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HEALTH

‘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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TRAVEL NEWS

Covid face mask rule on flights in Europe set to be eased

The mandatory EU-wide mask requirement for air travel is set to be dropped from Monday, May 16th, but airlines may still require passengers to wear masks on some or all flights

Covid face mask rule on flights in Europe set to be eased

Europe-wide facemask rules on flights are set to be ditched as early as next week in light of new recommendations from health and air safety experts.

The European Union Aviation Safety Agency (EASA) and European Centre for Disease Prevention and Control (ECDC) dropped recommendations for mandatory mask-wearing in airports and during flights in updated Covid-19 safety measures for travel issued on Wednesday, May 11th.

The new rules are expected to be rolled out from Monday, May 16th, but airlines may still continue to require the wearing of masks on some or all of flights. And the updated health safety measures still say that wearing a face mask remains one of the best ways to protect against the transmission of the virus.

The joint EASA/ECDC statement reminded travellers that masks may still be required on flights to destinations in certain countries that still require the wearing of masks on public transport and in transport hubs.

It also recommends that vulnerable passengers should continue to wear a face mask regardless of the rules, ideally an FFP2/N95/KN95 type mask which offers a higher level of protection than a standard surgical mask.

“From next week, face masks will no longer need to be mandatory in air travel in all cases, broadly aligning with the changing requirements of national authorities across Europe for public transport,” EASA executive director Patrick Ky said in the statement. 

“For passengers and air crews, this is a big step forward in the normalisation of air travel. Passengers should however behave responsibly and respect the choices of others around them. And a passenger who is coughing and sneezing should strongly consider wearing a face mask, for the reassurance of those seated nearby.”  

ECDC director Andrea Ammon added: “The development and continuous updates to the Aviation Health Safety Protocol in light of the ongoing Covid-19 pandemic have given travellers and aviation personnel better knowledge of the risks of transmission of SARS-CoV-2 and its variants. 

“While risks do remain, we have seen that non-pharmaceutical interventions and vaccines have allowed our lives to begin to return to normal. 

“While mandatory mask-wearing in all situations is no longer recommended, it is important to be mindful that together with physical distancing and good hand hygiene it is one of the best methods of reducing transmission. 

“The rules and requirements of departure and destination states should be respected and applied consistently, and travel operators should take care to inform passengers of any required measures in a timely manner.”

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