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.



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Shopping sustainably is increasingly important given the severity of the climate crisis, but sometimes it's hard to know where to turn. Thankfully, Amazon is making it a little easier to browse thousands of products that have one or more of 19 sustainability certifications that help preserve the natural world.

The online retailer recently announced Climate Pledge Friendly, a program to make it easier for customers to discover and shop for more sustainable products. To determine the sustainability of a product, the program partnered with third-party certifications, including governmental agencies, nonprofits, and independent labs.

With a selection of items spanning grocery, household, fashion, beauty, and personal electronics, you'll be able to shop more sustainably not just for the holiday season, but throughout the year for your essentials, as well.

You can browse all of the Climate Pledge Friendly products here, labeled with an icon and which certification(s) they meet. To get you on your way to shopping more sustainably, we've rounded up eight of our favorite Climate Pledge Friendly-products that will make great gifts all year long.

Amazon

Jack Wolfskin Women's North York Coat

Give the gift of warmth and style with this coat, available in a variety of colors. Sustainability is built into all Jack Wolfskin products and each item comes with a code that lets you trace back to its origins and understand how it was made.

Bluesign: Bluesign products are responsibly manufactured by using safer chemicals and fewer resources, including less energy, in production.


Amazon

Amazon All-new Echo Dot (4th Gen)

For the tech-obsessed. This Alexa smart speaker, which comes in a sleek, compact design, lets you voice control your entertainment and your smart home as well as connect with others.

Reducing CO2: Products with this certification reduce their carbon footprint year after year. Certified by the Carbon Trust.


Amazon

Burt's Bees Family Jammies Matching Holiday Organic Cotton Pajamas

Get into the holiday spirit with these fun matching PJs for the whole family. Perfect for pictures that even Fido can get in on.

Global Organic Textile Standard: This certifies each step of the organic textile supply chain against strict ecological and social standards. Each product with this certification contains 95%-100% organic content.

Amazon

Naturistick 5-Pack Lip Balm Gift Set

With 100% natural ingredients that are gentle on ultra-sensitive lips, this gift is a great gift for the whole family.

Compact by Design (Certified by Amazon): Products with this certification are packaged without excess air and water, which reduces the carbon footprint of shipping and packaging.


Amazon

Arus Women's GOTS Certified Organic Cotton Hooded Full Length Turkish Bathrobe

For those who love to lounge around, this full-length organic cotton bathrobe is the way to go. Available in five different colors, it has comfortable cuffed sleeves, a hood, pockets, and adjustable belt.

Global Organic Textile Standard: This certifies each step of the organic textile supply chain against strict ecological and social standards. Each product with this certification contains 95%-100% organic content.

Amazon

L'Occitane Extra-Gentle Vegetable Based Soap

This luxe soap, made with moisturizing shea butter and scented with verbena, is perfect for the self-care obsessed.

Compact by Design (Certified by Amazon): Products with this certification are packaged without excess air and water, which reduces the carbon footprint of shipping and packaging.

Amazon

Goodthreads Men's Sweater-Knit Fleece Long-Sleeve Bomber

For the fashionable men in your life, this fashion-forward knit bomber is an excellent choice. The sweater material keeps it cozy and warm, while the bomber jacket-cut, zip front, and rib-trim neck make it look elevated.

Recycled Claim Standard 100: Products with this certification use materials made from at least 95% recycled content.

Amazon

All-new Fire TV Stick with Alexa Voice Remote

Make it even easier to access your favorite movies and shows this holiday season. The new Fire TV Stick lets you use your voice to search across apps. Plus it controls the power and volume on your TV, so you'll never need to leave the couch! Except for snacks.

Reducing CO2: Products with this certification reduce their carbon footprint year after year. Certified by the Carbon Trust.

Even as millions of Americans celebrated the inauguration of President Joe Biden this week, the nation also mourned the fact that, for the first time in modern history, the United States did not have a peaceful transition of power.

With the violent attack on the U.S. Capitol on January 6, when pro-Trump insurrectionists attempted to stop the constitutional process of counting electoral votes and where terrorists threatened to kill lawmakers and the vice president for not keeping Trump in power, our long and proud tradition was broken. And although presidential power was ultimately transferred without incident on January 20, the presence of 20,000 National Guard troops around the Capitol reminded us of the threat that still lingers.

First Lady Jill Biden showed up today with cookies in hand for a group of National Guard troops at the Capitol to thank them for keeping her family safe. The homemade chocolate chip cookies were a small token of appreciation, but one that came from the heart of a mother whose son had served as well.

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If the past year has taught us nothing else, it's that sending love out into the world through selfless acts of kindness can have a positive ripple effect on people and communities. People all over the United States seemed to have gotten the message — 71% of those surveyed by the World Giving Index helped a stranger in need in 2020. A nonprofit survey found 90% helped others by running errands, calling, texting and sending care packages. Many people needed a boost last year in one way or another and obliging good neighbors heeded the call over and over again — and continue to make a positive impact through their actions in this new year.

Upworthy and P&G Good Everyday wanted to help keep kindness going strong, so they partnered up to create the Lead with Love Fund. The fund awards do-gooders in communities around the country with grants to help them continue on with their unique missions. Hundreds of nominations came pouring in and five winners were selected based on three criteria: the impact of action, uniqueness, and "Upworthy-ness" of their story.

Here's a look at the five winners:

Edith Ornelas, co-creator of Mariposas Collective in Memphis, Tenn.

Edith Ornelas has a deep-rooted connection to the asylum-seeking immigrant families she brings food and supplies to families in Memphis, Tenn. She was born in Jalisco, Mexico, and immigrated to the United States when she was 7 years old with her parents and sister. Edith grew up in Chicago, then moved to Memphis in 2016, where she quickly realized how few community programs existed for immigrants. Two years later, she helped create Mariposas Collective, which initially aimed to help families who had just been released from detention centers and were seeking asylum. The collective started out small but has since grown to approximately 400 volunteers.