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‘Hospitals are overwhelmed’: Italian doctors describe the struggle of fighting the coronavirus outbreak

Doctors at the centre of the coronavirus outbreak in northern Italy have spoken out about the struggles they face daily to help the huge number of patients now coming through hospital doors.

'Hospitals are overwhelmed': Italian doctors describe the struggle of fighting the coronavirus outbreak
An ambulance arrives at a coronavirus testing centre set up outside a hospital in Lombardy. Photo: Miguel Medina/AFP

As the number of confirmed cases of coronavirus continues to rise across Italy and the country adjusts to life under new quarantine measures, doctors at hospitals in Lombardy, the northern Italian region hit hardest by the outbreak, have described how the crisis is pushing hospitals and staff to breaking point.

MAP: Which parts of Italy have been hardest hit by coronavirus?

In an emotional Facebook post, Dr. Daniele Macchini, an Intensive Care Unit physician in Bergamo, near Milan, shared how exhausted staff are facing a constant battle to save a growing number of patients as hospitals work “at 200% capacity”.

He pleaded with people across Italy to respect the quarantine rules, saying: “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.”

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 a condensed translation of his post (which can be read in Italian here).

“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 sure would 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. Now, the 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 rapid drama.

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.”

Photo: AFP

“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, they 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 ER is collapsing.

Reasons for entry are 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.

Some are 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 beds that did not exist before.

Photo: AFP

“The staff are exhausted. I saw new levels of tiredness on faces despite the already exhausting workloads they had. I saw the solidarity among 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.”

READ ALSO: 'Stay at home': What are Italy's coronavirus quarantine rules?

“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.”

At the start of her thread, Dr Silvia Stringhini, who is based in Geneva, warned against complacency about the virus elsewhere in Europe.

“I may be repeating myself, but I want to fight this sense of security that I see outside of the epicenters, as if nothing was going to happen 'here'.,” she wrote. “The media in Europe are reassuring, politicians are reassuring, while there's little to be reassured of.”

Dr Macchini is not the only medical professional to sound the alarm on social media over the crisis Italy's medical staff now face.

Dr Jason Van Schoor, a UK-based registrar in Anaesthesia & Intensive Care Medicine and academic fellow at UCL, posted a Twitter thread sharing the thoughts of a doctor friend in northern Italy, who echoed the words of Dr. Macchini.

“Lombardy is the most developed region in Italy and it has a extraordinary good healthcare, I have worked in Italy, UK and Aus and don’t make the mistake of thinking that what is happening is happening in a 3rd world country.”

“The current situation is difficult to imagine and numbers do not explain things at all. Our hospitals are overwhelmed by Covid-19, they are running 200% capacity”

“Staff are working as much as they can but they are starting to get sick and are emotionally overwhelmed.”

What should I do if I think I have COVID-19?

If you think you have the virus, do not go to hospital or your doctor's surgery.

Health authorities are worried about potentially infected people turning up at hospitals and passing on the virus.

A special Italian health ministry phone line has been launched with more information on the virus and how to avoid getting it. Callers to the 1500 number can get more information in Italian, English and Chinese.

In an emergency situation, you should always call the emergency number 112.

READ ALSO: UPDATE: What's the latest news and advice on coronavirus in Italy? 

According to the WHO, around 80 percent of people who contract the new coronavirus recover without needing special treatment.

 
Around one out of every six people who gets COVID-19 becomes seriously ill and develops difficulty breathing.
 
Some 3.4 percent of cases are fatal, according to the latest WHO figures. Older people and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness.

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COVID-19

Reader Question: What are Italy’s Covid quarantine rules for travellers?

Italy's quarantine rules have changed so many times over the past couple of years, it can be hard to keep track. Here's the latest information on when and how visitors need to self-isolate.

Reader Question: What are Italy's Covid quarantine rules for travellers?

Question: “One of your recent articles says you can exit quarantine by testing negative for the coronavirus. But you can also exit quarantine by obtaining a Letter of Recovery from Covid-19… true?”

Unfortunately, official proof of having recovered from Covid-19 won’t get you out of the requirement to self-isolate if you test positive for Covid while visiting Italy – though it can shorten your quarantine period.

Anyone who tests positive in Italy is required to immediately self-isolate for a minimum of seven days: that’s if the person in question is fully vaccinated and boosted, or has completed their primary vaccination cycle or recovered from Covid less than 120 days ago.

That period is extended to 10 days for those who aren’t fully vaccinated and boosted, or those who recovered from Covid or completed their primary vaccination cycle more than 120 days ago.

READ ALSO: Travel in Italy and Covid rules this summer: what to expect

In either case, the infected person must have been symptomless for at least three days in order to exit quarantine (with the exception of symptoms relating to a lost sense of taste or smell, which can persist for some time after the infection is over).

The patient must also test negative for the virus via either a molecular (PCR) or rapid antigen test on the final day of the quarantine in order to be allowed out.

Quarantined people who keep testing positive for the virus can be kept in self-isolation for a maximum of 21 days, at which point they will be automatically released.

Italy does not currently require visitors from any country to test negative in order to enter its borders, as long as they are fully boosted or were recently vaccinated/ have recently recovered from Covid.

READ ALSO: How tourists and visitors can get a coronavirus test in Italy

Some countries (including the US), however, do require people travelling from Italy to test negative before their departure – which means visitors at the tail end of their journey could be hit with the unpleasant surprise of finding out they need to quarantine for another week in Italy instead of heading home as planned.

It’s because of this rule that a number of The Local’s readers told us they wouldn’t be coming on holiday to Italy this summer, and intend to postpone for another year.

If you are planning on visiting Italy from a country that requires you to test negative for Covid prior to re-entry, it’s a good idea to consider what you would do and where you would go in the unlikely event you unexpectedly test positive.

Please note that The Local cannot advise on specific cases. For more information about how the rules may apply to you, see the Italian Health Ministry’s website or consult the Italian embassy in your country.

You can keep up with the latest updates via our homepage or Italian travel news section.

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