The New York Times

The New York Times 23 Mar 2020

'Brace Yourself': Doctors in Italy Share Coronavirus Advice


Officials in the U.S. and elsewhere fear they'll face a coronavirus scenario similar to Italy's soon. Three doctors and a nurse in Lombardy, the region hit hardest by the virus, described what they faced and offered advice to those awaiting the storm.

Acting on a hunch, two specialists in the Paris region decided to take another look at a number of patients who were treated in intensive care for pneumonia back in December and January. One patient, a man from a Paris suburb, tested positive for having COVID-19. Elaine Cobbe reports.
The UK has recorded its highest daily number of deaths from coronavirus. 938 more people died in hospital with the virus in the last 24 hours, close to the worst levels seen in Italy and Spain. The Prime Minister Boris Johnson was said to be "improving" as he prepared to spend a third night in intensive care. Downing Street said he was "sitting up in bed and engaging positively" with staff at St Thomas' Hospital in London. Meanwhile scientists have questioned whether the government can meet its target of 100,000 coronavirus tests a day by the end of April. Huw Edwards presents BBC News at Ten reports from Political Editor Laura Kuenssberg and Health Editor Hugh Pym.
In Italy, the elderly have been bearing the brunt of the COVID-19 epidemic. But the coronavirus crisis has also taken its toll on the hundreds of thousands of foreign live-in caregivers who look after them. Known as badantes , they work in Italy to support their families back home in eastern Europe. Among them are many Ukrainian women. The lockdown has left them either cut off from their families or their only source of income.
Mobsters in Italy are thought to be exploiting the chaos brought on by coronavirus, poverty and social distancing restrictions.

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“And this is really the eye of the cyclone.”
“A nightmare.
A nightmare.”
“Lombardy for sure is one of the most advanced regions
in Italy in terms of health care.”
“38-year-old with severe respiratory distress.
And immediately, in the next two, three hours
we see 10, 8, 9 patients exactly
with the same clinical presentation.”
“Every single square meter is occupied by beds,
every single aisle is filled up by beds.
And you can hardly recognize where you normally work.”
“The gastroenterology ward is not there anymore.
Internal medicine is not there.
Neurology has been replaced.
Doctors from other specialties have
been called to do shifts.”
“We had seven I.C.U. beds
and now we have 24.”
“As many as 5 to 10 percent of the severe cases and of deaths
are actually among the health care personnel.”
“We forget to eat,
we forget to drink,
and we keep on working.”
“I’m far away from my family since Feb. 19.”
“The worst is somebody dying in the isolated ward asking
for the wife, the husband for the last hours of their life
and having no chance to have anybody around
and dying on their own.”
“So the problem is that now we don’t have any intensive care
beds anymore.
We have to intubate, put on a helicopter
and transfer to another region, actually,
because in the region all the intensive cares are full.”
“Prepare more intensive care beds,
get more devices for mechanical ventilation.
Do the swab to everybody within the hospital
and be aware that somebody will not make it anyway.”
“We try to give our best to win not only the battle,
but win the war, finally.”

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