Hospitals in northern Italy are running out of beds
Nearly every day in the northern Italian region of Lombardy, more people arrive at hospitals than the day before – and all with the same virus. Some arrive barely able to breathe. Some are redirected to facilities farther away because space and resources are scarce and growing scarcer.
And within a few days, doctors and health experts say, even those hospitals will be filled up. The region at the center of Italy’s coronavirus outbreak, they say, is on the verge of running out of room for its most vulnerable patients.
Based on recent projections, Antonio Pesenti said, that moment is imminent.
‘‘It’s as if you were asking what to do if an atomic bomb explodes,’’ said Pesenti, the head of Lombardy’s intensive crisis care unit. ‘‘You declare defeat. We’ll try to salvage what is salvageable.’’
The uncontained eruption of coronavirus cases in northern Italy has pushed this country’s wealthiest region within inches of a healthcare collapse, while offering a warning to the rest of the world against waiting too long to control an outbreak.
Lombardy, home to Italy’s financial hub of Milan, boasts a health system as proficient as any in Western Europe. Its facilities have clung on through three weeks of galloping case growth by delaying surgeries, stopping HIV treatments, converting regular hospital space into Covid-19 units, and depending on exhausted doctors and nurses – some of whom are becoming sick themselves.
But it can’t keep up for much longer, with cascading implications for Italy’s ability to combat the virus. Already, the region has 4200 coronavirus patients in need of hospitalisation; Pesenti projected that over the next two weeks that number could grow nearly fivefold, to 20,000. As many as 3000 or 4000 of them would require intensive care.
Lombardy has just 737 intensive-care beds for coronavirus patients. More than 600 of them are filled.
‘‘It would be an impossible situation,’’ Pesenti said.
The region is racing to get more beds; it added 127 yesterday.
Giulio Gallera, Lombardy’s health chief, said yesterday that the region would reach its capacity in ‘‘five, six or seven days,’’ even if it tried to add more beds in hospital ‘‘cellars’’. In an interview with Italy’s La7 channel, Gallera described the possibility of adding 500 additional intensive-care beds at Milan’s expo center, the kind of rapidly assembled zone that China created in the hard-hit Wuhan area.
‘‘It would be very important,’’ Gallera said.
Lombardy’s health system has guided the entire country. As the system has come under increasing pressure in recent days, Prime Minister Giuseppe Conte has raced to set more-stringent nationwide measures, leading to a near-complete nationwide commercial lockdown on Wednesday.
The goal, officials say, is to keep people indoors and slow the growth of cases, easing the burden on the hospitals. But the results won’t be immediate, given the incubation period of the virus. Numbers are expected to continue to rise in the days ahead.
There is concern not only about Lombardy – where cases have risen from 2250 to 7280 in a week – but also other parts of the country, particularly in the poorer south, where the virus has spread less rapidly but hospitals are less equipped.
‘‘I’m afraid that the south of Italy could have in a few weeks a worse situation,’’ said Maria Rita Gismondo, a virologist at the Luigi Sacco Hospital in Milan.
Lombardy provides a grim picture of how the virus’s danger grows when a health system is overburdened.
The region accounts for about one-sixth of Italy’s population, but nearly 60 per cent of its coronavirus cases and 75 per cent of its coronavirus deaths. Among those treated in Lombardy, the fatality rate is more than twice as high – 8.5 per cent, compared with 4 per cent elsewhere in the nation. And the problem is snowballing: The region has reported nearly half of its 617
‘‘It’s as if you were asking what to do if an atomic bomb explodes.’’ Antonio Pesenti head of Lombardy’s intensive crisis care unit
coronavirus deaths in the past two days.
‘‘Lombardy is the Italian Wuhan, and the situation is worsening day by day,’’ said public health researcher Nino Cartabellotta, president of the Gimbe Foundation.
‘‘This is a red flag of the hospital overload in Lombardy, that goes along with the narrative of health professionals on the front line.’’
In interviews this week, and in social media posts that have gone viral, healthcare workers have described a feeling of powerlessness mixed with stress and fear. They stay away from their families. They speak angrily about those who still compare coronavirus to seasonal influenza. Cristina Mascheroni, the head of a Lombardy association of intensive-care doctors, said colleagues in WhatsApp groups were describing the situation as war-like.
Giovanni Rezza, the director of the infectious disease department at Italy’s National Institute of Health, said hospitals had not yet faced the challenge of being unable to treat patients, or having to choose which patients get lifesaving care and which don’t.
‘‘Up until now everybody is being ventilated,’’ Rezza said.
If hospitals run out of capacity, he said, decisions will be made based on life expectancy.
‘‘For us it’s really scary and unacceptable to do this kind of selection,’’ he said.
– Washington Post