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The strength of a chain is given by its weak link. This is often repeated by Silvio Brusaferro, president of the Higher Institute of Health. And in this chain called Covid, the weak link is them, intensive care. With the risk of running out of available places, leaving out not only other Covid patients but also those who are victims of other different disasters, a heart attack or a car accident. A dramatic scenario, although for now only potential. And above all the real reason why the government, not only the Italian, has chosen and was able to choose the path of emergency shutdown, with all the economic consequences that it entails. And that unfortunately are far from being potential, but already among us.
The numbers (the photo)
At first glance, the numbers don’t seem all that dramatic. There are 1,843 Covid patients admitted to intensive care. Taking into account the 7,123 available seats, we are at 25.8% of capacity. Taking as a reference the 8,939 seats that can be activated in case of need, with lung ventilators, we dropped to 20.6%. Considering then the 10,300 that could be reached with an additional stretch of fans, the occupancy rate falls below 18%. All good? In conclusion.
Limits
Partly because in those data there are only Covid patients, not the others. It was established that only 30% of beds in intensive care should be reserved for patients with Covid, precisely to make way for other diseases that certainly do not enter into emergency shutdown. But this limit has already been shot in several hospitals. Not only. Because one thing is the available beds, another is the personnel necessary to make them work. According to a union of anesthesiologists, Aaroi-Emac, only the 7,000 positions available today can work with today’s staff. But the real problem is another: photography is one thing, cinema is another.
The trend (the movie)
To predict the evolution of a phenomenon, its evolution over time matters more than the data measured at a precise moment. And the trend of admissions to intensive care, yes, is worrying. Yesterday the Covid patients who entered resuscitation grew by 5.5%. Not one bit. Also because the progression is not linear but geometric, that is, with an increasingly full-bodied increase, day after day. “We are not yet at the critical point but the pressure is there”, sums up Massimo Antonelli, director of the Department of Emergencies and Resuscitation of Gemelli in Rome, member of the scientific-technical committee. But when could the tipping point come? If the trend continues like this, we could already be there in mid-November ”.
The context
There are other elements that unfortunately make the film more realistic than the photo. Those entering intensive care today were infected at least two weeks ago. And two weeks ago the daily infections, which at that time seemed like a lot to us, were only 8 thousand. A quarter from yesterday. Not only. For the government to decide any new restrictions, the effects will be seen after 15 days. With the first wave, Covid’s ICU admissions had dropped below 2000, thus to a similar level to yesterday, on April 27 alone. A month and a half after the start of emergency shutdown. It is true that since then our doctors have learned many things in the field. But it is also true that back then we were heading towards summer, this time directly towards winter.
October 31, 2020 (change October 31, 2020 | 22:36)
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