A doctor in the heart of Italy's outbreak shares what life is like in the hospital now
Photo by JC Gellidon on Unsplash

Those of us living in countries like the U.S., where coronavirus has arrived but not quite exploded exponentially, seem a bit conflicted about what our individual responses should be.


Ideally, we'd simply heed the advice of medical experts at the CDC and WHO instead of politicians who have a vested interest in over-or under-hyping a potential pandemic. But in a heated election season, that appears to be a tall order.

Everyone agrees that we shouldn't panic (no one responsible would ever tell people to panic), but what does that mean exactly? Is stocking up on food and toilet paper a sign of panic, or a smart precaution? What's the sweet spot between alarmism and aloofness?

When numbers are still low where you live, it's easy to say, "Eh, this isn't that big of a deal." But the reality is even if you yourself are not at high risk of dying from the virus, millions of people are. And unlike the flu, there's no vaccine for this. Measures that might seem "extreme" or "panic-driven" are designed to keep spread of the virus to a minimum.

And an ICU physician working in the heart of the outbreak in Italy, Dr. Daniele Macchini, has eloquently explained why limiting the spread is vital.

On February 27, Italy had 650 confirmed cases of COVID-19. Less than two weeks later, they have more than 10,000. The entire country is on lockdown and hospitals are over capacity—a massive contrast to the calm that preceded the storm in the Bergamo hospital where Dr. Macchini works.

Dr. Macchini posted a description on Facebook of what the hospital was like on March 6 vs. what it was like a week before. Below is a condensed translation of his post (which is written in Italian and can be read in its entirety here).

"After much thought about whether and what to write about what is happening to us, I felt that silence was not responsible.

I will therefore try to convey to people far from our reality what we are living in Bergamo in these days of Covid-19 pandemic. I understand the need not to create panic, but when the message of the dangerousness of what is happening does not reach people, I shudder.

I myself watched with some amazement the reorganization of the entire hospital in the past week, when our current enemy was still in the shadows: the wards slowly "emptied", elective activities were interrupted, intensive care were freed up to create as many beds as possible.

All this rapid transformation brought an atmosphere of silence and surreal emptiness to the corridors of the hospital that we did not yet understand, waiting for a war that was yet to begin and that many (including me) were not so sure would ever come with such ferocity.

I still remember my night call a week ago when I was waiting for the results of a swab. When I think about it, my anxiety over one possible case seems almost ridiculous and unjustified, now that I've seen what's happening. Well, the situation now is dramatic to say the least.

The war has literally exploded and battles are uninterrupted day and night. But now that need for beds has arrived in all its drama. One after the other the departments that had been emptied fill up at an impressive pace. The boards with the names of the patients, of different colours depending on the operating unit, are now all red and instead of surgery you see the diagnosis, which is always the damned same: bilateral interstitial pneumonia.

Now, explain to me which flu virus causes such a rapid drama. And while there are still people who boast of not being afraid by ignoring directions, protesting because their normal routine is"temporarily" put in crisis, the epidemiological disaster is taking place.

And there are no more surgeons, urologists, orthopedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us. Cases are multiplying, they arrive at a rate of 15-20 admissions per day all for the same reason. The results of the swabs now come one after the other: positive, positive, positive. Suddenly the E.R. is collapsing.

Reasons for the access always the same: fever and breathing difficulties, fever and cough, respiratory failure. Radiology reports always the same: bilateral interstitial pneumonia, bilateral interstitial pneumonia, bilateral interstitial pneumonia. All to be hospitalized.

Someone already to be intubated and go to intensive care. For others it's too late... Every ventilator becomes like gold: those in operating theatres that have now suspended their non-urgent activity become intensive care places that did not exist before.

The staff is exhausted. I saw the tiredness on faces that didn't know what it was despite the already exhausting workloads they had. I saw a solidarity of all of us, who never failed to go to our internist colleagues to ask "what can I do for you now?"

Doctors who move beds and transfer patients, who administer therapies instead of nurses. Nurses with tears in their eyes because we can't save everyone, and the vital parameters of several patients at the same time reveal an already marked destiny.

There are no more shifts, no more hours. Social life is suspended for us. We no longer see our families for fear of infecting them. Some of us have already become infected despite the protocols.

Some of our colleagues who are infected also have infected relatives and some of their relatives are already struggling between life and death. So be patient, you can't go to the theatre, museums or the gym. Try to have pity on the myriad of old people you could exterminate.

We just try to make ourselves useful. You should do the same: we influence the life and death of a few dozen people. You with yours, many more. Please share this message. We must spread the word to prevent what is happening here from happening all over Italy."

Macchini was speaking to his countrymen, but those of us who live in nations with numbers like Italy had two weeks ago should take note. It's not just a matter of our own personal risk of critical illness; it's also about the capacities of our hospitals and the availability of medical personnel. (I live five hours from Seattle, and a nurse friend here told me yesterday that facilities are offering up to $5000 a week for nurses to go work in Seattle right now to help manage the outbreak there. Things are getting real, real quick.)

Italy had 650 cases less than two weeks ago. As of the writing of this article, the U.S. has 755. If we don't take extreme measures—which many will call mistakenly call "panic"—to keep spread to a minimum, we may soon be facing the same dire straits Dr. Macchini describes in Italy.

Let's all agree to hunker down at home as much as possible, wash our hands religiously, avoid crowded spaces, stop hoarding medical equipment, and ask that our government be proactive with testing and truthful and transparent about the numbers. And let's do all of the above without calling any of it "panic." At this point, it's not panic, but practicality.



Photo by Tim Mossholder on Unsplash
True

Glenda moved to Houston from Ohio just before the pandemic hit. She didn't know that COVID-19-related delays would make it difficult to get her Texas driver's license and apply for unemployment benefits. She quickly found herself in an impossible situation — stranded in a strange place without money for food, gas, or a job to provide what she needed.

Alone, hungry, and scared, Glenda dialed 2-1-1 for help. The person on the other end of the line directed her to the Houston-based nonprofit Bread of Life, founded by St. John's United Methodist pastors Rudy and Juanita Rasmus.

For nearly 30 years, Bread of Life has been at the forefront of HIV/AIDS prevention, eliminating food insecurity, providing permanent housing to formerly homeless individuals and disaster relief.

Glenda sat in her car for 20 minutes outside of the building, trying to muster up the courage to get out and ask for help. She'd never been in this situation before, and she was terrified.

When she finally got out, she encountered Eva Thibaudeau, who happened to be walking down the street at the exact same time. Thibaudeau is the CEO of Temenos CDC, a nonprofit multi-unit housing development also founded by the Rasmuses, with a mission to serve Midtown Houston's homeless population.

Keep Reading Show less

When it comes to the topic of race, we all have questions. And sometimes, it honestly can be embarrassing to ask perfectly well-intentioned questions lest someone accuse you of being ignorant, or worse, racist, for simply admitting you don't know the answer.

America has a complicated history with race. For as long as we've been a country, our culture, politics and commerce have been structured in a way to deny our nation's past crimes, minimize the structural and systemic racism that still exists and make the entire discussion one that most people would rather simply not have.

For example, have you ever wondered what's really behind the term Black Pride? Is it an uplifting phrase for the Black community or a divisive term? Most people instinctively put the term "White Pride" in a negative context. Is there such a thing as non-racist, racial pride for white people? And while we're at it, what about Asian people, Native Americans, and so on?

Yes, a lot of people raise these questions with bad intent. But if you've ever genuinely wanted an answer, either for yourself or so that you best know how to handle the question when talking to someone with racist views, writer/director Michael McWhorter put together a short, simple and irrefutable video clip explaining why "White Pride" isn't a real thing, why "Black Pride" is and all the little details in between.


Keep Reading Show less
Photo by Tim Mossholder on Unsplash
True

Glenda moved to Houston from Ohio just before the pandemic hit. She didn't know that COVID-19-related delays would make it difficult to get her Texas driver's license and apply for unemployment benefits. She quickly found herself in an impossible situation — stranded in a strange place without money for food, gas, or a job to provide what she needed.

Alone, hungry, and scared, Glenda dialed 2-1-1 for help. The person on the other end of the line directed her to the Houston-based nonprofit Bread of Life, founded by St. John's United Methodist pastors Rudy and Juanita Rasmus.

For nearly 30 years, Bread of Life has been at the forefront of HIV/AIDS prevention, eliminating food insecurity, providing permanent housing to formerly homeless individuals and disaster relief.

Glenda sat in her car for 20 minutes outside of the building, trying to muster up the courage to get out and ask for help. She'd never been in this situation before, and she was terrified.

When she finally got out, she encountered Eva Thibaudeau, who happened to be walking down the street at the exact same time. Thibaudeau is the CEO of Temenos CDC, a nonprofit multi-unit housing development also founded by the Rasmuses, with a mission to serve Midtown Houston's homeless population.

Keep Reading Show less

The subject of late-term abortions has been brought up repeatedly during this election season, with President Trump making the outrageous claim that Democrats are in favor of executing babies.

This message grossly misrepresents what late-term abortion actually is, as well as what pro-choice advocates are actually "in favor of." No one is in favor of someone having a specific medical procedure—that would require being involved in someone's individual medical care—but rather they are in favor of keeping the government out of decisions about specific medical procedures.

Pete Buttigieg, who has become a media surrogate for the Biden campaign—and quite an effective one at that—addressed this issue in a Fox News town hall when he was on the campaign trail himself. When Chris Wallace asked him directly about late-term abortions, Buttigieg answered Wallace's questions is the best way possible.

"Do you believe, at any point in pregnancy, whether it's at six weeks or eight weeks or 24 weeks or whenever, that there should be any limit on a woman's right to have an abortion?" Wallace asked.

Keep Reading Show less

As the once-celebrated Information Age devolves into the hell-hole-ish Misinformation Age, many of us feel a desperate sense of despair. It's one thing to have diverse perspectives on issues; it's entirely another to have millions of people living in an alternate reality where up is down, left is right, and a global pandemic is a global hoax put on by a powerful cabal of Satanic, baby-eating, pedophile elites.

Watching a not-insignificant portion of your country fall prey to false—and sometimes flat out bonkers—narratives is disconcerting. Watching politicians and spokespeople spout those narratives on national television is downright terrifying.

Clearly, the U.S. is not the only country with politicians who pander to conspiracy theorists for their own gain, but not every country lets them get away with it. In a now-viral interview, New Zealand's Tova O'Brien spoke with one her country's fringe political party leaders and showed journalists exactly how to handle a misinformation peddler.

Her guest was Jami-Lee Ross, leader of the Advance New Zealand party, which failed to garner enough votes in the country's general election this weekend to enter parliament. The party, which got less than one percent of the vote, had spread misinformation about the coronavirus on social media, and Ross's co-leader, Billy Te Kahika, is a known conspiracy theorist.

But O'Brien came prepared to shut down that nonsense.

Keep Reading Show less