Doctors in Italy speak out on ‘harrowing experience’ UK could face with battling coronavirus

Country’s experience shows need to act decisively before healthcare system is stretched beyond its limit, Federica Marsi reports from Milan

Medical workers attend to patients at Brescia’s Poliambulanza hospital (AFP/Getty)

The photograph of a nurse collapsed onto a desk, her surgical mask still covering her mouth and nose, has become the symbol of an overwhelmed medical force. As the virus takes on pandemic proportions, Italy offers a grim glimpse of what awaits if governments cannot ‘‘flatten the curve’’ of new cases.

Doctors on the frontline of the coronavirus outbreak in Italy have seen their professional and personal lives upended in less than three weeks, as the arc of contagions rises above 31,000.

The country’s experience is a case in point of the need to act decisively before the health system is stretched beyond its limits, Tony Sabatini, head of the department of Medicine, Gastroenterology and Endoscopy at Fondazione Poliambulanza in Brescia, told The Independent.

“My ward has been completely transformed over the past weeks, it feels as if I’ve been doing a different job,” he said. Around 80 per cent of the hospital – a hub for cardiovascular medicine the northern Lombardy region – has been converted to treat patients who have developed the acute respiratory syndrome that is the trademark of Covid-19.

Medical personnel specialised in fields as far off as orthopaedics have received just a few hours training before being sent out to monitor infected patients in need of mechanical ventilation.

“We enter the rooms fully covered by our protective gowns and patients feel lost,” Sabatini said. “They can’t identify their doctors and they feel isolated, alone and afraid. You can sense their fear of dying.”

Alongside the emotional toll, Sabatini said all medical personnel at the hospital have lost count of the extra hours of work as they cater to 350 infected patients, 50 of whom are in intensive care. The hospital’s emergency room was also converted to accommodate 50 additional patients in need of mechanical ventilation.

“Our hospital is full to the brink,” Alessandro Triboldi, general director of Fondazione Poliambulanza, told The Independent. He has not been home or seen his wife, also a doctor, since the crisis started.

Among the logistical difficulties of managing the pandemic is finding ventilators and oxygen tanks. “Normally every two weeks we would order two oxygen tanks each containing 6,000 litres of oxygen,” Triboldi said. “Now we have an additional tank of 10,000 litres and we are adding a second one, and we refill them every two days.”

The economic loss endured by a hospital renowned for cardiovascular surgery is incalculable. But it is not yet time to count the losses. “Our first concern is to save lives,” the director said.

The northern Lombardy region, where the hospital is located, has been the hardest hit by the spread of the virus. As of yesterday, it registered 16,220 cases out of a total of 31,506 nationwide.

In Italy, a country with the second-oldest population on earth, the death rate has been strikingly high, with over 2,500 people succumbing to the virus. Fewer young people have also ended up in intensive care units, including the 38-year-old marathon runner known as Italy’s “patient one”.

A countrywide ban on movement came into force on 8 March in a bid to slow contagions. Italian prime minister Giuseppe Conte warned that the beneficial effects of social distancing would be felt after two weeks. At present, an average of 3,000 contagions are still emerging every day.

“We are probably about to reach the peak of our contagions,” said Marco Bordonali, head of the emergency room at the Fatebenefratelli San Giuseppe hospital in Milan, where he assists 100 Covid-19 patients. “At present we are still expanding [to cater for more].”

Marco Bordonali and his team at Fatebenefratelli San Giuseppe hospital, Milan (Federica Marsi/ The Independent)

Bordonali, who took part in missions abroad to contain the spread of epidemics including Africa’s ebola outbreak, said all countries, including Italy, have been slow to understand the seriousness of the virus.

“At first we thought it was just pneumonia, but we soon realised this wasn’t the case,” he said. “When colleagues in France or the UK tell me they only have a few cases, I reply: ‘You should prepare for the worst-case scenario’.”

The two top priorities in the containment of Covid-19 are setting up a dedicated access point and ward for infected patients, and enforcing social distancing so as to slow the rate of contagion. “The idea of letting the virus spread so as to develop immunity is surely not the correct approach,” he said.

Doctors have been increasingly exposed to the risk of infection as medical supplies dwindle and governments squabble over exports and rationing of face masks. At least 1,700 doctors have been infected in Italy, according to Doctors Without Borders, which called on EU member states to collaborate.

In the ASST hospital operating in the towns of Lecco and Merate, 119 medical personnel have been infected. This had been a “harrowing experience”, director Paolo Favini told The Independent.

Thirty-six Chinese doctors arrived yesterday to swell the hospital’s ranks, as part of the country’s efforts to help the second-worst affected nation in the world.

The Chinese Republic also sent a plane loaded with medical supplies to Italy, including masks and respirators, in contrast to EU member states who earlier this month refused Rome’s requests for help.

Favini said the hospital was frantically recruiting medical personnel from all fields, including trainees and pensioners, to match the needs.

To all hospitals bracing for an outbreak, he had only one message: “Do not underestimate the virus. This is an emergency.”