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This is an account from one of the doctors in Italy. https://twitter.com/jasonvanschoor/status/1237142891077697538?s=19 https://twitter.com/jasonvanschoor/statu
by moultano 7y ago
This is an account from one of the doctors in Italy. https://twitter.com/jasonvanschoor/status/1237142891077697538?s=19 https://twitter.com/jasonvanschoor/status/123714289107769753...
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."
- hnaccy 7y agoDoes that mean they're just triaging them and letting them die?
- techolic 7y agoIt hurts me to say this, but that's what happened in Wuhan for the first few weeks.
- rorykoehler 7y agoThat's exactly what it means. If you go in /r/europe there was an interview with a doctor posted confirming this https://www.reddit.com/r/europe/comments/ffs5ng/coronavirus_doctor_in_bergamo_its_like_a_war_we/ https://www.reddit.com/r/europe/comments/ffs5ng/coronavirus_...
- chewz 7y agoExactly this. https://www.brusselstimes.com/all-news/belgium-all-news/health/99412/coronavirus-we-must-choose-who-to-treat-says-italian-doctor-covid-19-christian-salaroli/ https://www.brusselstimes.com/all-news/belgium-all-news/heal...
- grey-area 7y agoThat's what you need to do when the country is unprepared, and the health service is overwhelmed. Similar situations will play out in the US unless strict protocols are enforced now.
- LandR 7y agoIn the UK one of our top health people said that if this gets out of control "hard decisions will have to be made" 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.
- deleted 7y ago[deleted]
- esistgut 7y agoPlease note that Lombardy has a very very good health service. The OECD put a score on this [1]: 9.9/10. This is in the top 5% across all regions. Other european regions seem to have lower average scores and their governments are not taking serious actions. [2] How the US is reacting from my perspective (italian confined near Rome) seems borderline madness. Something about this situation confuses me a lot. [1] https://oecdregionalwellbeing.org/ITC4.html https://oecdregionalwellbeing.org/ITC4.html [2] https://www.youtube.com/watch?v=s85xG9Ol3Po https://www.youtube.com/watch?v=s85xG9Ol3Po
- datashow 7y agoActually this event may also become a test of the validity of those measures / indicators. One may argue those measures / indicators are not setup for this purpose.
- sciinfo 7y agoNo healthcare treatment in real life can be sufficient for an exponential growth of severe cases that require skilled staff and specialized equipment. Health service ranking focuses on treatment I suppose. We need a different ranking for epidemic prevention and control.
- mantap 7y agoPoliticians have no understanding of exponential growth. They look at low numbers and think "we have a lot of time" then are surprised later when they in fact don't.
- throwaway122378 7y agoThat account has TEN tweets spanning 2013 - 2020. Then this thread. Don’t believe everything you read even if it sounds like a believable novel
- koheripbal 7y agoDoesn't that increase the credibility? Most working professionals don't tweet much at all. I think I have 5 tweets in the last 10 years.
- luckydata 7y agoThis is an idiotic comment. The thread is a literal translation of this article written by the MD telling the story: https://www.ecodibergamo.it/stories/bergamo-citta/con-le-nostre-azioni-influenziamola-vita-e-la-morte-di-molte-persone_1344030_11/ https://www.ecodibergamo.it/stories/bergamo-citta/con-le-nos... this is an online profile for the doctor: https://www.dottori.it/daniele-macchini-516895 https://www.dottori.it/daniele-macchini-516895 The post was originally shared on Facebook.
- graeme 7y agoThat’s actually a different thread. Though, the doctor in the thread above is also real.
- streb-lo 7y agoWhy is it idiotic? It could absolutely be true -- but there are definitely interests out there who may wish to spread panic. I could just as easily create a similar low-volume Twitter account with the opposite portrayal -- doesn't mean people should believe me.
- muyuan 7y agoI am a Chinese living in Bay Area. What's described by the Italian doctor was exactly like the situation in Wuhan right after the lockdown for the first 2-3 weeks. Unfortunately, I think it will hit Italy harder this time, China locked down Wuhan but every other provinces send in supplies and doctors to help, just building new hospitals is not enough, and I don't see France/Germany doing the same to Italy. The US response so far feels very much like what I saw early Jan in China, the government kept assuring the public everything is in control and risk is very low. One could argue it's either cover up or they simply didn't know, I think it's a combination of both. But I really cannot understand why US is handling it this way after seeing what happened in Wuhan and now Italy, it almost feels like Trump has some secret weapons ready to save the day. You would think that, since most of the leaders are in a high risk demographic and spend large chunk of their time shaking hands with strangers, they would be more vigilant
- pengaru 7y ago> it almost feels like Trump has some secret weapons ready to save the day. You would think that, since most of the leaders are in a high risk demographic and spend large chunk of their time shaking hands with strangers, they would be more vigilant 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.
- xienze 7y ago> 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. Can't really disagree, but I feel like I'm taking crazy pills with the way people in the US are talking about the response now. Was the US MSM not spending all of January and February telling us "calm down, you know the common flu kills WAY more people than this thing and we don't freak out about it!" and complaining how Trump's proposed Chinese traveler ban was both a) racist and b) would have little to no effect?
- sciinfo 7y ago
- tanilama 7y agoBasically, the whole area had turned into Wuhan. Sad but people are their own now. Hopeless.
- kaiabwpdjqn 7y agoWhat do the healthcare workers actually do while caring for these people? Is this something that actually requires significant medical knowledge? 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?
- sciinfo 7y agoMost severe cases require trained medical staff. Since ~20% of infections requires hospitalization, no healthcare system is prepared for an exponential rise in SARS-CoV-2 infections. Most fatalities are from pneumonia. Lots of details are available all over. You may want to read up.
- kaiabwpdjqn 7y agoMy point is that medical staff are trained to respond to many things. Training newbies to respond to one thing would probably be easy and fast. Especially if most people just need fluids, oxygen, and aspirin. Burning out doctors to maximize survival rates up front is... bad
- cstejerean 7y agoIf all you needed is something that a person with no training could handle they’d send you home and have a family member care for you.
- kaiabwpdjqn 7y agowell it’s a good thing I didn’t suggest that
- nradov 7y agoAspirin isn't an effective treatment.
- kaiabwpdjqn 7y ago
- asdfasgasdgasdg 7y agoThanks for posting this. You just helped me decide to take advantage of work from home until this situation is done.
- jiggawatts 7y agoI fixed the formatting, typos, and expanded the jargon: 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.
- hef19898 7y agoAm I the only to catch the very first sentence? "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.
- honestoHeminway 7y agoThe doctor posted a cut of a article on twitter. So its basically a retweet.
- ghego1 7y agoI am from Italy and every single friend of mine working in healthcare as a doctor has confirmed me that the situation is like the one described here. A friend of mine who is an orthopedist outside lomdardia has also confirmed that they have already asked him to work extra hours and they are already at full capacity, so he's preparing to assist covid patients. 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.
- hef19898 7y agoSo doctors work overtime during situations like this. Surprise. My problem with these reports is that they have a tendency to spread fear, especially the way the are presented. They also undermine trust in public information which only makes it harder to implement measures, in turn making it harder to contain the virus.
- bonzini 7y agoOrthopedists being reallocated to treating pneumonias goes a little beyond "working overtime".
- cm2187 7y agoI am struggling to reconcile this story with the numbers of deaths so far vs the number of deaths in any given year. A french infectious disease specialist mentioned that 2017 had been a bad year for infectious respiratory diseases in France, with over 60,000 additional deaths in winter, to the point that it affected life expectancy tables [1]. I don’t remember any mention of hospitals being overwhelmed and doing war-time triage then. 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 https://www.youtube.com/watch?v=pb8Q1yr2cjo
- hef19898 7y agoWhich shows how damn important context is. Without 100% testing (which I don't think to be necessary) for COVID-19 and comaprative baselines case numbers aren't tellig us anything. Without the proper domain expertise to actually interpret the numbers that is. So whithout that particular domain expertise, epidemilogy and virology, I don't interpret the numbers or build models, rather I believe the experts to make sense out of them.
- exolymph 7y agoFlu season is accounted for in normal hospital beds and other capacity planning. A sudden huge surge in need for ICU care is not accounted for.
- cm2187 7y agoBut my point is that surely these additional 60,000 people (and probably many more who recovered) must have gone through ICU.
- MLpractitioner 7y agoNot necessarily, and maybe they didn't need artificial ventilation which is the big deal here.
- 7y ago
- asdfman123 7y agoThat's the problem with coronavirus that everyone's missing. 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.