COVID-19 patients: when and whom to ventilate?

The coronavirus disease-19 (COVID-19) pandemic has severely strained intensive care unit (ICU) resources worldwide. It is estimated that a country like India with a population of 1.3 billion, has one doctor for every 1,457 individuals, 1.7 nurses per 1,000 people, approximately 1.9 million hospital beds, 95 thousand ICU beds, and 48 thousand ventilators. As the cases of severe acute respiratory syndrome (SARS) increase rapidly, finding ICU beds, ventilators, intensivists, and critical care nurses remains a big challenge. The need for mechanical ventilation in COVID-19 patients, however, remains a subject of debate. A Chinese study reported that invasive ventilation was required in only 2.3% of 1,099 COVID-19 positive patients.