The ultimate COVID thread

[Lawpy]

The discussion now is when all the ventilators are in use. Then what?
At that point we just wait for attrition and search from the ventilators. And then triage based on comorbidities.

what about using one ventilator for more than one patient in a modified setup?

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[Lawpy]

PulmCrit - Splitting ventilators to provide titrated support to a large group of patients

COVID-19 might out-strip the number of mechanical ventilators available to us. This has led to interest in using a single ventilator to support

emcrit.org

 

[pgg]

And in the midst of all this crisis, I guess the usual amount of GSWs, broken hips, threatened rupture AAAs, small bowel obstructions will magically heal themselves [sarcasm off]. Those folks will be competing for bedspace with Covid overflow. Lord help us.

That's what I keep telling my (mostly under age 50) friends who think this is no big deal. Or that the media is blowing it out of proportion to hurt Trump.

When their healthy ass gets T-boned in an intersection on their way to [insert social event] in defiance of shelter-in-place advisories, and they get hauled off to an emergency room that's overflowing with COVID-19 patients, maybe they'll acquire a clue. But probably not.

 

[anbuitachi]

The discussion now is when all the ventilators are in use. Then what?
At that point we just wait for attrition and search from the ventilators. And then triage based on comorbidities.

at this point we are already asking and receiving ventilators from less hit hospitals in our health system to ship us over some of their extra vents.

 

[radsisrad]

This thing is bigger then trump. I it keeps up for any amount of time it will be the defining story of our lifetime. What do you think Obama or Clinton would have done differently? We live in a free society with easy international travel. By the time China realized it had a problem this virus was already here....
Europe is not doing any better and they don’t have trump....

People like to point fingers at others whom they a;ready dislike, and Trump bears the brunt of public ire for precisely this reason. Of course, it's politically-incorrect to point out that the cause for this global catastrophe is either disgusting eating/hygiene habits in a certain part of the world or extraordinarily poor quality control in that same country's labs... so people need to resort to displacement on an acceptable object (our president).

If I were he, I would not have played down the virus in the beginning, but we were truly operating in uncharted waters for quite a bit of time. People also are prone to forget the fact that there have been strong arguments from highly intelligent people on all sides of virtually every debate regarding the best approach(es) toward this pandemic.

I agree with the poster above who wrote that authoritarianism is a key component of a strong national response. There is no way to deal with this in a large society other than with brute force. I live near a large US city (not exactly a locale awash with MAGA signs), and I know that compliance with the principles of self-isolation are abysmal. This country was doomed to suffer badly from COVID19, and it has more to do with the population/culture than it does with a particular administration.

 

[pgg]

Do you think our preparation and response to this was adequate?

No. But preparation and response to black swan events are never adequate. They can't be.

There are always mistakes, errors, oversights that set the stage for them to occur, or be worse than they "had to be" according to some arbitrary yardstick. There are always voices that warned ahead of time.

I can't look at that map and convince myself that any level of preparation, or even a perfect response (whatever that might have looked like) would have prevented any of those red dots from blossoming in North America.

If Pakistan lost control of a bomb and some terrorists melted Manhattan, we'll be talking about how Pakistan has been mismanaged since 2001, how three administrations had their heads in the sand, and how our preparation and response was inadequate. There's been no shortage of voices warning about Pakistan's weak civilian government, the de-facto military dictatorship actually in control, its pandering to Islamic extremists, its eternal stupid Kashmir pissing match with fellow nuclear power India, the shoddy controls of its nuclear arsenal. Those criticisms would be true, but Manhattan would still be slag.

This has certainly given us yet another window into the mess of high turnover understaffed dysfunction of this administration. But I suspect we're going to look back on this and understand that there was no stopping it, that no plausible level of preparation could have prevented it. That many things coulda shoulda been done to mitigate it, or #flattenthecurve. Half the population of the world or more is going to catch this virus in the next couple years no matter what we do. The world doesn't have 330K cases in every country (except North Korea, naturally!) because every head of state is an idiot. Event though some are.

 

[chocomorsel]

at this point we are already asking and receiving ventilators from less hit hospitals in our health system to ship us over some of their extra vents.

At least you are hoping. Let’s not find out.

 

[chocomorsel]

At least you are hoping. Let’s not find out.

How about we move this over to the clinical discussions side since this one is 24 pages and about economy?

 

[vector2]

People like to point fingers at others whom they a;ready dislike, and Trump bears the brunt of public ire for precisely this reason. Of course, it's politically-incorrect to point out that the cause for this global catastrophe is either disgusting eating/hygiene habits in a certain part of the world or extraordinarily poor quality control in that same country's labs... so people need to resort to displacement on an acceptable object (our president).

If I were he, I would not have played down the virus in the beginning, but we were truly operating in uncharted waters for quite a bit of time. People also are prone to forget the fact that there have been strong arguments from highly intelligent people on all sides of virtually every debate regarding the best approach(es) toward this pandemic.

I agree with the poster above who wrote that authoritarianism is a key component of a strong national response. There is no way to deal with this in a large society other than with brute force. I live near a large US city (not exactly a locale awash with MAGA signs), and I know that compliance with the principles of self-isolation are abysmal. This country was doomed to suffer badly from COVID19, and it has more to do with the population/culture than it does with a particular administration.

It would be a lot easier for trump and his administration to play the victim and continue blaming others if he wasnt on tape for the last 2 months downplaying the seriousness and acting like a totally unprepared, irresponsible idiot.





I do agree tho that we have far too many people not taking this seriously and not following principles of self-isolation, including Rand Paul who continued using the Senate gym while awaiting his (eventually positive) covid test.

 

[dhb]

Mark my words, people. It will be a sh-tfest! Just a couple of weeks from now, we'll need as much psych support as the millennials.

Patients will be dying in droves, we'll be denying care to senior citizens to save the younger ones, and we'll be running out of all kinds of resources, including human ones, unless some miracle happens and the idiots in charge curfew the cities. Even then, it will take a month to really feel the results.

Is the US really going to have 100x more deaths thna the rest of the world?

 

[nimbus]

No. But preparation and response to black swan events are never adequate. They can't be.

There are always mistakes, errors, oversights that set the stage for them to occur, or be worse than they "had to be" according to some arbitrary yardstick. There are always voices that warned ahead of time.

View attachment 299431

I can't look at that map and convince myself that any level of preparation, or even a perfect response (whatever that might have looked like) would have prevented any of those red dots from blossoming in North America.

If Pakistan lost control of a bomb and some terrorists melted Manhattan, we'll be talking about how Pakistan has been mismanaged since 2001, how three administrations had their heads in the sand, and how our preparation and response was inadequate. There's been no shortage of voices warning about Pakistan's weak civilian government, the de-facto military dictatorship actually in control, its pandering to Islamic extremists, its eternal stupid Kashmir pissing match with fellow nuclear power India, the shoddy controls of its nuclear arsenal. Those criticisms would be true, but Manhattan would still be slag.

This has certainly given us yet another window into the mess of high turnover understaffed dysfunction of this administration. But I suspect we're going to look back on this and understand that there was no stopping it, that no plausible level of preparation could have prevented it. That many things coulda shoulda been done to mitigate it, or #flattenthecurve. Half the population of the world or more is going to catch this virus in the next couple years no matter what we do. The world doesn't have 330K cases in every country (except North Korea, naturally!) because every head of state is an idiot. Event though some are.

Still too early to tell but there is this.

And look at Netherlands. The response matters.

 

[narcotics999]

Still too early to tell but there is this.

View attachment 299433


And look at Netherlands. The response matters.

do you believe the # in california?

 

[Mman]

Is the US really going to have 100x more deaths thna the rest of the world?

the rest of the world is going to have a lot more deaths coming up

 

[JiPo]

Futures already hit the limit down within 15 minutes of opening. Going to be another bloodbath tomorrow.

 

[nimbus]

do you believe the # in california?

No. Both NY and Ca have much higher numbers. I’m taking call tonite in Ca. Hopefully my shift is not like @anbuitachi’s.

 

[Lawpy]

I found this from an article:

"Cuomo called on the federal government to nationalise the acquisition of medical supplies, warning that the private sector was engaging in “price gouging”. Masks to protect wearers from the virus normally cost 85 cents but were now selling for $7 as states were forced to compete with each other."

 

[deleted941485]

I found this from an article:

"Cuomo called on the federal government to nationalise the acquisition of medical supplies, warning that the private sector was engaging in “price gouging”. Masks to protect wearers from the virus normally cost 85 cents but were now selling for $7 as states were forced to compete with each other."

I don’t understand. He wants to set up a single purchaser? Ok why? So he can bid 1 dollar on a mask. You’ll probably still run into the same problem not enough masks.

 

[Wkrdoc]

It would be a lot easier for trump and his administration to play the victim and continue blaming others if he wasnt on tape for the last 2 months downplaying the seriousness and acting like a totally unprepared, irresponsible idiot.





I do agree tho that we have far too many people not taking this seriously and not following principles of self-isolation, including Rand Paul who continued using the Senate gym while awaiting his (eventually positive) covid test.

Just stop

 

[Wkrdoc]

Will someone show me where experts think we are on the bell curve versus Italy?

 

[deleted941485]

Futures already hit the limit down within 15 minutes of opening. Going to be another bloodbath tomorrow.

Honestly why the hell haven’t they shut this down yet? The limit down nonsense seems completely ridiculous.

 

[GravelRider]

No. But preparation and response to black swan events are never adequate. They can't be.

There are always mistakes, errors, oversights that set the stage for them to occur, or be worse than they "had to be" according to some arbitrary yardstick. There are always voices that warned ahead of time.

View attachment 299431

I can't look at that map and convince myself that any level of preparation, or even a perfect response (whatever that might have looked like) would have prevented any of those red dots from blossoming in North America.

If Pakistan lost control of a bomb and some terrorists melted Manhattan, we'll be talking about how Pakistan has been mismanaged since 2001, how three administrations had their heads in the sand, and how our preparation and response was inadequate. There's been no shortage of voices warning about Pakistan's weak civilian government, the de-facto military dictatorship actually in control, its pandering to Islamic extremists, its eternal stupid Kashmir pissing match with fellow nuclear power India, the shoddy controls of its nuclear arsenal. Those criticisms would be true, but Manhattan would still be slag.

This has certainly given us yet another window into the mess of high turnover understaffed dysfunction of this administration. But I suspect we're going to look back on this and understand that there was no stopping it, that no plausible level of preparation could have prevented it. That many things coulda shoulda been done to mitigate it, or #flattenthecurve. Half the population of the world or more is going to catch this virus in the next couple years no matter what we do. The world doesn't have 330K cases in every country (except North Korea, naturally!) because every head of state is an idiot. Event though some are.

I’m not saying that this could have been prevented or that it wasn’t inevitable the moment that dude ate that bat in China. I am not talking about the numbers infected or the seriousness of the disease itself. What I am saying is we wasted weeks, not days, in responding to this. First we were trying to decide if this was a liberal media hoax then when we realized this was a real thing we wasted more time fumbling with tests. In a moment like this you need a leader that can make swift and decisive responses. We did not have such a leader. Instead we had someone trying to politicize this at his rallies.

Time is/was of the essence in an event like this. If our healthcare system gets overwhelmed...and it looks as if NYC is about to be overwhelmed...it will be because we wasted weeks in responding to this. Those wasted weeks will translate into thousands, if not tens of thousands of deaths...many unnecessary.

 

[Mad Jack]

what about using one ventilator for more than one patient in a modified setup?

Not possible. To do independent lung ventilation you need two ventilators for one patient, to give you an idea of how not possible it is. Basically the way the valves and triggers and everything else works, it would be impossible on multiple levels due to the problems it would create with synchronization, even if the patients were paralyzed (as people have varying pulmonary resistance and compliance, different ventilatory requirements, etc).

 

[deleted941485]

Not possible. To do independent lung ventilation you need two ventilators for one patient, to give you an idea of how not possible it is. Basically the way the valves and triggers and everything else works, it would be impossible on multiple levels due to the problems it would create with synchronization, even if the patients were paralyzed (as people have varying pulmonary resistance and compliance, different ventilatory requirements, etc).

Yeah I don’t understand how a vent splitter would even work well.

 

[BLADEMDA]

Honestly why the hell haven’t they shut this down yet? The limit down nonsense seems completely ridiculous.

The stock market is absolutely crashing again. The s and p level of 2150 will likely be blown right through on the way to 2,000.The S and P level of 1850 is looking more and more like a key level of support. But, if the panic continues we won't have a stock market in 2-3 weeks.

 

[Wkrdoc]

The stock market is absolutely crashing again. The s and p level of 2150 will likely be blown right through on the way to 2,000.The S and P level of 1850 is looking more and more like a key level of support. But, if the panic continues we won't have a stock market in 2-3 weeks.

This is getting scary

 

[Mman]

Honestly why the hell haven’t they shut this down yet? The limit down nonsense seems completely ridiculous.

shut down what? A market exists so people can buy and sell as they see fit. It only benefits investors for a market to remain open. You think people needing cash would like it if their mutual fund shares could not be redeemed?

 

[Ronin786]

The stock market is absolutely crashing again. The s and p level of 2150 will likely be blown right through on the way to 2,000.The S and P level of 1850 is looking more and more like a key level of support. But, if the panic continues we won't have a stock market in 2-3 weeks.

This right here is my theory as to why we haven't enacted the defense protection act. Trump is still worried that he's going to signal to the market that **** has hit the fan.

 

[BLADEMDA]

We’re at a point where the market needs to rally soon to interrupt the mechanistic selling spiral, where a fast and vicious rally of even 10-15% would look like a mere rote bounce on a chart.

And we’re at a spot where, if the S&P fails to hold current levels near 2300, the popular next downside technical target of 2150 might not even seem all that scary because it’s “only” 6.7% lower - less than half what was lost last week alone.

Breaking down this sell-off, among the most extreme and rare Wall Street has ever seen

We're at a point where the market needs to rally soon to interrupt the mechanistic selling spiral.

www.cnbc.com

 

[BLADEMDA]

This is getting scary

I am now buying stocks at the Goldman predicted low of 2,000. I still think 1850 is the best support level because that was the number it held for quite some time 6-7 years ago.

If we fall below 1850 then this will be much worse than the market crash of 2008/2009.

 

[BLADEMDA]

if markets cannot hold above the 2,351 level and instead break and hold below, Maley warns that it could be a steep decline back to lows not seen since early 2016 at around 1,829. A drop to that level would represent a total 46% fall from records set a month ago.

 

[BLADEMDA]

Once we drop below 2150 the next major support is 1850 then 1600.

 

[Wkrdoc]

I am now buying stocks at the Goldman predicted low of 2,000. I still think 1850 is the best support level because that was the number it held for quite some time 6-7 years ago.

If we fall below 1850 then this will be much worse than the market crash of 2008/2009.

Does this correlate with about 16k for the Dow?

 

[Wkrdoc]

We are going to lose 50% on this deal

 

[BLADEMDA]

Forecasts for Dow and S&P 500 'lows'
It’s the job of top strategists at Wall Street firms to crunch numbers related to economic growth and corporate earnings and predict how bad bear markets will get. And recent market calls from stock gurus suggest more losses are coming.

This past Friday, Goldman Sachs said it expected a mid-year low of 2,000 for the S&P 500, which equates to a further 17% drop from Wednesday’s close of 2,398 — and a total bear market decline of 41% from the Feb. 19 record close of 3,386.15. (Don’t panic, though. The firm sees the broad market gauge rebounding and ending the year at 3,200.)

Similarly, Credit Suisse’s worst-case scenario is a 20% drop in U.S. corporate earnings which would drive the S&P 500 down to 2,200, a decline of 8% from Wednesday’s close.

 

[Wkrdoc]

This right here is my theory as to why we haven't enacted the defense protection act. Trump is still worried that he's going to signal to the market that **** has hit the fan.

If we don’t find some bipartisan cooperation this deal might change the course of history.

This is what I was worried about weeks ago, overreacting could crash the entire economy and it appears that’s exactly where we are headed.

 

[BLADEMDA]

Does this correlate with about 16k for the Dow?

Yes. 45% from the all time high is right around 16,000 in the DOW. That is a good place to really start buying stocks: 16,300

 

[BLADEMDA]

If we don’t find some bipartisan cooperation this deal might change the course of history.

This is what I was worried about weeks ago, overreacting could crash the entire economy and it appears that’s exactly where we are headed.

The market is in a free for all downward spiral. Once we hit 2150 (this week) the market will quickly test 2,000. I do hope we bounce a bit at these levels or 1850 here we come.

 

[Wkrdoc]

Yes. 45% from the all time high is right around 16,000 in the DOW. That is a good place to really start buying stocks: 16,300

That’s my target. Wasn’t sure if we’d get there, now it’s looking very likely

 

[Mad Jack]

The stock market is absolutely crashing again. The s and p level of 2150 will likely be blown right through on the way to 2,000.The S and P level of 1850 is looking more and more like a key level of support. But, if the panic continues we won't have a stock market in 2-3 weeks.

1350 my friend. That is the bottom

 

[nimbus]

I am now buying stocks at the Goldman predicted low of 2,000. I still think 1850 is the best support level because that was the number it held for quite some time 6-7 years ago.

If we fall below 1850 then this will be much worse than the market crash of 2008/2009.

This is much worse than 2008.

 

[Money-Moniker]

Bet no one in the administration was thinking of this last year in their fervor for more tariffs....


“ WASHINGTON (Reuters) - The U.S. Trade Representative’s office in recent days granted exclusions from import tariffs for dozens of medical products imported from China, including face masks, hand sanitizing wipes and examination gloves, filings with the agency showed on Friday.

...

Medline International Inc has already received exclusions on 30 products ranging from surgical gowns to face masks and medicine cups, most of which the company applied for at the end of January. A number of the exclusions were granted on Thursday, USTR documents showed.

The products were included in a fourth round of tariffs on Chinese goods imposed by Trump on Sept. 1, 2019, amid heated U.S.-China trade negotiations.

The tariff rate on the medical products was initially set at 15%, but was lowered to 7.5% on Feb. 15 as part of the Phase 1 U.S.-China trade agreement. The deal leaves in place tariffs on about $370 billion worth of imports from China, including 25% duties on goods valued at around $250 billion.”

U.S. excludes Chinese face masks, medical gear from tariffs as coronavirus spreads

The U.S. Trade Representative's office in recent days granted exclusions from import tariffs for dozens of medical products imported from China, including face masks, hand sanitizing wipes and examination gloves, filings with the agency showed on Friday.

www.reuters.com

You have it exactly backwards though. We are up chit's creek without a paddle precisely because manufacturing has been offshored to Asia. This is why it seems like every single one of East Asia's 1.5 billion plus inhabitants is wearing a new mask every day while here in the land of the "service economy" we can't even get them for our healthcare workers and first responders. It is also why China is able to threaten us with stopping shipments of critical medical equipment and pharmaceuticals, on whose importation we are completely reliant.

The current crisis has exposed to the public eye what has been blatantly obvious for decades to anyone who cared to look into the issue: the loss of manufacturing, besides being economically ruinous, is also a grave national security threat. Imposing tariffs on high value added and critical industries is precisely what needs to be done in order to ameliorate this situation and end our reliance on potentially hostile governments. Literally the only good thing that can potentially come out of the current crisis is that it will serve as an impetus to accelerate the process of bringing manufacturing back to the USA, whether through tariffs or outright government diktat.

 

[pgg]

Geez Blade, you're talking numbers again, with complete confidence, that are completely different than the numbers you were completely confident about a week ago, which were completely different than the week before that.

 

[nimbus]

Will someone show me where experts think we are on the bell curve versus Italy?

 

[vector2]

You have it exactly backwards though. We are up chit's creek without a paddle precisely because manufacturing has been offshored to Asia. This is why it seems like every single one of East Asia's 1.5 billion plus inhabitants is wearing a new mask every day while here in the land of the "service economy" we can't even get them for our healthcare workers and first responders. It is also why China is able to threaten us with stopping shipments of critical medical equipment and pharmaceuticals, on whose importation we are completely reliant.

The current crisis has exposed to the public eye what has been blatantly obvious for decades to anyone who cared to look into the issue: the loss of manufacturing, besides being economically ruinous, is also a grave national security threat. Imposing tariffs on high value added and critical industries is precisely what needs to be done in order to ameliorate this situation and end our reliance on potentially hostile governments. Literally the only good thing that can potentially come out of the current crisis is that it will serve as an impetus to accelerate the process of bringing manufacturing back to the USA, whether through tariffs or outright government diktat.

There is no universe in which we are the economy of the future, we pay our workers highly, and it's based on manufacturing cheap medical products. All the tariffs did for these goods (and many other essential but relatively easy to make items) is reduce supply because domestic suppliers know that there is no way on earth a hospital can afford to pay 10x the cost for American vs. foreign manufactured facemasks. We win by creating the jobs of the future- not starting a trade war so we can have our workers competing against some Thai sweatshop worker making $2 an hour.

 

[BLADEMDA]

Geez Blade, you're talking numbers again, with complete confidence, that are completely different than the numbers you were completely confident about a week ago, which were completely different than the week before that.

I am not confident at all. All I do know is that the market is going lower. I have posted that my initial assessment of an S and p 500 of 2500 was way too optimistic. I was hoping 2350 (Dec 2018 low) would hold. That low is NOT going to hold so the bottom is going to be much lower.

FFP and others were correct in posting this pandemic would wreak havoc on the USA. That havoc continues as does the fear/panic on Wall Street. All I can say is that stocks are a fantastic buy at 2150 but an even better buy at 1850.

I am very optimistic about 2021 but not so much about this year. This will be a painful year for anyone needing to sell equities at this point to raise cash.

I am going to find this post in a year and prove to you that stocks at 2150 were a great buy no matter how low they may go over the next 1-6 weeks.

 

[Ronin786]

If we don’t find some bipartisan cooperation this deal might change the course of history.

This is what I was worried about weeks ago, overreacting could crash the entire economy and it appears that’s exactly where we are headed.

The DPA doesn't need bipartisan support though.

 

[Money-Moniker]

There is no universe in which we are the economy of the future, we pay our workers highly, and it's based on manufacturing cheap medical products. All the tariffs did for these goods (and many other essential but relatively easy to make items) is reduce supply because domestic suppliers know that there is no way on earth a hospital can afford to pay 10x the cost for American vs. foreign manufactured facemasks. We win by creating the jobs of the future- not starting a trade war so we can have our workers competing against some Thai sweatshop worker making $2 an hour.

You are simply misinformed about the realities of manufacturing in the present day. Labor costs are now almost irrelevant to the production of things like pharmaceuticals, chemicals, and advanced medical products. I'm not going to get into the weeds here on a topic that requires thousands of words to address, but I'll just say it's utterly ridiculous that this country spends tens of billions of dollars on pharmaceutical research only to then depend on foreign nations for the damn physical pills that this research made possible. This is a situation that must and will change as a result of the current crisis. The fact that China is taking advantage of the strong hand offshoring has given it and threatening to kill hundreds of thousands of our citizens by witholding medical supplies makes me very certain of this.

 

[Mad Jack]

Yeah I don’t understand how a vent splitter would even work well.

Hospital turns its one ventilator into nine with some DIY mechanics

Dr Alain Gauthier, , an anesthetist at the Perth and Smiths Falls District Hospital in Ontario, Canada, learned how to rig the ventilator by watching YouTube videos created by two Detroit doctors.

www.dailymail.co.uk

Evidently this guy is doing it but I have no idea how it works with dead space and everything

 

[pgg]

I am not confident at all. All I do know is that the market is going lower. I have posted that my initial assessment of an S and p 500 of 2500 was way too optimistic. I was hoping 2350 (Dec 2018 low) would hold. That low is NOT going to hold so the bottom is going to be much lower.

FFP and others were correct in posting this pandemic would wreak havoc on the USA. That havoc continues as does the fear/panic on Wall Street. All I can say is that stocks are a fantastic buy at 2150 but an even better buy at 1850.

I am very optimistic about 2021 but not so much about this year. This will be a painful year for anyone needing to sell equities at this point to raise cash.

I have to admit, I'm having trouble not moving my AA to 80/20 or 90/10 or even 100/0 while this is going on. It'll be many years before I need or want to sell any equities.

 

[pgg]

Hospital turns its one ventilator into nine with some DIY mechanics

Dr Alain Gauthier, , an anesthetist at the Perth and Smiths Falls District Hospital in Ontario, Canada, learned how to rig the ventilator by watching YouTube videos created by two Detroit doctors.

www.dailymail.co.uk

Evidently this guy is doing it but I have no idea how it works with dead space and everything

That guy is a knucklehead, there's no way you'll ever get 9 people in the same room, much less ventiliated on one wimpy little anesthesia machine vent.

There's a better explanation of it here

PulmCrit - Splitting ventilators to provide titrated support to a large group of patients

COVID-19 might out-strip the number of mechanical ventilators available to us. This has led to interest in using a single ventilator to support

emcrit.org

Dead space per patient doesn't change - the space distal to the Y on each patient is unchanged. You split with some T pieces, put it on pressure control, and provided both patients have comparable lung compliance (not a trivial assumption), you get comparable tidal volumes to each patient. Move the sampling line from patient to patient to check CO2 levels intermittently, maybe tolerate some hypercapnia here and there, suppress any spontaneous breaths with opioids or vecuronium, it could work.