Read the whole thing, but this passage in particular is just chilling.
"5/ Patients above 65 or younger with comorbidities are not even assessed by ITU, I am not saying not tubed, I’m saying not assessed and no ITU staff attends when they arrest. Staff are working as much as they can but they are starting to get sick and are emotionally overwhelmed."
I can't believe I'm saying this as a libertarian but you have to put some faith into the government's action here. The public in a panic already took away all the masks healthcare providers needed to safely attend patients, diminishing the capacity to serve.
It is possible than one hospital may be overwhelmed, but surely it cannot be representative of hospitals across Italy or even a region.
[1] for french speakers: https://www.youtube.com/watch?v=pb8Q1yr2cjo
Sadly, it is representative of hospitals across all northern Italy: https://www.ilpost.it/2020/03/08/pesenti-emergenza-ospedali-... https://www.ilpost.it/2020/03/09/coronavirus-terapia-intensi... ("Affollamento e scelte difficili")
I remember my nurse friends freaking out in 2017 because they were having trouble dealing with the extra flu cases.
"From a well respected friend and intensivist/A&E consultant who is currently in northern Italy:"
Basically, that make this twitter thread uncorborated news unless someone reached out to the Italian doctor referenced in it.
Personally I know a girl whose soon-to-be husband from zero symptoms went to being intubated in 3 days. Luckily for him there were still machines available and he's relatively young and in good shape so they have allocated it to him.
One can surely ignore these reports as they are not provided first hand by doctors. In that case it is sufficient to wait. Soon this situation will be a reality in many more regions/countries so it will be easy to experience this first hand.
However official statements widely reported in the media are essentally saying similar things:
Antonio Pesenti, head of the Lombardy regional crisis response unit, told the Corriere della Sera newspaper the health system in Lombardy was “a step away from collapse” as intensive care facilities came under growing strain from the new cases.
“We’re now being forced to set up intensive care treatment in corridors, in operating theaters, in recovery rooms. We’ve emptied entire hospital sections to make space for seriously sick people,” he said.
https://www.reuters.com/article/us-health-coronavirus-italy/...
https://translate.google.com/translate?sl=it&tl=en&u=https%3...
If we had the hospital capacity to deal with it, it wouldn't be so bad. But the suffering (and mortality rate) spikes pretty significantly when you run out.
If we were halfway rational we'd be rapidly scaling up medical capacity now and practicing strong social distancing now... but people are too worried it would unduly wreck the economy.
Why should we wait 20 days for things to get terrible before going to quarantines and lock down? Surely China and Italy have shown us our future.
I partly think the problem is political. If you quarantine and the virus is controlled, then it looks like you panicked over nothing, because you took this huge reaction and nothing much happened. However, if you wait till it's sufficiently bad and then you quarantine everyone will understand what you did, and later, you may get praised for your decisive leadership in a time of struggle.
What I mostly wish is that citizens could throw some sort of flag now to say "This crisis is being poorly handled. If this goes badly, let's have a review, figure out why, and correct the problem once this is settled."
I don't want to go into longer detail as it will be subjective and seem political, but I'm expecting things to Get Weird.
And people distrust anything coming out of China's government so they simultaneously think China covered up a lot and there were way more dead, and they exaggerated how bad the virus is...
He's behaving entirely consistently with how he always has: deny everything, project perfection.
There's no signal here of a secret weapon, it's a complete shit show.
I am not sure what he is doing is even remotely serving himself that well either. Addressing the Coronavirus upfront is the only way to cheer up the market right now. Did he really think he can just fight this virus with speech or tweets?
This is bothering me no end, and severely impact my confidence in US itself overall. Damn it, this is a full on crisis, the shit is about to hit the fan so hard.
https://twitter.com/realDonaldTrump/status/12370273563148697...
https://twitter.com/realDonaldTrump/status/12370245512943820...
I'm amazed not only at these affirmations, but at the likes they get. Incredible.
Nobody knows the long term development of this virus. You could lock up everything, the economy collapses and it would hurt people even more than the virus might have. It is a gamble at this point.
Political games come into play if people demand answers that nobody can give. If some presume to be able to do that, they are lying to your face.
If this is over in June and 100,000 people died, what would we call this? It would just be another disease probably.
For people who lost loved ones it was a catastrophe, for other part of the normal life risk. Any publicly uttered judgement has to keep that in mind, so it will always be relative. Some are more forthcoming, but probably not public officials.
Of course the virus is not under control, how could it be? I would prefer measures to reduce its spread, but that is basically intuition and listening to some doctors with the knowledge that it just buys time.
Anyone using this crisis for political points doesn't really win any cookies with me personally, on the contrary.
The incentive to cover something up is just a reflex to save face. I don't like covering something up. There is a risk of disproportionate overreaction, but I think a bad information policy reinforces this. If they covered something up, it must be really bad, right?
“You know what solves it? When the economy crashes, when the country goes to total hell and everything is a disaster, then you’ll have a, you know, you’ll have riots to go back to where we used to be when we were great,”
https://www.rawstory.com/2019/01/country-goes-hell-2014-vide...
From a well respected friend and intensivist/A&E consultant who is currently in northern Italy:
I feel the pressure to give you a quick personal update about what is happening in Italy, and also give some quick direct advice about what you should do.
First, Lumbardy is the most developed region in Italy and it has a extraordinary good healthcare, I have worked in Italy, UK and Australia and don't make the mistake to think that what is happening here 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.
We've stopped all routine, all Operating Rooms have been converted to Intensive Care Rooms and they are now diverting or not treating all other emergencies like trauma or stroke. There are hundreds of patients with severe respiratory failure and many of them do not have access to anything above an oyxgen mask.
Patients above 65, or younger patients with comorbidities, are not even assessed by Intensive Care. I am not saying not tubed, I'm saying not assessed and no staff attends to them when they arrest. Staff are working as much as they can, but they are starting to get sick themselves and are emotionally overwhelmed.
My friends call me in tears, because they see people dying in front of them and they can only offer some oxygen. Ortho and pathologists are being given a leaflet and sent to see patients on ventillation. PLEASE STOP, READ THIS AGAIN AND THINK.
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, this is the pattern:
1) A few positive cases, first mild measures, people are told to avoid the Emergency Department. People still hang out in groups, everyone says not to panic.
2) Some moderate respiratory failures and a few severe ones that need intubation, but regular access to Emergency Departments is significantly reduced so everything looks great.
3) Tons of patients with moderate respiratory failure, that over time deteriorate to saturate intensive care first, then intubation equipment, then CPAP hoods, then even O2 masks.
4) Staff gets sick, so it gets difficult to cover for shifts, mortality spikes from all the other causes that can't be treated properly.
Everything about how to treat them is online but the only things that will make a difference are: do not be afraid of massively strict measures to keep people safe. If the governments won't do this at least keep your family safe: your loved ones with a history of cancer or diabetes or any transplant will not be tubed if they need it even if they are young. By safe I mean YOU do not attend them and YOU decide who does and YOU teach them how to. Another typical attitude is read and listen to people saying things like this and think "that's bad dude" and then go out for dinner because you think you'll be safe.
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.
What does tubed mean here?
That's basically a nice way of saying "We will have to let people die"
If you don't have beds and incubutors, you can't treat people. Then people start dying.
Similar situations will play out in the US unless strict protocols are enforced now.
Sad but people are their own now. Hopeless.
What does arrest mean? Is that cardiac arrest? Is that how people are dying? If they’re dying and people aren’t attending, should they even be there at all?
Most fatalities are from pneumonia. Lots of details are available all over. You may want to read up.