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Among the numbers of the epidemic there is one that in this phase of the second wave is particularly worrying, in terms of voice hospitalized with symptoms. These are patients who for various reasons cannot stay at home, but do not require intensive care either. Yesterday there were 13,955, out of a total of 255,090 positives (about 5 percent). Hospital wards are heading towards saturation, if there is not a slowdown in the spread of the virus. What’s going on? The relationship between ordinary hospitalizations and intensive hospitalizations for Covid 10 to 1 – underlined Carlo Palermo, National Secretary Anaao (main union of doctors and public health managers) -. evident that we face a troublesome situation. There are four regions with more than a thousand hospitalized patients with symptoms: Lombardy, Piedmont, Lazio and Campania.
Converted departments
Ordinary Covid beds are 15,422 throughout Italy (excluding intensive and sub-intensive therapies): in hospitals, as needed, entire wards are converted to Sars-CoV-2, from pulmonology to internal medicine. Of course this means close the areas to all non-Covid patients. Not only that: as happened in the first wave, several Regions employ hotels for the quarantine of less serious patients who cannot be isolated at home.
Psychological question
Why do we have so many regular patients today compared to March-April? The reasons are numerous – notes Luca richeldi, director of the Pulmonology Unit of the Gemelli Polyclinic in Rome and member of the Scientific Technical Committee -. Patients are identified in the early stages of infection and we have identified medications that are effective in stopping or slowing the progression of the disease. But there are other reasons too: Many people with symptoms go straight to the Emergency room, without contacting the family doctor by phone, as has been repeated since the beginning of the epidemic. And there is a very serious psychological issue: subjects positive for the coronavirus are afraid, they arrive at the hospital in a particular psychic condition. Non-Covid activities such as cardiology and oncology are already suffering from the increasing burden on healthcare facilities.
Lombardy
Lombardy is the region that suffers the most: almost 55 thousand positives, of which 2,715 hospitalized with symptoms and 271 in intensive care. The available beds are 3,848. In San Raffaele we have around 150 ordinary hospitalizations for Covid – says Moreno Tresoldi, head of general medicine and advanced therapies at the Milan hospital: Only half of these patients require low-flow oxygen therapy. There are more hospitalizations than are actually needed: some therapies can be followed at homewhereas CPAP (non-invasive mechanical ventilation) and high-flow oxygen require hospitalization. The solutions are there: in San Raffaele we have opened an outpatient clinic for paucisymptomatic patients, who are discharged directly from the emergency room and then monitored by phone contact and visits within 24 hours. The fact is that throughout Italy there are many green codes they are hospitalized.
Piedmont
In second place in terms of the number of hospitalizations in ordinary hospital wards is Piedmont, with 2,016 of 23,240 positive patients. There are 2,251 beds available, but – says the Region – they can be increased to 5,580 if necessary.
Lazio
Lazio, with 1,632 hospitalized for symptoms, has already exceeded its capacity of beds, which -according to data from the Ministry of Health- are 1,442. For many of these patients, home isolation would be sufficient, he says. Luca richeldi -: Antipyretics, heparin, cortisone and even oxygen can be administered at home. One thing all Italians should keep with them oximeter, because a low level of oxygen in the blood (value below 95) is an important sign of a possible worsening of the infection.
Campania
Hospitals overwhelmed also in Campania, with 1,210 occupied places (out of a total of 1,233). In some cases, patients are hospitalized because safe isolation is not possible in the homes where they live – he notes. Carlo Palermo -. Regions like Campania, Lazio and Sardinia are struggling open new Covid departments due to lack of staff. Possible solutions? Here’s what to do today: Hire 10,000 Doctors and Upgrade contagion testing and monitoring (It would be desirable to reach 400 thousand tampons a day). Also crucial improve home care, allowing family physicians and pediatricians to rub their patients for SARS-CoV-2.
October 28, 2020 (change October 28, 2020 | 07:21)
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