Situation in Bergamo: "We are far beyond the tipping point!"
Bergamo - the 120,000-inhabitant city in northern Italy with the picturesque old town was until recently a popular destination in wealthy Lombardy. The coronavirus SARS-CoV-2 is currently raging particularly hard here. A team of doctors from the region has now published a report that shows that the region has become completely out of control in the past few days. The team warns that today's patient-focused care is simply not well prepared for pandemics like COVID-19.
Intensive care physicians from a clinic in the city of Bergamo describe the current situation in the Papa Giovanni XXIII hospital, which was severely affected by Covid-19. The team describes the situation as a humanitarian crisis that cannot be managed with a centralized healthcare system. The report was recently published in the renowned journal "NEJM Catalyst".
Bergamo is Italy's epicenter of the COVID-19 epidemic
Lombardy is one of the richest and most densely populated regions in Europe and is most affected today. "We work in the Papa Giovanni XXIII hospital. in Bergamo, a brand new, ultra-modern facility with 48 intensive care beds, ”reports the medical team. Although it is a relatively small city, it is the epicenter of the Italian COVID-19 epidemic. Thousands of cases are currently registered there - more than in Milan or anywhere else in the country.
"Our own hospital is highly contaminated, and we are far beyond the tipping point," explain the doctors. 300 of 900 beds were occupied by Covid 19 sufferers. As many as 70 percent of the intensive care beds are reserved for seriously ill Covid 19 patients with a reasonable chance of survival. The entire hospital works far below normal care standards.
According to the report, this manifests itself in that, for example, older patients are not resuscitated. They die without adequate palliative care and are treated by physically and emotionally exhausted staff who previously had no personal contact with those affected.
To get out of control
According to the experts, the hospital is still relatively good-looking. The situation in the area is even worse. Most hospitals are overcrowded and on the verge of collapse, while medication, mechanical ventilators, oxygen and personal protective equipment are unavailable.
Those affected lie on mattresses on the floor. The cemeteries do not come after the funerals, pregnancy care and childbirth become unsteady, and the situation in the prisons is becoming increasingly explosive, according to the doctors. "Unfortunately, the outside world does not seem to know that this outbreak in Bergamo is out of control," the team wrote in the current report.
Pandemic solutions for everyone - not just for hospitals
"For example, we learn that hospitals could be the primary carriers of Covid-19 because they can quickly become populated by infected people, making it easier to transfer to non-infected people," said the medical team. Carriage of the infected could also help spread as ambulances and personnel become carriers. Other healthcare workers can also be asymptomatic carriers.
New ways to deal with pandemics
Pandemic solutions are therefore required for the entire population, not just for hospitals. Home care and mobile clinics could prevent unnecessary movements of infected people and relieve hospitals. Oxygen therapy could be moved to the homes of slightly ill patients, where the treatment could be monitored using a telemedical system.
This approach could limit hospitalizations to particularly severe cases, reducing the risk of infection, better protecting medical personnel and minimizing the use of protective equipment.
The corona virus is the rich Ebola virus
"This outbreak is more than just a phenomenon in intensive care, it is a crisis of public health and humanitarian aid," the team emphasizes. The corona virus can be called the Ebola virus of the rich. It needed a coordinated and transnational effort to contain it.
It hits where it hurts healthcare
"It is not particularly fatal, but it is very contagious," the doctors continue. The more socially organized and centralized society is, the further the virus spreads. The catastrophe that is currently unfolding in Lombardy could occur wherever the healthcare system is structured similarly - in almost all western countries. (vb)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Graduate editor (FH) Volker Blasek
- Mirco Nacoti, Andrea Ciocca, Angelo Giupponi, and others: At the Epicenter of the Covid-19 Pandemic and Humanitarian Crises in Italy: Changing Perspectives on Preparation and Mitigation; in: NEJM Catalyst, 2020, catalyst.nejm.org