Exclusive: “Everything is fine” – Italian doctors at the time of choice

US, WASHINGTON (ORDO NEWS/REUTERS) — The death race pauses at 1 p.m. daily.

It is at this time that the doctors of the intensive care unit of the San Donato polyclinic in Milan contact the relatives of their patients, all in critical condition, sedated and breathing only with help. an artificial respirator.

Until recently, this schedule was that of family visits and the lunch break of medical staff. Those days are over since hospitals in the north of the peninsula were faced with an influx of patients infected with coronavirus.

With each phone call, the doctors try to give no false hope: they know from experience that one in two patients will probably die before their eyes.

With the spread of the Covid-19 epidemic, places are becoming scarce in the intensive care units. And as soon as a bed becomes available, two anesthesiologists meet with a resuscitation specialist and an intern to decide who can fill the vacant place.

Several criteria are taken into account: medical history is one, but having a family is an advantage.

“We have to take into account the presence of a family capable of taking care of the elderly patients when they leave the intensive care unit, because they will need help,” explains Marco Resta, deputy director of the service.

And even if the patient has no chance of being admitted, you have to “look him in the eyes and tell him ‘everything is fine’. And this lie gnaws at you”.

AVANT-GARDE

A former military doctor, Marco Resta has never been faced with such situations, even at the front.

Doctors have warned: northern Italy, whose healthcare system is considered to be one of the most efficient on the planet, is at the forefront of the global health crisis.

The epidemic in Italy was first declared in Lombardy and Veneto, two of the richest regions of the peninsula and whose health system is now completely saturated.

In three weeks, 1,135 people needed intensive care in Lombardy, which has only 800 intensive care beds, according to figures gathered by Giacomo Grasselli, who runs the Polyclinic in Milan, another health facility in the Lombard capital.

Of course, the medical profession has always had to make choices in the treatment of patients with breathing difficulties. Critical care specialists always make predictions before choosing to intubate a patient, a particularly traumatic medical procedure.

But with the influx of patients, decision-making is multiplying and it is necessary to determine who will have greater chances of survival, who will have the right to live, a particularly painful dilemma in a country which remains marked by its Catholic heritage, where medically assisted death is not authorized and the population is the oldest in Europe, according to figures from Eurostat.

“We are not used to making such brutal decisions,” says Marco Resta.

SORTING

The Italian doctors are very clear: there are so many infected patients who show breathing difficulties that they cannot take risks by treating those whose chances of remission are the thinnest.

Alfredo Visioli was one of them. Aged 83, this old man from Cremona led an active life not long ago, at home, in the company of his German shepherd Holaf and took care of his wife, who suffered two years ago from a heart attack, says his granddaughter, Marta Manfredi.

He initially had only intermittent fever, but two weeks after being diagnosed with Covid-19, he developed pulmonary fibrosis which gradually weakened his breathing capacity.

It was the Cremona doctors who decided to intubate him to help him breathe.

“They said it would be useless,” says Marta Manfredi.

Her grandfather was put on morphine and died without her being able to see him again.

Marta Manfredi is now worried about the fate of her grandmother, also contaminated by the Covid-19, hospitalized and who now breathes using a machine. No one informed her of the death of her husband.

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The article is written and prepared by our foreign editors from different countries around the world – material edited and published by Ordo News staff in our US newsroom press.

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