Grandstand. New York doctors are at the forefront of a terrible war. At the end of March, there were 950 people infected with Covid-19 in the city. On April 6, there were over 130,000 and the toll continues to grow.
In the United States, it is estimated that to overcome the disease, almost a million Americans may need an artificial respirator. However, the country only has around 180,000 such machines. The White House has promised more, but considerations of low politics block the realization of this project.
Doctors are therefore forced to familiarize themselves with disaster medicine. They must determine which patients should be treated, given artificial respiration, or given priority in resuscitation and, conversely, who will not receive such care. These unsustainable decisions made these doctors the heirs of Baron Dominique-Jean Larrey (1766-1842), the chief surgeon of the imperial guard of Napoleon who developed in 1792 the principle of "Sorting" to decide which wounded soldiers should be treated and which could no longer be saved.
Some excluded patients
In 2015, New York State issued recommendations for the allocation of artificial respirators, based on laboratory tests on various organs, such as the kidneys and the pancreas. Coma patients, who no longer respond to pain or speech, are given lower priority. First, those who are most likely to die without these respirators and who are most likely to survive are treated. Certain patients will be excluded, especially those whose cancer or Alzheimer's have reached an advanced stage.
These recommendations have not yet been put into practice and several questions may arise, should they be used. Our political leaders have still not transcribed them into law, some oppose them for fear that the public will see the hospital commissions in charge of sorting as death panels, "death committees" (expression popularized by the ultra-conservative right).
In any event, patients and their families may not be able to appeal the decisions of the commissions already established by some hospitals to prepare for a possible shortage of artificial respirators.
For several weeks already, doctors have had to make difficult decisions, such as whether or not to try to resuscitate patients suffering from Covid-19 already on artificial respiration and whose heart or lungs have stopped working. In Britain, two-thirds of people on artificial respiration suffered and died from heart or respiratory failure.
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