The answer is not more ECMO (a machine to oxygenate the blood and bypass the lungs). We don’t have staff to care for basic nursing needs at this point. Cost of vaccine vs cost of ecmo in both dollars and the human cost of it are staggeringly different. In any disaster situation you are potentially faced with limited resources. Covid has created a disaster situation and those that have chosen not to vaccinate have compounded that. Limited resources means you use what you can on the most likely to survive. It sounds cold but it’s the reality. We are all doing our best and we aren’t rationing care based on vaccination status at this time but the unvaccinated are creating a situation where they are causing us to ration care in general. It sucks and the reality is we can’t save them all.