. Is this type of experimentation acceptable under the circumstances? What are the alternatives?
This is not a 40 minute episode of House where his completely crazy speculative treatment always works by the end of the commercial break. Maybe we simply don't want to experiment on people who are dying, and it would be better to let them die. But then who decides the circumstances under which this kind of crude experimentation is permitted?
Even if a solution is found that works, if it requires resources that can not be scaled to apply the solution widely, then perhaps an experiment that risks the life of a patient is not worth performing because it will have little wider impact. So if we can 3-d print a ventilator, but it requires so much 3-d printing that it takes days to make all the parts and a ton of model material, maybe this is not a feasible solution. So to have an impact, the solution has to use materials and manufacturing methods that are widely available.
I don't know the answer to these questions. But the answer is somewhere between: if we can't produce something that works perfectly and is completely risk-free, it is not worth doing; and: we just have to throw everything at the wall and see what sticks. That is the situation and somehow there will have to be some kind of consensus about what risks are acceptable in a crisis stiuation like we find ourselves in.
I wouldn't like to be misunderstood nor do i want you to think that i'm just opposing your opinion because i like being hater.
However, i would like to point out few things that i thing are the problems which you don't see in this situation.
(p.s. i lived through the last war in Balkans for 3.5-4 years. I remember pretty well how things were functioning. In my place we had about 35-40k people in a very narrow place, between an Airport and a hill and that place was completely surrounded from all sides except for one road which was open for fire but was not blocked physically and could take you over the hill and to another part of the city. The hospital was in the basement of the building where i lived and i remember very clearly killed and wounded people and i also remember clearly in what conditions those doctors were doing their job as i was also a patient there at one point!)1. I take the assumption that this is really "emergency state". I don't want to discuss if it is or not.
2. Lack of patience in American people is a huge problem
3. Lack of basic life skills like cooking, proper cleaning, filtering water etc. I have many friends that moved in USA and i visited some of them in past period, very common discussion was how an average American have no clue about basic life skills. (i'm talking an average! not all!)
4. Due to insane expenses in your medical care, the values of proper care for big masses is impossible.
5. As the doctors are perceived to be "rich and smart", living very comfortable and sometimes even luxurious life in USA, maybe some of them would not be as available for service as emergency situation expects people to be. We have seen such thing happening in my city, some of the doctors were leaving as soon as they got a chance.
6. As i said in 4. The expenses are problem but in this situation it will completely destroy financial situation of an average people. So far we know that it takes about 3 weeks to recover, in a lot of cases it required most of that time to have the patient hospitalize, having in mind that an average day in a hospital in USA is about 3-4k, + additional services that would definitely be required in this situation, some of infected could be charged maybe even 100k for the service, especially when you have situation that insurance can simply cancel your contract and let you pay 100% of your expenses.
7. In USA you have very long history of "investors" that later on dictate the prices of the products. Sometimes the investors are great thing but sometimes you just have very immoral people so you get this:
Drug Goes From $13.50 a Tablet to $750, Overnight: https://www.nytimes.com/2015/09/21/business/a-huge-overnight-increase-in-a-drugs-price-raises-protests.html8. You have decades of scientific explorations and researches. Chasing references, papers to be published and chasing money for another research
JUST FOR THE SAKE OF MONEY AND POPULARITY WITHOUT ANY REALLY CONCERNS ABOUT WHAT AND WHY THEY WORK ON . That immoral and unethical approach to life and work brought you to this situation. That is why they charge you 400USD in NYC for COVID19 test instead to do it for 40$. As there is nothing which makes the 6.5$ costing test with import taxes to cost 400$!
I stay behind the prices that i mentioned as i have insight in prices in this situation.
9.
Using legal system in this situation to pressure your doctors maybe can make even more dead people as they would not maybe try some alternative help..
Remember, it if is emergency, there is no place for accusations and this is not engineering job, you can't evaluate and measure everything nor you can establish 100% correct procedures that would always be successful.
IMHO those are bigger problems for USA than wrong usage of ventilators.I remember nurses staying up hole night next to a patient, pumping in an air, stopping blood, doing some of the many smaller surgeries as sometimes, after the shelling of my place, there were 30+ people in a small hospital and only two experienced surgeons that took more serious wounds and were only overlooking some of nurses helping some other patients with light wounds. That is really emergency state and when rules change.Wish you all to stay healthy and to be safe.
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