Doctor in the heart of Italy’s coronavirus outbreak shares what life is like in the hospital right now

Coronavirus might not have ascended to its peak yet (in fact, it’s highly likely that we’re only at the beginning of the storm) but it’s still causing a host of problem worldwide.

Here in the U.S., it’s easy to place panic and hyperbole surrounding the virus on the shelf alongside SARS and Ebola – i.e. not allowing yourself to get worked up over something that could turn out to be nothing.

And yet … and yet, whilst not giving in to blind fear is always advisable (never more so when the world seems on the verge of a pandemic) it’s more than merely sensible to know what it is we’re likely to come up against.

The reality of the situation as it stands is that coronavirus could prove lethal to millions. Now, even if you yourself are young, perfectly healthy and therefore may have little to fear, that doesn’t mean others are quite so lucky.

There is no vaccine for coronavirus and nor is there likely to be for a long time to come. That means that the elderly, the sick, the very young and those with underlying health problems could be left at its mercy if it continues to grow as it has.

With this in mind, an ICU physician working at Ground Zero of the outbreak in Italy, Dr. Daniele Macchini, has taken pains to try and drive home the importance of keeping the spread of the virus to an absolute minimum.

In una delle costanti mail che ricevo dalla mia direzione sanitaria a cadenza più che quotidiana ormai in questi giorni,…

Posted by Daniele Macchini on Friday, March 6, 2020

Italy had 650 confirmed cases of COVID-19 on February 27 of this year. Fast forward less than two weeks and that number stands at more than 10,000. The entire country is in a quarantine, hospitals are overrun with patients and a war against coronavirus is being waged on an alarming level.

Dr. Macchini, who happens to be working in the eye of the storm, posted to Facebook to detail the contrast between how things were in anticipation of the corona outbreak and how they are now that its hit with full force.

*His post has been translated from Italian. The original can be read above.

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

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.”

Dr. Macchini might have been writing his address with the rest of his country in mind, but his words should be adhered by us all. Though coronavirus seems like a distant fear right now, one that’s teeth and claws are a world away, its creeping up on us quicker than many would like to believe.

The question now is: are we sufficiently equipped to handle cases on the scale Italy is facing? If coronavirus sweeps the U.S. in its entirety can our infrastructure cope under its weight? Can we honestly say we can tackle this thing head on and not suffer tremendous losses in the process?

The way forward for us lies not in fighting a pitched battle against coronavirus but in eliminating the threat before it ever gets to that stage.

This means taking all the necessary precautions to halt the spread of the disease, including washing hands and avoiding crowded spaces where possible. It means not hoarding medical equipment and not panicking so as to invite widespread fear.

Share this article to spread Dr. Macchini’s important message around. Let’s be safer, together.