>>I suspect using scarce ICU beds for those most likely to recover would be the rational choice - I assume the under 50s have a far better outcome than the over 70s!
I would expect a combination of risk/survivability factors are taken into account, including discussion with the patient.
A large number of people with severe Covid are entirely alert despite being at death's door.
Very old/frail patients may/should be offered palliation rather than a protracted ICU stay with the possibility of survival and the likelihood of being increasingly disabled after even if they survive.
"Ceiling of Care" is the euphemism that appears to be used these days (eg. "ward level" would mean not for ICU). The same decisions are made every day, to be fair, even in General Practice - a failing care home resident may have a slim chance of recovery with full bhuna hospital care but it might not be in the patient's best interest (transfer to acute ward, different environment and staff, unpleasant treatments, etc). Best practice is of course to discuss with the patient, or to know the patient's wishes if they are unable to make an informed decision.
Almost everyone on a ventilator for any length of time suffers pneumonias and many suffer clots/strokes/sepsis/kidney failure before they perhaps recover, to wake up having had a tracheostomy and their bodies generally pretty wrecked.
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