At a press conference on Wednesday, New York state Health Commissioner Howard Zucker and Gov. Andrew Cuomo responded to a question about whether coronavirus patients may need another form of treatment instead of ventilators.
- Governor, there is an emergency room physician in New York City-- and I'm sure Dr. Zucker is going to comment on this too-- who says he's seeing a very high percentage of patients-- maybe 70%-- die who are put on ventilators. He is thinking the approach is all wrong. We need to rethink the protocol that these patients might not need the ventilators. They might need oxygen instead.
HOWARD ZUCKER: So I think-- I can't comment on exactly what they're saying. But the fact is when someone shows up in the emergency room, there's a handful of things that are going to take place. One is the oxygen is the initial therapy that someone needs. But the fact is that if someone's respiratory status gets worse, they're going to need respiratory support. The real question may be, is there other interventions that one can do. We are looking at what other possible therapies would be out there that could possibly be given earlier, and that's all experimental.
- Is it possible the ventilators might be doing more harm than good?
HOWARD ZUCKER: So, the issue with ventilators in general is that if you-- if someone goes on a ventilator and the governor has spoken about this before, about how long people stay on the ventilator-- the longer you stay on the ventilator, you end up potentially causing damage to a lung. It's a pressure that's being pushed into your lungs. And you're constantly putting pressure into those little air sacs in the lungs. It can damage them, and the high levels of oxygen also can damage your lungs. But the fact is, it's what's called the catch-22 in a lot of ways, which is where you need the ventilator, but if you're on it a long time, it can cause harm. That's why you try to get them off as fast as possible.
- Is this why, I'm curious, Boris Johnson is being treated with oxygen rather than a ventilator?
HOWARD ZUCKER: Excuse me? I'm--
- Or-- in Great Britain.
HOWARD ZUCKER: I can't comment on his case, but-- obviously because I don't know the information. But when someone comes in, the initial thing to do is to give someone oxygen by mask. And if someone gets worse, then you end up intubating them. What's happened with these patients is that they get-- they get worse relatively quickly. And so there's a lot of interventions that have to happen relatively quickly as well.
ANDREW CUOMO: I'm not a medical doctor, obviously. But, look. Nobody wants to put people on the ventilator. I've discerned that much. And I think these-- you're right. The percentage of people who go on the ventilator who never come off the ventilator is incredibly high. I've even heard like closer to 80%. I don't think the ventilator is doing that. I think that's why they're on the ventilator. They're doing the ventilator as basically a last resort. So when they put you on the ventilator, it's because everything else has failed, and that's why the mortality rate is so high on the ventilator. And that's what we're seeing here. That death rate is going up because it's the people who have been on a ventilator seven days, 10 days, 15 days. And they're passing away. So when we had that big increase in hospitalizations about 10 days ago, two weeks ago-- that big spike in hospitalizations-- what we're seeing is the people who went into the hospital on that day 10 days ago, 12 days ago, who didn't get better, who was put on a ventilator, is now passing away. And that's what's driving this death toll.