Killed by Covid, Italy is still the black shirt. “Too many sick people are late to the hospital”

Keep going down the contagion rate and above all I finally decrease Covid deaths and access to intensive care. Signs of optimism prevail in the Civil Protection bulletin that every day photographs the progress of the pandemic in our country. At last 24 hours the new positives They were 36,176 against 34,283 on Wednesday, but compared to 250,186 swabs processed, almost 16,000 more. The most positive percentage fell again for the third day in a row, albeit slightly, and went from 14.6 to 14.4. Yesterday the deaths from Covid were 653 (-100), while the increase in resuscitation slows down (+42 compared to +58 the day before and +120 registered on Tuesday).

The Covid newsletter of November 20

the cautious optimism, which we breathe in these last days, does not annul a record, much less enviable, achieved by our country in the fight against the Coronavirus. The reference is to the bronze medal in the ranking of the states with the highest fatality rate for Covid among a hundred positives, prepared by Johns Hopkins University in Baltimore.

In Italy, the index is close to 4% (3.8%), surpassed only by those of Mexico (9.8%) and Iran (5%). The virtuous are called Spain (2.8%), France (2%) and especially Germany (1.6%). How do you explain such a marked gap with other major powers in Europe? The father of the rehabilitation technique of the prone patient in intensive care, Luciano GattinoniEmeritus Professor of Anesthesia at the University of Göttingen, Teutonic land, and at the Milan Polyclinic, has a very precise idea about the Italian debacle.

Professor, why so many deaths in Italy?

“Searching for a single cause that explains the reason for so many deaths for Covid means going astray on its own. The answer lies in a chain of factors, each with its own value.”

Let’s start with those who discuss the inequality of the count: if Italy counts among the victims of Covid also those who for a long time have been attracted by multiple pathologies and in a terminal state, are they less of ‘wide sleeve’ abroad?

Surely the reason for death is not classified in the same way. Some deaths are also indicated in our records with a generic ‘cardiocirculatory arrest’, which in itself means little or nothing as we all die with a heart that stops. That said, I refuse to think that there is a planetary race to hide victims of Sars-Cov2. Let’s be serious, it is not this aspect that in itself justifies our fatality rate ”.

Is it the fault of the lower number of evidence processed?

“It is clear that with a few swabs the death toll ends. So far we have carried out just over 18 million tests, the German ones 25, but it is also true that France and Spain are not too far from us. And yet they rank lower. “

We go to the hospitals, professor: are there weaknesses here too that penalize us?

“Without a doubt, let’s only think about the number of nurses per thousand inhabitants. In Germany we are at 13.6, in Switzerland we are rising to 17, we are no more than six, more than half less. All this. This means that not only do we have few doctors in the wards, but we also have to face a significant shortage of nurses in intensive care where the role of this type of care is fundamental. Added to this is the chapter on health spending per capita ”.

Rock the figures.

“In Germany it is around 6 thousand dollars compared to our 4 thousand which in any case is more than the 3 thousand invested by Bern. Is everything explained then? Not really, since Switzerland mourns less dead than we do ”.

In summary, going back to the beginning: there is no single criterion, be it statistical, economic or health, to justify the Italian ranking.

“Exactly the same is true of the age of the population, which in Italy is among the highest in the world. From a clinical point of view, however, there is one more fact that can no longer be avoided.”

What are you thinking, professor?

“We suffered it during the first wave and in part we continue to experience it today. Too many patients continue to arrive late, too late to the hospital. Although today we have scientific evidence that shows that the use of cortisone and heparin helps reduce mortality with a mortality of up to 30%, speed of hospitalization is still essential. Unfortunately, local medicine does not always have an effective control of positives at home. When I hear Lazio TAR say that family doctors should not visit the home of patients, I jump on my chair. This is not how patients are treated, on the contrary. “