Regarding the treatment: I've really been wondering about that. Is there more standardization now? Less intubation right away? Are the obese housed in seated positions, or lying on their sides? It does seem the medical care at first was utterly chaotic.
Will we ever know the answers?
Outside of my professional wheelhouse but from what I can gather, yes! When our 'thought leaders' were screaming about more ventilators Trump ran out and forced new production. By the time they came online it was apparent that 80% of people put on them died. Not to say the ventilators themselves were the problem but certainly evidence of zero to negative effect.
It is my understanding they are using, in the most severe hospitalized cases, a regimen of intravenous anti-virals, steroids, fluids, vitamins and minerals as one might use to fight any viral infection or severe flu. But you'd have to check, I think there is still no standard protocol used universally and that's the fault of the CDC/NIH (Fauci!) who bet the farm on vaccines and spent next to nothing on treatments throwing everyone under the bus for a year.
I'll add there is more awareness of and use of ivermectin (and maybe HCQ+ therapy) earlier in the disease cycle, again after a year of a massive institutional push to try to classify these very old, very safe, widely used medications (both of which are classified by the WHO as essential medications for every country to have stockpiles) as some kind of danger to humanity.
From what I've read and from talking to our son, who works in an ER, here's what I've picked up:
There are a lot of very good clinicians worldwide who observe patients, try new things, and talk to each other. Treatments have improved along with our understanding of the disease. One key learning is that this disease has distinct phases, and that the treatment has to correspond to the phase. Timing is critical. Not all patients progress through all phases. For patients in early stages of the disease, there are anti-viral treatments and immune supports that can slow down viral replication and help patients fight the virus. If they progress to a more inflammatory and damaging phase of the disease, steroids are called for to dampen the excessive response.
We heard a lot about ventilators early on. People who got very sick weren't getting enough oxygen. Many never got off the ventilators alive. Clinicians realized that many patients had 'silent hypoxia' where the mechanics of breathing seemed to be working but they weren't getting enough oxygen. There was a vascular issue and oxygen absorption was impaired at capillary level. Ventilators, if improperly adjusted, could do more damage to lung tissue by forcing air into the lungs. Doctors began to favor less forceful means such as oxygen via nasal canula and positioning strategies. It was recognized that clotting was a problem for many patients, so anti-coagulants were added to the regimen.
A lot of good clinical work has been happening, attacking this with existing tools one symptom at a time. There are a lot of unsung heroes.