Where the hospital beds are already full

Hospitals are on the brink of collapse, under pressure from hospitalizations for coronavirus steadily increasing? Currently, Italy has passed the threshold of one million registered cases since the beginning of the pandemic. And the most worrying figure arrives today from the hospitals: 32,525 patients are hospitalized, of which 3,081 are in intensive care (+122 compared to yesterday).

Analysis of data from the Ministry of Health by Fadoi, the scientific society of hospital internists, which cares for 70% of Covid patients, shows that internal medicine departments are already “exhausted.” Because if about two-thirds of the beds provided are already occupied by Covid patients, the rest of the places are in turn occupied by other types of patients, for whom the supply of beds is currently largely insufficient compared to the demand. assistance.

With the coronavirus, other diseases don’t go on vacation

The internist is in charge of caring for patients suffering from hepatological, autoimmune, allergological, gastroenterological, rheumatological disorders and all other general medical problems that do not require a surgical approach. But let’s take a look at the numbers that photograph the situation. From the analysis of the data referred to November 10 (28,633 hospitalized), 68% of the beds in medical services (out of a total of 39,910, of which 29,923 only in internal medicine) are effectively occupied by Covid patients. Much more than 40% indicated by the Higher Institute of Health as security threshold, given that the other diseases with the pandemic do not go on vacation and the need for hospitalization of other patients remains unchanged and the degree of saturation of the beds goes far beyond what is communicated.

Where the hospital beds are already full

And indeed many hospitals additional departments had to be opened in the medical area to accommodate patients. A simple analysis of the numbers does not give an idea because it could emerge that there are still beds available, whereas, instead, the total threshold has already been exceeded in most hospitals. The figure becomes more dramatic when the magnifying glass is focused on individual regions, with Piedmont (164.4% of beds occupied by Covid patients), Valle d’Aosta (191.7%) and Liguria (105.3%) Not only have they already exhausted all the places in the medical area but, precisely because they have occupancy rates higher than 100%, they have been using beds in rooms of other disciplines for a long time, such as surgery, orthopedics, cardiology.

COVID-19. Fadoi-Simi-Sigg-Sigot-Animo Appeal: “Hospitals on the brink of collapse. No to messages that mitigate the situation “

Open letter from the Scientific Societies of the Medical Area https://t.co/jleJ644NmW

– FADOI (@FADOIOfficial) November 11, 2020

About 100% of the beds reserved for patients positive for the virus are Lombardy (95.8%), the autonomous province of Bolzano (94%), followed by Campania (77.7%) and Lazio (76.3%). In total there are 14 regions (2/3) that exceed the safety threshold of 40%. But the trend is also worrying. In just two days, the beds in the theoretical and potentially available internal medicine rooms for patients without Covid have gone from the already reduced 12,875 to 8,869, that is, in 48 hours 4,006 beds have already been eroded, leaving a reserve of places destined to be sold out in a few days. Speaking of national numbers, because at the regional level Piedmont, Valle d’Aosta, Lombardy and Liguria are already ‘sold out’ even for Covid patients.

And as mentioned, the 8,869 “residual” beds are not actually available places because they are all already occupied by non-Covid patients and, in fact, the medical area is expanding dramatically, turning to beds from other departments to deal with the abnormal request for hospitalization. “Hospitals are on the brink of collapse due to the concomitant shortage of healthcare staff and beds. The staff is the same almost everywhere, but hospitalizations and the need for patient care have increased significantly,” says Dario Manfellotto, president of Fadoi.

Martina Luoni: “I am 26 years old and I have cancer, hospitals cannot cure me of covid”

“In internal medicine, patients are guaranteed all treatments, including oxygen therapy and non-invasive ventilation, trying to avoid reaching intubation or death. In addition, internists continue to assist patients, who suffer from other major illnesses, such as respiratory failure, heart failure, sepsis, acute pneumonia, but for these the possibilities of access to hospitals are decreasing. And it is clear – he continues – that a probable consequence, if not certain, will be the increasing difficulty to guarantee the quality standards of non-Covid exacerbated chronically ill care.

Fresh growth of the contagion curve

The Fadoi survey numbers say that of the nearly 30,000 beds in internal medicine wards 70% appear to be occupied by Covid patients. A rapidly growing percentage. The same survey shows that, to regain control of the situation in hospitals, it would be necessary to cool the growth of the contagion curve. This is because, despite the high number of beds occupied by Covid patients, the rate of hospitalization of positives, including both those assisted in the medical area and in intensive care, remains low at the national level: around 5 , 8% of those infected. Although later in Trentino and Liguria it reaches double figures, respectively with 11.3 and 10.6% of positives who need a bed. But the large number of infected people, with hundreds of thousands of Covid patients, puts the national health system to the test even with this low percentage of hospitalizations.

Intensive care, the 12 regions beyond the critical threshold

Unfortunately, it is no better on the front of intensive therapy. The 30% threshold of intensive care beds occupied by Covid-19 patients, defined as “critical” by the Ministry of Health in the coronavirus emergency, has now been widely exceeded. According to data processed by Agenas, the National Agency for Regional Health Services (updated to November 10), the Italian average has in fact increased rapidly in recent days, reaching 37%, but is on red alert in some regions and in the 2 autonomous provinces. from Trentino Alto Adige, who have widely surpassed him. At the top of the “black list”, Umbria, which has now reached 57% saturation of its intensive beds, followed by Piedmont (56%), the autonomous province of Bolzano and Lombardy with 54%.

• Abruzzo 26%
• Basilicata not received
• Calabria 16%
• Campania 33%
• Emilia Romagna 38%
• Friuli Venezia Giulia 27%
• Lazio 27%
• Liguria 44%
• Lombardy 54%
• Walking 46%
• Molise 21%
• Piedmont 56%;
• Pa Bolzano 54%,
• Pa Trento 42%
• Apulia 30%
• Sardinia 30%
• Sicily 27%
• Tuscany 47%
• Umbria 57%
• Aosta Valley 50%
• Veneto 20%

In total, therefore, in 12 regions the guard level was reached or exceeded: Campania, Emilia Romagna, Liguria, Lombardy, Marche, Piedmont, Trentino Alto Adige, Tuscany, Umbria, Valle D’Aosta, Puglia 30%, Sardinia 30%.