In early March, most doctors in the United States had never seen a person sick with COVID-19. Four months later, nearly every emergency room and intensive care physician in the country is intimately familiar with the disease. In that time, they\u2019ve learned a lot about how best to treat patients. But in some cases, they\u2019re still taking the same approach they did in the spring. <\/p>\n

\u201cThere\u2019s so much that\u2019s different, and so much that\u2019s the same,\u201d says Megan Ranney, an emergency physician and associate professor at the Brown University Department of Emergency Medicine. <\/p>\n

For the first few months of the pandemic, recommendations for every incremental decision made in a hospital were changing faster than they ever have before. \u201cYou almost couldn\u2019t keep up \u2014 from one day to the next, your practice would change and your protocols would change. It was really disorienting for doctors and nurses,\u201d Ranney says. <\/p>\n

Information spread between colleagues, through medical education blogs and podcasts, and on social media. Doctors talked about new research on Twitter and shared new strategies in Facebook groups and on WhatsApp. If a suggestion that floated by a doctor in a Facebook group was low-risk and seemed like it might be helpful, it could be put into practice immediately. \u201cIf it\u2019s a small change, they could start using it the next day,\u201d she says. <\/p>\n

That\u2019s how the now-common practice of asking patients with COVID-19 to flip onto their stomachs spread: through word-of-mouth and on social media. When someone is on their back, their organs squish their lungs and make it harder for their airways to fully expand. When someone is on their stomach, their lungs have more room to fill up with air. The advice started circulating through the medical community before there was a formal, published study on the practice. <\/p>\n

Testing it out wouldn\u2019t have many downsides (it wasn\u2019t dangerous to patients), and it was easy to do. \u201cThere\u2019s this possibility that it could be positive, and there were a lot of stories about it having a positive effect,\u201d Ranney says. \u201cSo, it spread in a much more organic and quick way, because it was something that we could do, but we weren\u2019t worried it would hurt patients.\u201d<\/p>\n

Doctors like Seth Trueger, an assistant professor of emergency medicine at Northwestern University, saw the position help patients get enough oxygen to avoid needing a ventilator. \u201cI started jokingly call it \u2018tummy time,\u2019\u201d he says. Studies are starting to validate<\/a> those observations, finding that patients who spent time on their stomachs were, in fact, better off. <\/p>\n