Italy continues to be pummeled by the coronavirus: Deaths now top that of China, health care system pushed to the limit – is there even an end in sight?

Italy’s struggle with the coronavirus (COVID-19) pandemic reached a grim milestone on Thursday as its number of fatalities overtook that of China, where the virus first emerged.

A total of 427 deaths were registered in the country over the past 24 hours. This brought the national tally to 3,405 deaths since authorities reported the COVID-19 outbreak on February 21. In comparison, China has recorded 3,231 deaths since early January according to most recent estimates from the World Health Organization.

“We need time”

According to health experts, the Mediterranean country – which has the highest number of COVID-19 cases outside of China at 41,035 – is vulnerable to the virus, given its population. The U.S. Centers for Disease Control and Prevention, in its latest guidance, has identified older adults and those with serious underlying medical conditions as populations most at risk of the disease.

To note, Italy’s 60-million strong population is also among the world’s oldest. In a 2017 United Nations report, around 30 percent of Italians were aged 60 or above – the second oldest citizenry after Japan. Officials and experts believe that this could be a factor for the high number of fatalities.

Health care system groans under coronavirus

The coronavirus pandemic, which is poised to infect over 200,000 people worldwide, continues to push the country’s health care systems to the brink of collapse. The country’s Ministry of Health has reported that over 10 percent of those infected are health care workers.

In Lombardi, a prosperous region in northern Italy that also boasts of having one of the best public health systems in the world, the coronavirus has filled hospitals to capacity, leaving doctors and other health care professionals struggling to keep up.

“We are on our last legs, physically and physiologically,” says Francesca Mangiatordi, speaking to Italian television on Wednesday. Her heartbreaking photo of nurse and colleague Elena Pagliarini – collapsed face down with her mask on after 10 straight hours of work – has become the nation’s symbol of an overwhelmed system.

In the interview, she urged people to protect themselves to avoid spreading the virus: “Otherwise the situation will collapse, provided it hasn’t already.”

Doctors in the region are also finding themselves in dire straits, as the coronavirus continues to ravage the region. In just four weeks, doctors are now shifting to a wartime footing, forcing them to triage patients as resources continue to dwindle.

“The war has literally exploded and battles are uninterrupted day and night,” wrote Daniele Macchini, a doctor in Bergamo, the hardest-hit city in the hardest-hit region in Italy.

For Massimo Puoti, the head of infectious medicine at Niguarda Hospital, one of the largest in Lombardi, doctors are in the middle of a war to limit infections, while learning more about the enemy.

“We need time.”

Difficult situations call for even more difficult choices

The situation has become so dire that doctors may soon make harrowing choices as to who gets access to life-saving resources such as intensive care beds and ventilators – and who doesn’t.

Recent guidance released by the country’s association of anesthesiologists and intensive care doctors advises healthcare professionals to prioritize patients “with the greatest chances of survival” if medical resources become scarce. (Related: Up to 86 percent of people walking around with the coronavirus don’t even know they have it (because they show no symptoms).)

Further, the document even suggests treatment be given to those who are more likely to survive, stating:

It may be necessary to impose an age limit to [enter] into intensive care … in order to [preserve] what may be extremely scarce resources for those who, first of all, have the highest probability of survival and, secondly, may have more years of life saved.

But according to Dr. Marco Vergano, a Turin-based anesthesiologist and the lead author of the document, the recommendations should only be followed when all other options are exhausted.

“This is an extraordinary and unprecedented emergency situation,” he added. “Even epidemiologists and virologists aren’t sure what will happen in Italy the next week or in a couple of weeks.”

But with the way things are going, these measures may be implemented sooner than later.

Learn more about the ongoing coronavirus pandemic at Pandemic.news.

Sources include:

Reuters.com

WHO.int

CDC.gov

NYTimes.com

SCMP.com

CBC.ca