From World Economic Forum
'Every ventilator becomes like gold' - doctors give emotional warnings from Italy's Coronavirus outbreak
Last updated 10 March 2020.
- Italian doctors are taking to social media to share what it's like to work at hospitals battling coronavirus.
- One doctor warned against complacency in a country where more than 7,000 people have been infected by COVID-19.
- The whole of Italy is now under quarantine measures to curb the spread of the virus.
As COVID-19, or the coronavirus, spreads across Europe, responses are mixed. While World Health Organization (WHO) guidance underscores the seriousness of the situation and some employers encourage people to work from home, for many people life simply continues as normal.
But one doctor who is at the heart of the outbreak in Bergamo, northern Italy, has taken to social media to issue an emotional warning on the reality that could await elsewhere if complacency wins.
But one doctor who is at the heart of the outbreak in Bergamo, northern Italy, has taken to social media to issue an emotional warning on the reality that could await elsewhere if complacency wins.
At the time of writing, the whole of Italy is under quarantine measures as it battles to contain an epidemic that has infected more than 7,000 people and killed at least 463 in the country. According to the WHO, one-fifth of people infected need hospital treatment - and this could be enough to overwhelm healthcare systems if the epidemic spreads.
The flattened curve shows how a reduced rate of coronavirus infection could reduce the strain on hospitals
Image: Ester Kim, Carl T. Bergstrom
Dr Daniele Macchini, an Intensive Care Unit physician in Bergamo, a city near Milan, shared his experience of working in a hospital where exhausted staff battle to save patients. His Facebook post was picked up in an Italian newspaper and translated on Twitter by Dr Silvia Stringhini, an epidemiologist and researcher based at the Geneva University's Institute of Global Health.
Below is the text of the translation, which you can also read in the thread above. As context, 80% of people with coronavirus experience mild symptoms, but an acute form of the illness can lead to life-threatening pneumonia. The elderly are particularly vulnerable.
Dr Daniele Macchini's post, translated by Dr Silvia Stringhini
"After much thought about whether and what to write about what is happening to us, I felt that silence was not responsible.
"I will therefore try to convey to people far from our reality what we are living in Bergamo in these days of Covid-19 pandemic. I understand the need not to create panic, but when the message of the dangerousness of what is happening does not reach people I shudder.
"I myself watched with some amazement the reorganization of the entire hospital in the past week, when our current enemy was still in the shadows: the wards slowly 'emptied', elective activities were interrupted, intensive care were freed up to create as many beds as possible.
"All this rapid transformation brought an atmosphere of silence and surreal emptiness to the corridors of the hospital that we did not yet understand, waiting for a war that was yet to begin and that many (including me) were not so sure would ever come with such ferocity.
"I still remember my night call a week ago when I was waiting for the results of a swab. When I think about it, my anxiety over one possible case seems almost ridiculous and unjustified, now that I've seen what's happening. Well, the situation now is dramatic to say the least.
"The war has literally exploded and battles are uninterrupted day and night. But now that need for beds has arrived in all its drama. One after the other the departments that had been emptied fill up at an impressive pace.
"The boards with the names of the patients, of different colours depending on the operating unit, are now all red and instead of surgery you see the diagnosis, which is always the damned same: bilateral interstitial pneumonia.
"Now, explain to me which flu virus causes such a rapid drama. [post continues comparing Covid19 to flu, link here]. And while there are still people who boast of not being afraid by ignoring directions, protesting because their normal routine is 'temporarily' put in crisis, the epidemiological disaster is taking place. And there are no more surgeons, urologists, orthopedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us.
"Cases are multiplying, we arrive at a rate of 15-20 admissions per day all for the same reason. The results of the swabs now come one after the other: positive, positive, positive. Suddenly the E.R. is collapsing.
"Reasons for the access always the same: fever and breathing difficulties, fever and cough, respiratory failure. Radiology reports always the same: bilateral interstitial pneumonia, bilateral interstitial pneumonia, bilateral interstitial pneumonia. All to be hospitalized.
"Someone already to be intubated and go to intensive care. For others it's too late... Every ventilator becomes like gold: those in operating theatres that have now suspended their non-urgent activity become intensive care places that did not exist before.
"The staff is exhausted. I saw the tiredness on faces that didn't know what it was despite the already exhausting workloads they had. I saw a solidarity of all of us, who never failed to go to our internist colleagues to ask, 'What can I do for you now?'
"Doctors who move beds and transfer patients, who administer therapies instead of nurses. Nurses with tears in their eyes because we can't save everyone, and the vital parameters of several patients at the same time reveal an already marked destiny.
"There are no more shifts, no more hours. Social life is suspended for us. We no longer see our families for fear of infecting them. Some of us have already become infected despite the protocols.
"Some of our colleagues who are infected also have infected relatives and some of their relatives are already struggling between life and death. So be patient, you can't go to the theatre, museums or the gym. Try to have pity on the myriad of old people you could exterminate.
"We just try to make ourselves useful. You should do the same: we influence the life and death of a few dozen people. You with yours, many more. Please share this message. We must spread the word to prevent what is happening here from happening all over Italy.
"I finish by saying that I really don't understand this war on panic. The only reason I see is mask shortages, but there's no mask on sale anymore. We don't have a lot of studies, but is it panic really worse than neglect and carelessness during an epidemic of this sort?"
AND ONE MORE THING FROM SNOPES:
https://www.snopes.com/fact-check/trump-fire-pandemic-team/
AND ANOTHER THING (if you saw the mess of a news conference this afternoon: https://www.joemygod.com/2020/03/google-trump-just-lied-about-us-building-a-site/
AND ONE MORE THING FROM SNOPES:
https://www.snopes.com/fact-check/trump-fire-pandemic-team/
AND ANOTHER THING (if you saw the mess of a news conference this afternoon: https://www.joemygod.com/2020/03/google-trump-just-lied-about-us-building-a-site/
5 comments:
That's what we're actively trying to do in Canada -- flatten the curve. Virtually everything is shut down and people are staying home. Let's hope it works!
So many people here think that this is all hype and unnecessary closing down of everything they want to do. Then, when the precautions actually "work" they will say, "see, it was no big deal."
It is notoriously difficult to argue with belief in Infallible Authority, so I won't try. Though it seems quite obvious to me that the doctors and scientists are making up their Pronouncements as they go along. Yesterday, the CDC was saying no gatherings of more than 50 people. Today, it's down to 10 people. And this morning Clueless Leader says the Crisis may go on until July or August. I don't know about all that.
What I can say for certain. is that M.P. is already losing half a month's pay from his school-janitor job while the schools are closed - and no annual leave to cover that. That's a huge chunk of our combined income here in retirement. So tell me, who is going to pay our rent and our light bill? You? If not, who?
It's easy to be glib about things when they don't affect your own life one way or the other. It's quite another when they bite hard.
I'm not sure if you are saying I'm being glib or if that was just in general. I am well aware of the impact this is having on average working folk. It is unprecedented. Would it have been better to go about business as usual and have the hospitals and health care workers get overwhelmed? Perhaps. Then we all would (or some of us would) have our jobs, schools, and groceries. It would "thin the population" quickly and decisively. Is the general welfare worth a few thousand lives of senior citizens? Just posing questions.
There are proposals in the works to help people - social programs being supported by democrats AND republicans.
So far Leon is still employed but it's looking like he may be furloughed at some point. I have only SS for an income, but we have been frugal for so long that we have a cushion that should see us through. I hope you can get what you need to survive. There may be unemployment compensation for MP.
I didn't mean you in particular - but everyone I see on the media - and I avoid seeing more than I have to - seems to think it's just like a mental health day to tell everyone to stay home for 2 weeks - a month - who knows how long. Fine if you have leave to cover it. Or a nice cushion as you say. Or the Bank of Mom & Dad. Not everyone does, though. But since I commented, M.P. has said he *could* get unemployment - IF the janitors are officially laid off. No word yet on whether they will or not.
As to the big questions about hospitals and nurses and all of that, I have no answer. I am not yet certain that anyone does. But I'm sitting here counting canned goods and toilet paper rolls, wondering when the madness will stop. July? August? THIS senior citizen may be a statistic by then, ya know?
It's all too crazy to think about.
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