Italian hospitals are so ‘overwhelmed’ by coronavirus that strokes and trauma are going untreated and some elderly patients are not even being assessed, a doctor at the centre of the crisis has said.
Doctors in Italy have been forced into life-or-death decisions over who should receive intensive care with authorities desperately trying to find more beds.
A medic in northern Italy told a friend in the UK that hospitals were running at ‘200 per cent capacity’ with operating theatres hurriedly converted into intensive care units.
Non-coronavirus cases are being sidelined with some medics being given a ‘leaflet’ and told to perform specialist tasks for which they are not qualified, while some patients over 65 are not even being assessed, the doctor said.
In addition, medical staff themselves are becoming ‘sick and emotionally overwhelmed’ and left ‘in tears’ because they cannot stop people dying, they said.
The medic’s comments were published in a Twitter thread by UK-based friend Jason van Schoor, an anaesthetist and clinical fellow at University College London.
The doctor also issued a warning for the UK, saying that the Italian chaos would repeat itself in Britain ‘if you don’t take it seriously’.
Experts have suggested that the UK outbreak is around two weeks behind that in Italy, meaning Britain could be heading for a similar nightmare within a fortnight.
Medics treat a patient at a hospital in Schiavonia, in northern Italy which has been worst-affected by the coronavirus outbreak in the country
Part of the Twitter thread in which a UK-based anaesthetist relays a message from a doctor in northern Italy. ITU means intensive treatment unit and OR means operating room. NIV means non-invasive ventilation
Mr van Schoor said he was passing on a message from a ‘well-respected’ friend who worked as an intensive care medic and A&E consultant in northern Italy.
‘The current situation is difficult to imagine and numbers do not explain things at all,’ the unnamed medic told Mr van Schoor.
‘Our hospitals are overwhelmed by Covid-19 [the disease caused by coronavirus], they are running 200 per cent capacity.
‘We’ve stopped all routine, all operating rooms have been converted to intensive care units and they are now diverting or not treating all other emergencies like trauma or strokes.
‘There are hundreds of patients with severe respiratory failure and many of them do not have access to anything above a reservoir mask.
‘Patients above 65, or younger with comorbidities, are not even assessed by [intensive care], I am not saying not tubed, I’m saying not assessed.’
The medic added: ‘Staff are working as much as they can but they are starting to get sick and are emotionally overwhelmed.
‘My friends call me in tears because they see people dying in front of them and they con only offer some oxygen.’
The medic added that Lombardy, the area of northern Italy at the centre of the crisis, was ‘the most developed region in Italy and has extraordinary good healthcare’.
‘Don’t make the mistake to think that what is happening is happening in a third world country,’ they said.
Offering advice for the UK, the doctor said: ‘We have seen the same pattern in different areas a week apart, and there is no reason that in a few weeks it won’t be the same everywhere.’
Describing the pattern, the medic said it would start with a few cases – as the outbreak did in the UK – before spiralling into a major crisis where intensive care units are ‘saturated’.
They warned that staff would ‘get sick so it gets difficult to cover for shifts’ while mortality would ‘spike from all other causes that can’t be treated properly’.
‘We have seen it, you won’t be [safe] if you don’t take it seriously. I really hope it won’t be as bad as here but prepare,’ the doctor said.
Experts have warned that the UK is following the same trajectory as Italy, and could end up in a similar situation within two weeks.
University College London biology professor Dr Francis Balloux, said: ‘The trajectory of the epidemic in the UK is so far roughly comparable to the one in Northern Italy, but with the epidemic in Northern Italy two to three weeks ahead of the situation in the UK.’
Dr Balloux said that it was possible the UK could face a similar lockdown to the one which has brought Italy to its knees.
Adam Kay, the bestselling British author and former doctor, warned in a tweet about the crisis in Italy: ‘This is us in a fortnight’.
Italy has suffered the worst outbreak in Europe and one of the heaviest outside China, with more than 9,000 cases confirmed and 463 dead.
Northern Italy has been worst affected, but the government’s drastic quarantine measures have now been extended to the entire country.
The UK currently has 321 confirmed cases, with five deaths.
A coffin is taken out of a hospital in the presence of two relatives and a funeral home employee in Venice today, with funerals banned because of the nationwide lockdown
Healthcare workers wearing protective suits, masks and gloves are pictured at work in the Amedeo di Savoia hospital in Turin
The virus is spreading so fast in Italy that doctors are making comparisons to wartime triage medics deciding who lives, who dies and who gets access to intensive care.
The Italian society of anesthesiology and intensive care has published 15 ethical recommendations to consider when deciding on intensive care admissions.
The criteria include the age of the patient and the probability of survival, and not just ‘first come first served.’
‘It’s a reasoning that our colleagues make,’ said Dr Guido Giustetto, head of the association of doctors in northern Piedmont.
‘It becomes dramatic if, rather than doing it under normal situations, they do it because the beds are so scarce that someone might not have access to medical care.’
The Lombardy government has been scrambling to increase its capacity, converting operating and recovery rooms into isolated wards.
It has cobbled together 150 more beds in the last two weeks and expects another 150 in the coming week.
‘Unfortunately we’re only at the beginning,’ said Dr Massimo Galli, head of infectious disease at Milan’s Sacco hospital.
Speaking to SkyTg24, Galli noted that the numbers of infections registered in Lombardy last week were similar to those in Wuhan, China in late January.