Italy has recorded the highest number of COVID-19 cases after China. Despite the lockdown measures put in place by Prime Minister Giuseppe Conte, the spread hasn’t abated. The pressure on the health system, already affected by years of cuts and understaffing, has been acute. Nurses and doctors work around the clock. Medical students are being asked to step in earlier than planned, canceling their final exams in an effort to help with the pandemic. The effects of the coronavirus on health workers fighting this virus has been exhausting and extreme. There is currently no end in sight.
Oscar Quagli, general surgeon, and Giulia Canaletti, nurse, are currently working in two different hospitals in northern Italy. They have graciously agreed to answer our questions on the situation.
Q: Could you tell us a little about yourself? A quick intro.
OQ: My name is Oscar Quagli and I’m a doctor specializing in general surgery at the University of Milan. I’m currently training on the job rotating from hospital to hospital in the Lombardy region.
GC: I’m Giulia, 30 years old and am a nurse. I work in the ER (Emergency Room) at the St. Bartolomeo hospital in Sarzana, one of the many hospitals battling with this national emergency. I love my job and I do it with passion every day but I cannot deny that I am a little scared about the situation. For weeks now, I have been avoiding contact with all my family members, friends, nieces and nephews as I’m worried that I might be a carrier of the virus. I’m starting to feel quite lonely and under a lot of pressure.
Q: How would you describe the situation in your area?
OQ: At the moment, Lombardy is the most affected region. We currently have between 17,000 and 28,000 Italian patients with 45%-50% of them having to be hospitalized. Of those, about 10% require the ICU (Intensive Care Unit) for respiratory assistance (intubation). For now, the mortality rate in Italy is around 3%. Unfortunately, we have already run out of available beds and we are scrambling trying to set up new ICU locations. We are all hands on deck at the moment. Everyone has been asked to help with the pandemic. All non-essential surgeries have now been canceled and we are all dealing with Covid-19 patients as a top priority.
GC: Unfortunately, the situation is not under control, I would love to say the opposite but I just can’t. We are actually expecting a surge in cases within the next 15 days. We are prepared but really scared.
Q: How have your working hours changed and how has your day to day been affected by this emergency?
OQ: The availability of all healthcare professionals is 24/7. We have all been requested to make ourselves available at all times during this emergency. In the meantime, we still have to guarantee all emergency and vital surgery procedures, which are still happening every day. We are all working at the maximum of our capacities and more. As this is a novel virus, we are all learning on the job, even the more experienced of us. Working closely with each other and communicating with Chinese doctors (who have worked on the pandemic in Wuhan), we have tried to come up with a detailed plan to help as many people as we can.
GC: Our working hours are quite long ranging between eight to 11 hours a day. More often than not, we have no rest in between and we stay longer than we are meant to. During my hours, I try to drink as little as possible to avoid taking many breaks. We have to wear a lot of protective gear, including overalls, protective goggles, shoe covers, masks and two pairs of gloves. You can imagine how difficult it would be to go to the toilet. All the protective equipment is also really tight and by the end of the day we all have bruises and marks on our skin. We are obviously really physically and mentally exhausted but we soldier on.
Q: What is the average age of the patients in your area?
OQ: Initially, most patients were over 65, but lately we have started seeing an increase in patients between the ages of 30 and 50, with some requiring ICU care too.
GC: Unfortunately, there is no average age. We see patients from 40 to 80 years old. Some of my young 30- to 40-year-old colleagues are also home with the virus. The only pattern seems to be that usually the elderly and patients with underlying issues are the most affected and that children (for the moment) seem to be displaying minor symptoms, if any.
Q: How is your hospital coping with the extra caseloads?
OQ: The hospital I’m currently working at (Saronno) has been designated as the Covid-19 center. We have 9 ICUs already in use, plus a unit for patients requiring extra care but not respiratory assistance. We are also working on a new ICU unit for patients transferring from other hospitals. As a last measure, we are also prepared to convert our surgery rooms into more ICUs.
GC: My ER has built a temporary outside tent where we check all patients before admission. This way we can separate patients showing Covid-19 symptoms (fever, cough, and breathing issues) from those with other symptoms.
Q: What recommendations do you give the public/your patients?
OQ: The recommendations are always the same. Don’t go outside unless strictly necessary. Maintain a social distance of at least a meter. Cover your mouth when coughing and sneezing and use a tissue to catch the sneeze or cough and dispose of it in the garbage straight away. Wash your hands frequently with water and soap. Do not touch your face (mouth, nose and eyes in particular). If you are displaying symptoms, use a mask.
GC: I talk to all my patients in a kind manner and try to reassure them that everything will be ok.
Q: Any words of hope on the situation?
OQ: We must be responsible and follow the government’s advice accurately. This is the only way we can stop the spread of the virus. Stay home. We will keep fighting and we will come out on the other side together.
GC: I really hope this period will pass quickly because at the moment it’s like living a nightmare. We work under stress with little sleep and no time for food. It’s hard, but together we will make it through.
Q: Anything else you would like to add?
GC: Yes, I would like to remind everyone that once this emergency is over, we will still be working long hours with minimal funding. Do not call us heroes now. We do it every day. It would also be good if everyone would keep using the ER for real emergencies, as is happening now, not for every little ailment which ends up overloading the system.
Opinions expressed in this article are those of the individual, not of Bébé Voyage, unless specifically indicated to that effect.
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If you are interested in reading more about what life is like in Italy right now during the quarantine, check out our interview with a family in Pavia to see how their life has changed.
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