Coronavirus: ‘We must choose who to treat,’ says Italian doctor
Monday, 09 March 2020
Patients with viral pneumonia, in acute respiratory failure, are first placed on non-invasive ventilation. Credit: Belga
An Italian doctor in Lombardy, a region of Italy that has been quarantined due to the new coronavirus (Covid-19) outbreak, has stated that doctors have to choose who to treat “according to age and state of health, as in war situations.”
“To say that you do not die from the coronavirus is a lie that fills me with bitterness,” said Dr. Christian Salaroli, an anaesthetist, in an interview with the Italian daily Il Corriere della Sera on Monday.
Salaroli said that the emergency is so big in Italy that he and his colleagues must now select the patients who will or will not be able to access mechanical resuscitation (by intubation) from among the most seriously ill. Patients with viral pneumonia, and are in acute respiratory failure, are first placed on non-invasive ventilation (NIV), using an oxygen mask.
“It’s a first step, but after a few days, we have to choose. Since there is, unfortunately, a disproportion between hospital resources, resuscitation beds and critically ill patients, not everyone can be intubated,” Salaroli said. “We decide based on age and state of health,” he added.
“If a person between 80 and 95 years old has severe respiratory failure, it’s likely we will not go ahead. If they have multi-organ failure, with more than two or three vital organs, it means that their mortality rate is 100%,” he added.
Asked about the Italian government’s decision to quarantine more than 15 million people in northern Italy in an attempt to contain the epidemic, Salaroli said it was “fair but a week late.”
What matters now, he said, is to “stay at home, stay at home. I keep repeating it over and over again. I see too many people on the street, you have no idea what is happening,” he said.