“on the scale of a major war,” and adding, “The number of casualties may actually be even higher than what the Armed Forces experienced in World War II.”At first I thought that might be exaggerated but that was before I read the New York Times article describing triage in Italy:
“In a context of grave shortage of health resources,” the guidelines say, intensive care should be given to “patients with the best chance of success” and those with the “best hope of life” should be prioritized.
The guidelines also say that “in the interests of maximizing benefits for the largest number,” limits could be put on intensive care units to reserve scarce resources to those who have, first, “greater likelihood of survival and secondly who have more potential years of life.
THIS JUST CAME IN:
"When Italy announced its first Covid-19 case three weeks ago, it started aggressively testing people, making it the first country in Europe to record skyrocketing numbers of infected patients and to see its markets collapse. My ever-optimistic father, who worked in public health for decades and has been texting me calm and reasoned updates throughout the outbreak, wrote earlier this week that “things are getting hard.” Coming from him, that means they are really bad.
In the U.S., despite weeks of notice, officials are scrambling to get a grip on a quickly approaching disaster. Trump’s press conference last night was the most terrifying public statement I have ever heard, even from him. Days ago, as the number of infections rose at home, I began hearing about friends of friends here in New York who were struggling to get tested despite worsening symptoms. And yet as cases multiply in the U.S., the number of people tested here remains abysmally low. No one knows what’s coming, but we know far less here in the U.S. than people do back home.
It is a tragic irony that a public health emergency unlike anything we have seen in generations would come as Americans are constantly told that the idea of health care as a fundamental right is entitled, radical, crazy talk. What is crazy, to anyone outside the United States, is that it’s even a question.
Back in Italy, people are worried they’ll get themselves or their loved ones sick, they are angry at directives that came late, they are even scared that hospitals won’t be able to keep up. But there are more hospital beds and doctors per capita in Italy than there are in the U.S. The Italian government’s harsh restrictions are in part an effort to stop the virus from spreading to the south, where the health care system is weaker. But for all their fears, Italians don’t have to worry that tests won’t be available, or that they’ll have to pay for those tests, or for any of their care. They don’t have to fear that if they seek help now, they’ll get a surprise bill later or that medical costs will bankrupt them."
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Alice Speri
22.8 % of Italians are 60 and older. It’s why Italy has a 5% death rate from COVID-19
In Pennsylvania:
Even though Boomers and older generations accounted for 43% of eligible voters, they cast 49% of the ballots. SEE BOTTOM OF POST.
"ROME — The mayor of one town complained that doctors were forced to decide not to treat the very old, leaving them to die. In another town, patients with coronavirus-caused pneumonia were being sent home. Elsewhere, a nurse collapsed with her mask on, her photograph becoming a symbol of overwhelmed medical staff.
In less than three weeks, the coronavirus has overloaded the heath care system all over northern Italy. It has turned the hard hit Lombardy region into a grim glimpse of what awaits countries if they cannot slow the spread of the virus and ‘‘flatten the curve’’ of new cases — allowing the sick to be treated without swamping the capacity of hospitals.
If not, even hospitals in developed countries with the world’s best health care risk becoming triage wards, forcing ordinary doctors and nurses to make extraordinary decisions about who may live and who may die. Wealthy northern Italy is facing a version of that nightmare already.
“This is a war,” said Massimo Puoti, the head of infectious medicine at Milan’s Niguarda hospital, one of the largest in Lombardy, the northern Italian region at the heart of the country’s coronavirus epidemic.
He said the goal was to limit infections, stave off the epidemic and learn more about the nature of the enemy. “We need time.”
This week Italy put in place draconian measures — restricting movement and closing all stores except for pharmacies, groceries and other essential services. But they did not come in time to prevent the surge of cases that has deeply taxed the capacity even of a well-regarded health care system.
Italy’s experience has now underscored the need to act decisively — quickly and early — well before case numbers even appear to reach crisis levels. By that point, it may already be too late to prevent a spike in cases that stretches systems beyond their limits.
With Italy having appeared to pass that threshold, its doctors are finding themselves in an extraordinary position largely unseen by developed European nations with public health care systems since the Second World War."
MORE AT:
New York Times
By Jason HorowitzUpdated 8:39 p.m. ET
"Trump, Sanders & Biden addressed the Coronavirus outbreak. In my opinion Bernie is the only one who got it right. What's obvious to anyone who is not dependent on income, or bribes from pharmaceutical & insurance industries is that we must have Medicare for All to deal with pandemics...
Bernie Sanders, speaking a short time later, was if anything more sober, declaring that the crisis was “on the scale of a major war,” and adding, “The number of casualties may actually be even higher than what the Armed Forces experienced in World War II.”
While Trump was criticized for sowing confusion in his 11-minute Oval Office address Wednesday — focusing on problems more foreign than domestic, more economic than medical — Biden and Sanders focused squarely on how a commander in chief might use his powers to tackle a spreading pandemic. Biden outlined how the Pentagon could build new hospital beds, how researchers could strive for a vaccine, and how testing kits should be free and readily available. Sanders said the government should pressure pharmaceutical companies to provide eventual virus-related medications at-cost, set up a national hotline that could help people assess their symptoms, and dramatically increase testing...
About 90 minutes after Biden began his remarks, Sanders stood before a wall plastered with campaign signs in a hotel near his home in Burlington, Vt., and issued the most dire assessment, declaring a “global economic meltdown” and a potential human and economic toll on the “scale of a major war.”
Leaning heavily on a lectern, Sanders said the United States is “at a severe disadvantage” compared with other countries because it does not offer universal health care, and he urged the nation to learn from other countries that are testing for the coronavirus at a much higher rate.
Sanders — who also convened a roundtable discussion with doctors on the coronavirus on Monday — has called for the government to take such actions as paying for hospital visits and vaccines and guaranteeing workers’ paychecks.
“While we work to pass a Medicare-for-all single-payer system, the United States government today must it make it clear that in the midst of this emergency, everyone in our country, regardless of income or where they live, must be able to get all of the health care they need without cost,” Sanders said."
MORE AT:
WASHINGTON POST
Biden and Sanders aim to project presidential stature on coronavirus after Trump’s shaky address
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