Who precedes the treatment of coronavirus? Young or old? This ethical dilemma must be addressed by doctors in Italy.
In Lombardy, the rich area at the heart of Italy's coronavirus eruption, a lack of beds and medical supplies are forcing doctors to make increasingly difficult choices.
As the number of cases continues to rise - more than 7.900 yesterday, with over 70% in Lombardy - hospitals are trying to increase the number of beds available in intensive care units. Some have closed entire chambers to use them in severe cases of coronavirus. Others have turned surgeries into intensive care units. Doctors work exhaustive shifts to cover the hours of their sick colleagues.
Without a clear indication of when it will come to a climax, anesthesiologists and doctors are being called upon to make increasingly difficult decisions about who will have access to a bed and a ventilator when there is not enough to meet all needs.
"It is a fact that we have to choose who to treat and this choice is up to us facing ethical dilemmas," a doctor working at one of Milan's largest hospitals told Politico.
Hospitals in northern Italy are saturated with coronavirus patients
Lombardy has about 900 beds available for patients in need of intensive care, but in some provinces, particularly in Bergamo, Lodi and Pavia, hospitals are "almost saturated", the doctor said.
"Save the Younger and Not the Elderly"
At the moment the commands are as follows: Save supplies for those patients who are most likely to survive. This means giving priority to younger, otherwise healthy patients than older people, who may have pre-existing health issues.
"We do not want to discriminate," said Luigi Riccioni, an anesthesiologist and head of the Siiarti Ethics Committee, of the Italian Society of Anesthesia, Analgesia, Rejuvenation and Intensive Care, who co-authored the new guidelines Italian hospitals.
"We know that the body of an extremely fragile patient is unable to accept certain treatments compared to that of a healthy person." With these recommendations, Riccioni said he wants to make sure doctors and medical staff are not alone "in the face of such a difficult moral choice."
At the same time, pressure on doctors is extremely high, with many feeling increasingly anxious, said Julie Gallera, a Lombard social welfare consultant, who said she saw some practitioners cry. They are afraid, he said, that they cannot provide everyone with the care they need as demand exceeds resources.
An Italian doctor speaks of a "war scene"
In an interview that went viral after its publication in the Italian newspaper Corriere della Sera, Christian Salaroli, an anesthesiologist at a hospital in Bergamo, referred to war scenes where elderly patients have to be banished. "The choice is made in an emergency room used for mass events, where only patients with coronavirus enter. "If a person is between 80 and 95 years old and has severe respiratory failure, he probably won't." The principle of "he who comes first, he is served first" no longer exists, said Mario Ritchie, an anesthesiologist who works at a hospital in Cremona.
The government's decision on Sunday to place some areas in northern Italy, including Lombardy in quarantine, was a welcome move for health professionals trying to keep up with the rapidly growing number of cases. On Monday night, Prime Minister Giuseppe Conte announced the expansion of the quarantine to the rest of the country.
What will happen once the outbreaks in southern Italy begin to increase?
But in a country where health policy is in the hands of regional authorities, some say that Rome should have acted faster and more decisively to make sure all areas worked together. "It needed clearer messages and less ambiguous text," Gallero said in an interview with the Italian television network La7, referring to a decree signed by the government on Sunday.
A leak in the plan, which appeared in major newspapers on Saturday, caused panic in the area as tens of thousands of people fled south to flee quarantine measures for the coronavirus.
Health experts are now awaiting the arrival of the virus in southern Italy, which has so far recorded fewer than 300 cases of coronavirus, said Giuseppe Sophie, an anesthetist at Milan's Policlinico hospital.
Italy's northern and central regions are not only the richest in the country - generating 40% of GDP - they also have the best healthcare systems. "In the south, we are in danger of a disaster," Sophie said
Source: iefimerida.gr -
https://www.iefimerida.gr/kosmos/koronoios-dilimma-giatron-italias-poion-na-sosoyn
