“There is a risk of returning to the past”

“The sick hospitalized in these days in intensive care for Covid-19? In Lombardy there are about thirty (30 according to the update released today by the Region, ed). There is no great movement, but these patients are as seriously ill as those of March. And I expect similar mortality, around 40%. For the upcoming winter season it is unfortunately difficult to make predictions now. And we need to see, for example, what happens after the opening of schools, the impact of which could be seen in about 20 days. What is certain is that there is a need to continue dealing with the Covid problem, because it has not passed. If we’re wrong, come back out. Look at the case of Israel: it is not a country where organization is poor, but they have found a second wave, worse than the first “. The reflection is of Antonio Pesenti, director of the Anesthesia-Intensive Care Department of the Milan Polyclinic and coordinator of intensive care in the crisis unit of the Lombardy Region for the coronavirus emergency.

“Of course there is a risk of a return to the past, a new wave of patients – explains Adnkronos Salute – A colleague from Greece called me and says that they are experiencing a second wave” of Covid-19. “In France they are not far away. Everything obviously depends on the extent of the second wave. We were very lucky and it should be emphasized so that people are not deluded. The first wave hit in Lombardy, Emilia Romagna, Piedmont, but if in Italy it was a second arrives with percentages even one tenth of those in Lombardy is a disaster “.

As for the increase in hospitalizations in intensive care which is being recorded in recent weeks, “for now the situation is manageable, while it seems to me that the number of patients in Italy has significantly increased. In Lombardy – specifies the expert – we are still firm to the 5 reference hospitals (Sacco, Policlinico and Niguarda in Milan, Pavia and Brescia) which in principle provide specific intensive care for Covid “. Facilities that still have free places. “Secondly, we have another 12 hospitals” ready to take the field. “After that, the plan foresees the use of the beds in the Fair”.

The situation is under control for the moment, Pesenti points out. But “we absolutely have to make sure it doesn’t get out of hand,” he warns. The average age of patients in intensive care “has decreased a bit. It is 10-15 years younger than before and there are also 25 years old”. What has changed since March? “Today the number of infected is under control – the specialist reasons – Before there were probably one and a half million in Italy. The numbers cannot be estimated without swabs and at the end of February we had not done so many swabs. There were guidelines precise of the World Health Organization, it seemed to be right, but this time the pandemic was a catastrophe. After all, I repeat, we were lucky, even though we were the first outside China “to face Covid-19.

“Nobody knew anything at the time. They called me from France, Spain, few believed what I was saying, what was happening. The forecasts were heavy and took us a bit”, recalls the doctor. For the coming months, he continues, “I am confident that we will come to winter with an adequate supply of protective equipment”. This was one of the most critical points of the emergency phase: “I am sure we will be reassured”.

As for the controversy in recent weeks between those who highlighted the low numbers of patients and those who instead continued to reiterate the need not to loosen their grip, Pesenti observes: “In reality, everyone says the same thing, and that is that at the moment there are fewer patients . And therefore also the seriously ill. Everyone has spent a month seeing very few sick people. Now they are back, and they are 10 times more than the minimum touched. But we are always at a much lower level. There was a time when we also had 1,500 patients in intensive care. This spring at one point there were no sedatives because we had never had so many patients in intensive care. “

The invitation is therefore “not to give up now. The truth is that at the moment there is still no specific effective therapy – recalls Pesenti – There are adjuvants. The situation must not get out of hand. They say that the flu vaccination could help to decrease the possibility of confusing other infections with Covid, if we manage to vaccinate at least 70-80% of the population. But you need to have the doses and that’s not certain, since you can’t prepare a vaccine a year in advance “and we these are technical times necessary to produce it.

The important thing, concludes the expert, is not to be caught unprepared. Don’t waste the lessons of the emergency. An example of what could have been done better? “Perhaps screening for teachers should not have been voluntary, but mandatory. Public health has its needs, even if individual freedoms are important. And it does not seem useful to me – he concludes – to have ideological battles on Covid-19″.

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