Initially, the guidelines for treatment recommended that most critical COVID cases were to be treated as if they had acute respiratory distress syndrome (ARDS), which advises the use of ventilators. It is known however that ventilators can be very dangerous to patients and there have been many reports from doctors around the world, warning against the use of ventilators.

Among doctors who have come out publicly about the use of ventilators, is critical care doctor Dr Cameron Kyle-Sidelle. He was tasked with starting an intensive care unit in New York to for the sickest patients. After a few weeks in this unit, on 31 March 2020, he published a YouTube video, where he recounted how he was expecting to find patients with a virally-induced illness that would begin with mild symptoms and then progress to pneumonia and then ARDS, where ventilators could be used to assist the patients to breathe since their muscles would be too fatigued to do the work. Instead, he was finding that many patients appeared to have a condition akin to high altitude sickness, with oxygen-starved cells. While ARDS patients also have low oxygen and the disease does compromise the oxygen supply to the lungs, the patients he was seeing did not share the other ARDS symptoms. He cautioned that these patients did not respond well to being put on ventilators and that the incorrect treatment could cause a lot of harm. This set of symptoms must not be treated as pneumonia, he said.

In a New York Times video of 14 April 2020, more doctors express surprise that they are seeing patients exhibiting such low oxygen saturation levels. Italian Doctor Luciano Gattinoni also explains that they were finding about half the patients had the expected ARDS profile but about half had this different profile and if they weren’t treated differently it could lead to death. In a pinned comment, the producer noted that many doctors she had approached did not want to speak publicly, though they concurred.  Another (rare) doctor who ventilated publicly on this issue is Pulmonary and Critical Care Specialist Dr Hesham Hassaballa.