EM clinicians are seeing covid pts talking and alert with sats in the 60s.. Many are comparing the pathophysiology to HAPE as opposed to ARDS or High compliance vs a Low compliance disease state. These pts are being intubated very early and clinicians are using the ARDsNET table to target PEEP to the FiO2 requirements. With mortality at 50-80% when ventilated are we missing something here? Should we tolerate lower saturation goals? Should we hold off on intubation and employ a NIV approach? CPAP? HFNC?What is the O2 extraction like for pts with COVID these patients are rarely hypercarbic? what are the SVO2 samples like? Is it possible that the happy hypoxic COVID pt has acclimated to the disease state? Should we concentrate more on pulmonary vasodilation? Is anyone using epoprosternol?