Hospitals in Italy are over capacity. People are prioritized based on chance of survival. Anyone unlucky is left to die because there is not enough equipment.
Yesterday the news was that anybody over 80 is not treated. They simply don't have the capacity for it, and survival chances are better for people under 80.
It's not a rule i've read on any Italian report. There was a doctor in Bergamo who said that they might have to do that in an interview and it was misreported in the international media. (I'm Italian living abroad) the Italian healthcare system is regularly listed in the top 10 in the world and Lombardy is usually number 1 in Italy. They are building a massive facility in one of the exhibition centers in Milan, it's tough but they're doing amazing work, from what I read and what I hear from people. I am much more worried for my friends in the USA..
Then i probably read the misreported quote. I'm Danish, and despite having lived in northern italy for a few years, i sadly don't speak/read italian :)
As Italy is "3 weeks" ahead of us, news from there is being monitored closely as it could signal what might happen here.
Lombardy intensive care coordinator Grasselli said he believed that, so far, all patients with a reasonable chance of recovering and living an acceptable quality of life had been treated.
I wonder if we're getting mixed messages here; that is, it's inevitable doctors give up on some cases and unplug them from the ICU but that is always a risk in ICU for any reason to be there.
Doctors "Give Up" on people all the time. If you have advanced pancreatic cancer, are 85 and a heavy smoker, most doctors are going to suggest you go home and spend your last few days with loved ones.
What I see at the moment on HN and elsewhere is a lot of people who seem to believe that in Italy the hospitals are already overrun and people are being turned away in large numbers because all the beds are gone already days ago.
But this doesn't match what is actually happening there, according to the Italian government. What they're saying is so far they've had to turn away noone; that everyone who needs treatment is getting it.
I think this mismatch is coming from a couple of places. One is mis-interpreting doctors switching off life support for patients who can theoretically be kept alive using e.g. ECMO but for whom their lungs are destroyed and they wouldn't really have a life afterwards. That's terribly sad but isn't the same thing as patients who are in the middle of making a full recovery being switched off, or people who could be saved being denied beds because there just aren't enough. Another is a confusion between "we're about to run out of beds" and "we think we're about to run out of beds".
I'm not trying to downplay the seriousness of the situation here, but we have also have to keep our heads and double check things being claimed about that seriousness, as it's always tempting in times of crisis to lose our heads and go full sandwich-board. Maybe by tomorrow Italy will actually be there, but as of yesterday at least, it seems they aren't.
The confusion probably comes from the definition of treatment. It's possible for simultaneously nobody to be turned away due to lack of a bed, whilst terminal cases they know they can't save are now being turned off quicker i.e. less aggressive intervention than before. That's what Grasselli is saying:
Lombardy intensive care coordinator Grasselli said he believed that, so far, all patients with a reasonable chance of recovering and living an acceptable quality of life had been treated. But he added that this approach is under strain. “Previously, for some people we would have said, ‘let’s give them a chance for a few days.’ Now we have to be more stringent.”
So if you have a terminal cancer and get coronavirus that means you don't get a ventilator. That's the nice part.
The next part is "living an acceptable" quality of life. This probably means anyone not brain damaged and anyone they think won't require oxygen later. Might mean people not currently on oxygen when they get covid-19.
And despite all of that he says that this system is under strain.
What are the results of the "over capacity"? Are hundreds of people who could have recovered from the virus dead today because they didn't have access to oxygen, or ICUs?
How does that quote contradict the parent? If you were a doctor, and you wanted to communicate the concept of triage without baldly stating that people are being left to die, how would you phrase it?
Not sure how, but definitely wouldn't lie about it. Plenty of 80 year-olds would have a chance of making it, so they wouldn't be turned away according to that declaration.
