Among the numbers of the epidemic there is one that in this phase of the second wave is particularly worrying, in terms of voice hospitalized with symptoms. These are patients who for various reasons cannot stay at home, but do not require intensive care either. Yesterday there were 13,955, out of a total of 255,090 positives (about 5 percent). The hospital wards are heading towards saturation, if there is not a slowdown in the spread of the virus. What’s going on? The ratio between ordinary hospitalizations and intensive hospitalizations for Covid of 10 to 1 – underlines Carlo Palermo, national secretary Anaao (the main union of doctors and public health managers) -. evident that we are facing a problematic situation. There are four regions that exceed a thousand hospitalized with symptoms: Lombardy, Piedmont, Lazio and Campania.
Ordinary Covid beds are 15,422 throughout Italy (excluding intensive and sub intensive therapies): in hospitals, depending on the needs, entire wards are converted to Sars-CoV-2, from pulmonology to internal medicine. Of course this means close the areas to all non-Covid patients. Not only that: as happened in the first wave, several Regions employ hotels for the quarantine of less serious patients who cannot be isolated at home.
Why do we have so many ordinary inpatients today compared to March-April? The reasons are numerous – he points out Luca Richeldi, director of the Pneumology Unit at the Gemelli Polyclinic in Rome and member of the Scientific Technical Committee -. Patients are identified in the early stages of the infection and we have identified drugs that are effective in stopping or slowing the progression of the disease. But there are other reasons too: many people with symptoms go directly to the Emergency room, without contacting the family doctor by phone, as has been repeated since the beginning of the epidemic. And there is a very serious psychological issue: coronavirus positive subjects are afraid, they arrive at the hospital in a particular psychic condition. Non-Covid activities, such as cardiology and oncology, are already suffering from the growing burden on healthcare facilities.
Lombardy is the region that suffers the most: almost 55 thousand positives, of which 2,715 hospitalized with symptoms and 271 in intensive care. The available beds are 3,848. At San Raffaele we have about 150 ordinary hospitalizations for Covid – he says Moreno Tresoldi, head of general medicine and advanced therapies in the Milan hospital -: only half of these patients require low-flow oxygen therapy. There are more hospitalizations than are really needed: some therapies can be followed at home, while CPAP (non-invasive mechanical ventilation) and high-flow oxygen require hospitalization. The solutions are there: we opened at San Raffaele an outpatient clinic for paucisymptomatic patients, who are discharged directly from the emergency room and then monitored by telephone contact and visit within 24 hours. The fact remains that throughout Italy there are many green codes they are hospitalized.
In second position for numbers of hospitalizations in ordinary hospital wards is Piedmont, with 2,016 of 23,240 positive patients. There are 2,251 beds available, but – says the Region – they can be increased in case of need up to 5,580.
Lazio, with 1,632 hospitalized with symptoms, has already exceeded its bed capacity, which – according to data from the Ministry of Health – are 1,442. For many of these patients, home isolation would be sufficient – he says Luca Richeldi -: antipyretics, heparin, cortisone and even oxygen can be administered at home. One thing that all Italians should keep with themselves oximeter, because a low level of oxygen in the blood (value less than 95) is an important signal of possible aggravation of the infection.
Overflowing hospitals also in Campania, with 1,210 occupied beds (out of a total of 1,233). In some cases, patients are hospitalized because it is not possible to carry out safe isolation in the homes they live in – he points out Carlo Palermo -. Regions such as Campania, Lazio and Sardinia have difficulties open new Covid departments for lack of staff. Possible solutions? Here’s what you should be doing today: hire ten thousand doctors and upgrade contagion testing and tracking (it would be desirable to reach 400 thousand tampons a day). Also crucial improve home care, allowing family doctors and pediatricians to swab their patients for SARS-CoV-2.
October 28, 2020 (change October 28, 2020 | 08:57)
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