Resuscitations, the seats are there: for now only 7.4% is occupied

The focus returns to intensive care. Yesterday they welcomed 30 more people infected with the coronavirus. Throughout Italy there are 420 serious patients. A low number if compared to the over 1,300 cases that Lombardy alone had to treat in some dramatic days in March. But the comparison with last spring is not enough. There are other data to consider to understand if the Regions are ready to face the second wave. Intensive care units are the departments dedicated to patients in critical conditions, both due to Covid-19 and for other pathologies or traumas. In the most agitated moments of the emergency, the Regions most affected opened beds for this type of patient wherever possible. After the peak they all had to draw up a plan to expand the departments. At the national level, an increase of 3,553 places has been planned compared to the starting 5,179, the Ministry of Health said. To these are added another 4,225 of semi-intensive therapy, half of which can be converted for critically ill patients. To create more beds, you need machinery, work, space and time. And to date, while the infections rise, the maxi-plan is not completed.

38 percent of scheduled beds have been activated, the ministry says, without providing regional details: Italians have 6,529 resuscitation beds at their disposal. We are far from the goal of 8,732. The tender to start the construction sites was launched by the extraordinary commissioner for the emergency Domenico Arcuri at the beginning of October and will close today at 2 pm The forecast to see the workers at work by the end of the month. How many intensive beds are occupied today and how much space is there if cases increase rapidly? Altems, the High School of Economics and Management of Health Systems of the Catholic University, in the latest report calculates this percentage both on the total available pre-Covid beds and on the places we will have in the future. The Courier service did the same with the data as of yesterday. Nationwide, the saturation is 7.4 percent. Seven out of 100 beds for the seriously ill are occupied by infected people. The others are not all free: in part they welcome people with other pathologies.

Regional photography is more difficult. We have created a fork, not knowing at what point in each hospital the expansion of intensive care, explains Americo Cicchetti, director of Altems and coordinator of the report. Among the worst data is that of the Aosta Valley, with 30 percent saturation taking into account pre-emergency beds (90 percent in March). Campania follows, with 18.2 per cent: worse than spring when the epidemic had not overwhelmed it. In third position Sardinia with 16 per cent of the beds occupied, compared to 11 seven months ago. In fourth place Liguria, with 14.4 percent, still far from the 81 percent of the past. Lombardy, a land tormented by the first wave, which went from 122 per cent (with beds created from nothing to keep up with requests) to yesterday’s 5.6, Piedmont from 86 to 7.3, Veneto from 48 to 4.9. Some areas are still at zero: the case of Molise, Basilicata, the autonomous province of Trento. Yet Cicchetti invites us to go further. The increase in places should be such as to allow both Covid and non-Covid patients to be managed. Otherwise there is the risk of blocking the rest of the healthcare activity again. From next week, the university’s monitoring will link virus admissions only to scheduled additional beds.

The first to look closely at the data are the hosts of these departments: anesthesiologists-resuscitators. Yesterday during the online round table of the Siaarti (Italian Society of Anesthesia, Analgesia, Intensive Care and Intensive Care) the experts shared what they see in the ward. We oscillate between 7 and 15 percent of patients who end up in intensive care – summarizes the vice president Antonello Giarratano -. The disease has not changed, but the infected are younger, so they are less likely to worsen and the tracking is more effective. The professor says he is worried about the many asymptomatic people: so we don’t know who to defend ourselves from. And the trend of infections goes up. It must be stopped now with more stringent measures. We are late for the expansion of intensive care posts. We had a cicada summer.

There is another point that is close to his heart. With the decree Calabria was given the opportunity to postgraduates of the fourth and fifth year to be hired and work in their field of specialty. Some regions have taken action, others have settled on the emergency Covid contracts. And so there is a risk that resuscitation residents end up in other departments. We need a ministry audit.

12 October 2020 (change October 12, 2020 | 00:27)



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