The underground doctors’ movement questioning the use of ventilators

In the 1780s, medical authorities largely agreed: insufflation of the rectum with tobacco smoke was the best treatment for near-drowning. Therefore, the Royal Humane Society lined the banks of the river Thames with tobacco smoke enema kits and rewarded heroic members of the public who used them to ‘save’ drowning victims.

It’s easy to laugh at their efforts. With our modern insistence on evidence-based medicine, we would never significantly invest in medical infrastructure that has not been proven beneficial by a randomised control trial. Except of course we have, and we continue to do so. No area of medicine is immune to these lapses. But it is my own specialty of life-support medicine where this has recently been thrown into the sharpest relief.

As I previously reported in the Spectator, there has never been a randomised control trial to show that sedating people with severe pneumonia in order to put a breathing tube down their throat (the process known as intubation), in order to hook them up to a mechanical ventilator is lifesaving at any particular point in their illness. Neither has there been such a trial in chimps, dogs, sheep or rats. Yet it is a firmly entrenched belief that intubation and ventilation are necessary once a patient requires a high level of supplemental oxygen. Or it was.

While most Western governments were in a mad dash to manufacture ventilators for Covid-19 pneumonia in March, a burgeoning movement within the medical community was starting to question their use. This movement largely operated outside of the traditional networks of academic journals and conferences. Rather, it used Twitter, YouTube, and even podcasts.

The first public statement from this clandestine movement seems to have come second-hand from the influential cardiologist and blogger, Dr John Mandrola: