We shouldn't overstate the need for ECMO, especially in regards to ventilator care, as Sweden only has 3 operational (soon to be 6) ECMOs total and all of them are in Stockholm. Yet Gothenburg still manages an 80%+ survival rate after ICU care. As I said, the differences in survival rate is probably attributable more to the medical decision about who to put in a ventilator then it is any particular proficiency or expertise in the medical and nursing community of that nation.
Because for all its other shortcomings, the main problem the US health care system faces right now is that the rest of the US society was not prepared and the US suffered a massive spike of Covid-19 patients. The health care system is left to cope with a ton of patients and not enough resources. And that's on top of the generally poor level of health of Americans (especially in terms of obesity, one of the major risk factors of Covid-19 complications) compared to Europeans or Chinese, which will likely make more US citizens die of Covid-19 then comparable populations.
At the same time though, I wouldn't want to compare much to Sweden, because Sweden is just letting their higher risk patients die. I would hope that would not be a model anyone would want to follow. Giving someone a death sentence by refusing to treat them is not exactly what anyone would consider an ideal model.
When we even manage to have 101 year old patient survive to return to her knitting, sometimes the risk assessment can be proven wrong, and those that have been denied care should not have their fates decided for them like that.
When you have higher risk populations, you should work harder to mitigate it via universal PPE distribution methods rather than denying care to those most at risk due to healthcare system being overwhelmed. I think how Germany has been doing a better job than most:
https://www.nytimes.com/2020/04/04/world/europe/germany-coronavirus-death-rate.html
ALSO:
“Number four, all things considered, the German health-care system and hospital system has been modernized by the Social Democrats and Christian Democrats over the last 20 years ... this meant we had more hospital beds, more ventilators, more ICU (Intensive Care Units) beds and more hospital doctors, roughly speaking, than any other comparable country in Europe ... So our system is in a reasonable shape for such an epidemic.”
Germany seems to be taking the epidemic in its stride with a high number of cases but a low number of deaths, thanks to a number of factors.
www.cnbc.com
"Germany is better equipped to treat seriously ill patients, with 28,000 intensive care beds, while in Italy there are only 5,000. In total, there are about 450,000 beds in all general hospitals in Germany. About 100,000 of these are currently empty. "
Experts see a number of possible reasons why Germany has fared better than Italy in the pandemic so far.
www.cbsnews.com
"A 50-year-old Chinese man who almost lost his life to Covid-19 was able to leave hospital on Friday after undergoing a complicated medical procedure known as extracorporeal membrane oxygenation. A 50-year-old man infected with the novel coronavirus was admitted to the intensive care unit at Tongji Hospital in Wuhan last month suffering with respiratory failure. Doctors put him on a ventilator, but his blood oxygen saturation remained dangerously low.
As the man was at a high risk of organ failure, the doctors opted to carry out a procedure known as extracorporeal membrane oxygenation (ECMO), which provides prolonged cardiac and respiratory support to people whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life.
After eight days, the machine was disconnected and the man was able to breathe on his own. Five days after that he was able to sit up in bed and feed himself. On Friday afternoon he was discharged from hospital.
The lack of availability of such life-saving techniques and equipment could be one of the reasons the death toll in Italy is so high. The country, which is now the epicentre of the pandemic, has had more than 4,032 fatalities from just over 47,021 confirmed infections – a mortality rate of about 8.5 per cent.
Chinese doctors use extracorporeal membrane oxygenation to rescue critically ill patient from verge of death.
www.scmp.com
To make it worse, because Germany did what they were supposed to do and stocked up early, they have other nations trying to take their supply:
Without health, all is nothing.
www.nytimes.com