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Originally posted by pianojuggler:
Is there any analysis and explanation of why Italy is being hit so hard? Why it's spreading so fast?

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It’s not clear why Italy’s Covid-19 outbreak spiraled so quickly relative to other European countries, but there are several competing theories.

One is that an aggressive testing campaign centered in wealthy Lombardy has inflated the problem at a time when other countries have lagged in detecting cases. So Italy is more of a harbinger of what’s to come across Europe than a unique hot zone.

Another is that intense spread of the virus in the hospital system, before doctors realized there was a problem, may have amplified the outbreak. Some 10 percent of medical workers in Lombardy have been infected, according to a March 3 Washington Post report, and health workers account for 5 percent of those infected in the country. (Bolstering this explanation: The WHO-ECDC joint mission report suggests Italy should work on its infection prevention and control measures in hospitals.)

There’s also speculation about whether Italy’s burden is particularly severe because of the country’s aging population. Covid-19 is known to hit older adults particularly hard. That, along with the fast rise in confirmed cases, has tested the limits of the health system.

In a public letter, Italian doctors had a similar warning for the world: “We are seeing a high percentage of positive cases being admitted to our intensive care units (ICUs), in the range of 10 per cent of all positive patient[s].

“We wish to convey a strong message: Get ready!”

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Originally posted by jon-nyc:
Wow. Click the link and read the whole thread.

https://twitter.com/Yascha_Mou.../1237731864233807872

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Originally posted by wtg:
They are already pretty bad.

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Two weeks ago, Italy had 322 confirmed cases of the coronavirus. At that point, doctors in the country’s hospitals could lavish significant attention on each stricken patient.

One week ago, Italy had 2,502 cases of the virus, which causes the disease known as COVID-19. At that point, doctors in the country’s hospitals could still perform the most lifesaving functions by artificially ventilating patients who experienced acute breathing difficulties.

Elise A. Mitchell: The shortages may be worse than the disease

Today, Italy has 10,149 cases of the coronavirus. There are now simply too many patients for each one of them to receive adequate care. Doctors and nurses are unable to tend to everybody. They lack machines to ventilate all those gasping for air.

Now the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) has published guidelines for the criteria that doctors and nurses should follow in these extraordinary circumstances. The document begins by likening the moral choices facing Italian doctors to the forms of wartime triage that are required in the field of “catastrophe medicine.” Instead of providing intensive care to all patients who need it, its authors suggest, it is becoming necessary to follow “the most widely shared criteria regarding distributive justice and the appropriate allocation of limited health resources.”

The principle they settle upon is utilitarian. “Informed by the principle of maximizing benefits for the largest number,” they suggest that “the allocation criteria need to guarantee that those patients with the highest chance of therapeutic success will retain access to intensive care.”

The authors, who are medical doctors, then deduce a set of concrete recommendations for how to manage these impossible choices, including this: “It may become necessary to establish an age limit for access to intensive care.”

Those who are too old to have a high likelihood of recovery, or who have too low a number of “life-years” left even if they should survive, will be left to die. This sounds cruel, but the alternative, the document argues, is no better. “In case of a total saturation of resources, maintaining the criterion of ‘first come, first served’ would amount to a decision to exclude late-arriving patients from access to intensive care.”

https://www.theatlantic.com/id...hospital-bed/607807/

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Italian authorities voiced growing concern on Sunday over how much longer strained health systems could cope with the coronavirus outbreak, as thousands of new cases were recorded over the past 24 hours and several hundred more people died.

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With 24,747 cases and 1,809 deaths by Sunday - a rise of 368 in the death toll in just 24 hours - Italy’s experience has offered an alarming example for other European countries which have begun seeing sharp rises in cases over recent days.

Lombardy, the heavily populated area around the financial capital Milan, has been the worst-affected region with 1,218 deaths. Of those, 252 were recorded in the last 24 hours.

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Most cases in Lombardy have been in small towns in areas like Bergamo and Brescia, but there have been fears of a major spread into Milan itself, which could overwhelm hospitals.

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Italy on Monday (Mar 16) reported 349 new deaths from the novel coronavirus, taking its total since last month to 2,158, the most after China.

The number of official COVID-19 fatalities has more than doubled since Thursday, when Italy's toll topped 1,000 for the first time. Italy now has 27,980 infections, compared to 15,113 four days ago.

It has reported more than 700 deaths in two days.

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The death toll from an outbreak of coronavirus in Italy has risen in the last 24 hours by 345 to 2,503, an increase of 16%, the Civil Protection Agency said on Tuesday.

The total number of cases in Italy, the European country hardest hit by the virus, rose to 31,506 from a previous 27,980, up 12.6%, the slowest rate of increase since the contagion came to light on Feb. 21.

Of those originally infected, 2,941 had fully recovered compared to 2,749 the day before. Some 2,060 people were in intensive care against a previous 1,851.

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The number of people dying from coronavirus in Italy has risen by 475 in one day to nearly 3,000 - the biggest increase since the outbreak.

There are a total of 35,713 confirmed cases in the country, with more than 4,000 having successfully recovered.

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If you're just joining us...

A warm welcome - especially if you're reading this from self-isolation.

The biggest news right now is that Italy has reported 427 more deaths in the last 24 hours, bringing its total death toll to 3,405. This means that more people have now died after getting the virus there than in China, where it originated.

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Behind each death is a human tragedy and almost two-thirds have been in the northern region of Lombardy. Five more doctors in Lombardy have died, bringing the number to 13. These include a Bergamo doctor, a lung specialist in Como, and the former head of Crema hospital.

Bergamo hospital doctor Stephano Fagiuoli reached out on Thursday in English: "We are in desperate need of both nurses and physicians together with ventilators and [protective clothing]."

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“Unfortunately we can’t contain the situation in Lombardy,” said Daniela Confalonieri, a nurse in Milan. “There’s a high level of contagion and we’re not even counting the dead anymore.”

“Look at the news that’s coming out of Italy and take note of what the situation is like,” she said. “It’s unimaginable.”

An army spokesman said 15 trucks and 50 soldiers had to be deployed to remove the dead from Bergamo, northeast of Milan, because the town cemetery had been overwhelmed.

Officials also sought help with cremations after the local crematorium was unable to keep up.

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Italy calls in military to enforce coronavirus lockdown as 627 people die in 24 hours

Soldiers were being drafted in to help enforce the lockdown in Italy on Friday as officials announced 627 new deaths, the largest single-day toll anywhere in the world since the coronavirus outbreak began.

Desperate scenes have unfolded in the north of the country, particularly the hard-hit Lombardy region where infections first exploded last month, as hospitals struggle to treat thousands of cases.

And Chinese medical experts helping Italy deal with the crisis have said the restrictions imposed in Lombardy are "not strict enough."

The government has now agreed that the military can be used to help enforce the lockdown, the president of the Lombardy region, Attilio Fontana, told a news conference on Friday.

"(The request to use the army) has been accepted... and 114 soldiers will be on the ground throughout Lombardy... it is still too little, but it is positive," Fontana said. "Unfortunately we are not seeing a change of trend in the numbers, which are rising."

The soldiers had until now been deployed in the region to ensure general security in the streets.

More than 4,000 people have now died from the disease in Italy, the country's civil protection agency said Friday -- more than any other nation -- and nearly 6,000 new infections were confirmed in the past day, bringing the total to more than 47,000 cases.

Daniela Confalonieri, an Italian nurse in Milan, the region's capital, said the situation was so dire that the dead were no longer being counted.
"We're working in a state of very high stress and tension," Confalonieri told Reuters.

"Unfortunately we can't contain the situation in Lombardy, there's a high level of contagion and we're not even counting the dead any more.
"Look at the news that's coming out of Italy and take note of what the situation really is like. It's unimaginable."

A hospital doctor in Bergamo, another Lombardy city, told CNN it had been hit so hard by the coronavirus that it is now sending patients who need intensive care to other parts of the country.

"Bergamo is sending ICU patients to other regions because we ran out (of space)," Dr. Stefano Magnone told CNN on Friday, adding that intensive care units in hospitals in nearby Brescia were also full. Brescia is the second-worst affected province, according to the civil protection agency.

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A doctor in the Lombardy city of Cremona, Romano Paolucci, told Reuters that he had "seen a lot of dead here" and that medical staff were battling to cope with a lack of equipment, long hours and increasing sickness within their own ranks.

"I would say that we are at the end of our strength," he said. "This is a small hospital and we are taking in a lot of people, I would say the capacity is finished.

"We do not have sufficient resources and especially staff because apart from everything else now the staff are beginning to get sick."

About 70% of those treated at the hospital for Covid-19 are surviving, he added.