A high-flow nasal cannula (HFNC) is commonly used in the management of hypoxic respiratory failure, and is associated with more ventilator-free days and lower mortality compared with standard oxygen therapy or non-invasive ventilation.

Nevertheless, its use in coronavirus disease 2019 (COVID-19) patients is complicated by the increased risk of particle dispersion (especially with coughing), potential depletion of oxygen supplies, and concerns that it is unlikely to change the natural course of viral pneumonia.

These factors have resulted in calls to forgo its use in favour of earlier intubation.

While these concerns are valid, they may have unintended consequences during the current pandemic.

Hospital policies directing earlier intubation of COVID-19 patients will accelerate consumption of intensive care unit (ICU) resources including ventilators, sedative medications, and human resources.

Lastly, creating a lower barrier to intubation and ICU admission obscures the true severity of the disease and distorts pandemic modeling.

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