As severe cases of COVID-19 spiked in northern Italy, emergency medicine doctor Marco Garrone paused during a chaotic shift to tweet a photo: two patients, next to each other in hospital beds, with arcs of tubing connecting them to the same ventilator. “This is what we are down to,” he wrote. “Splitting ventilators, and facing serious dilemmas like choosing who will be actually ventilated when everybody should. #TakeThisSeriously”

A month later, as caseloads skyrocketed across the pond in New York City, Columbia Presbyterian Hospital hurried to draft protocols for ventilator sharing. And around the same time, an emergency medicine doctor in Michigan named Charlene Babcock posted a YouTube tutorial featuring step-by-step directions on how to modify a ventilator so it can accommodate multiple patients. That video racked up nearly a million views in the ensuing weeks.

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