See I Told You So: Breathing Treatments Do Not Spread COVID

It's crucial to acknowledge that not all aspects of healthcare are firmly rooted in scientific certainty. While our goal is to ensure that every decision is grounded in science, the reality is that some choices are made based on current knowledge gaps. Take, for instance, the assertion that breathing treatments could potentially spread viruses—a precautionary measure was advocated, despite a lack of evidence supporting this claim.

In this scenario, the decision-makers erred on the side of caution, recommending the use of N95 masks during breathing treatments as a preventive measure in case patients were carrying a virus. This decision was driven more by the absence of concrete evidence rather than by established scientific findings.

This coincided with protocols permitting the transition of breathing treatments to inhalers for all patients with the flu or COVID. The aim was to prioritize our safety and minimize the risk of transmitting these infectious agents to fellow staff members and patients.

While switching to inhalers is appropriate for most patients (as most people they are ordered on don't need them anyway), breathing treatments remain crucial for those with severe COPD or asthma, as I experienced firsthand with COVID. However, despite advocating for this on numerous occasions, such patients only received breathing treatments on MY shifts. Otherwise, inhalers were prioritized, ignoring both patient and doctor preferences. And this, in my humble opinion, was not what was best for the patient.

Much in healthcare is done not because of science, but because it sounds right. It sounds like a logical assumption that breathing treatments spread diseases. It sounds good that wearing N-95 masks while doing breathing treatments on flu or COVID patients will prevent the spread.

But, I have said all along that the logic here isn't right. For one thing, where is the evidence that breathing treatments aerosolize anything other than the medicine they are supposed to aerosolize. Likewise, I have said it lacks logic to change breathing treatments to inhalers on flu or COVID patients when you are already wearing an N-95 mask in their rooms anyway.

I consistently presented well-founded arguments in discussions with friends on this topic, steadfast in my position. 

Over the years, comprehensive studies have concluded, and their results have been interpreted. The findings unequivocally indicate no evidence supporting the idea that breathing treatments spread viruses. Consequently, there's been a revision in protocols—we're no longer permitted to switch breathing treatments to inhalers for COVID patients, and the mandatory use of N95 masks during all breathing treatments has been lifted. It's a satisfying moment to see my enduring stance validated by the outcome of scientific investigation. (1-3)

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However, we are still obligated to wear N95 masks when entering any room with a patient diagnosed with the flu or COVID—a safety measure that remains crucial for good reason. In practical terms, the recent scientific evidence supports my stance once again, and I find satisfaction in being vindicated.

I have no qualms about taking a moment to revel in this triumph.

References

1. Mohammed Abdelrahim, Ibrahim Mohamed Elshazli, and Maha M. A. Mohamed. "Guidance on nebulization during the current COVID-19 pandemic." National Institutes of Health (NIH), 24 August 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8104341/. Accessed 21 December 2023.
2. Nadeem O. Kaakeh, MD, and Amal I. S. Kaakeh, MD. "Aerosolization of COVID-19 and Contamination Risks During Respiratory Treatments." National Institutes of Health (NIH), 15 June 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336259/. Accessed 21 December 2023.
3. Amit Kumar Nayak, Sneha Padhi, and Debasish Kar. "Treatment of respiratory viral infections through inhalation therapeutics." Advanced Drug Delivery Reviews, 186 (2023): 114542. https://www.sciencedirect.com/science/article/pii/S109455392200061X. Accessed 21 December 2023.