My remarks today are my own direct experience and opinion and not of any institution where I
have cared for my patients.
COVID-19 treatment was a process driven by a top-down approach. Information, including treatment dictates, was imposed on physicians rather than openly discussed. We were confronted with concerning recommendations regarding when to intubate, what medications were being recommended for or against, including the recommendations against steroid use early in the pandemic. Many of these recommendations were incongruent with standard practice in medicine including early intubation if they required more than 6 lpm of supplemental oxygen. Fortunately, we were in agreement that seemed ill advised and ultimately steroids were a key component requiring an individualized approach.