Use of Combined Prone Positioning and High-Flow Nasal Cannula, and Non-invasive Positive Pressure Ventilation to Prevent Intubation in COVID-19 Infection

Inclusion Criteria: * Patients with confirmed COVID19 infection or suspected COVID19 infection. * Patients requiring HFNC or NIPPV * Patients who are clinically stable and able to tolerate the changes in position that are routinely conducted as part of the standard of care in the medical ICU. * Patient should be able to provide informed consent to the study. Any participant speaking any language will be offered participation. * Able to actively participate in Assisted Manual Pronation Therapy per nursing assessment. Exclusion Criteria: Contraindication for prone positioning: * Intracranial pressure \>30 mm Hg or cerebral perfusion pressure \<60 mmHg * Massive hemoptysis requiring an immediate surgical or interventional radiology procedure * Tracheal surgery or sternotomy during the previous 15 days * Serious facial trauma or facial surgery during the previous 15 days * Deep venous thrombosis treated for less than 2 days * Cardiac pacemaker inserted in the last 2 days * Unstable spine, femur, or pelvic fractures * Hemodynamic instability or severe cardiac arrhythmia (chronic AFib is not a contraindication). Mean arterial pressure lower than 60 mm Hg, \>1 vasopressor agent or Norepinephrine equivalent dose \>0.06 mcg/kg/min * Pregnant women * Single anterior chest tube with air leaks * Burns on more than 20 % of the body surface * Delirium or altered mental status increasing fall risk while in prone position. * End-of-life decision before inclusion * Subject deprived of freedom, minor, subject under a legal protective measure * Unable to actively participate in Assisted Manual Pronation Therapy per nursing assessment * Lacking capacity to provide informed consent. * Individuals with mechanical or vascular disease precluding safe displacement of the head, for example: cervical spinal fusion, limited range of motion, or severe vascular occlusive disease of the head and neck. * Body mass index (BMI) greater than 70 kg/m2, or unable to actively participate in Assisted Manual Pronation Therapy per nursing assessment at any BMI value.