Coronavirus Episode 15: What’s Really Going On in Italy?
During this crisis, Italy has been the country that all other countries want to avoid mimicking. We’ve heard macabre stories of ventilator rationing, not enough coffins, and general havoc. However, yesterday I came across a recent interview with an Italian ICU doctor who was right in the middle of the worst area. What I heard astounded me as it was VERY different than the media stories. Let’s dig in.
Italy by the Numbers
There was GOOD NEWS out of Italy yesterday (above). I’ve been tracking their new cases every day and if everything holds when they report their numbers later in our day today, then they have reached their peak of coronavirus cases (1). That’s both good news and bad news for the U.S., as it took about two weeks from their strict regional shut down and just under that from the national shutdown to come down the other side of the curve.
That information could be good news for the U.S. if we had a strict national shutdown like Italy, but we really don’t yet. For example, here’s data from a cell phone tracking company on which states are doing well with reducing the movements of their citizens (2):
The blue states all get A’s (the northeast, Texas, parts of the midwest, Colorado, Nevada, and California). The green states get B’s, and Wyoming (orange) has had NO drop in the movement of its citizens over the past week.
The Italian Blackbox and Rumors
I’ve read lots of articles about the Italian coronavirus experience and they all seem to be the same:
- The number of ICU beds and ventilators required is far more than the supply
- Doctors are therefore rationing ventilators and only giving them to the young
- The Italian healthcare system is breaking down right in front of us
Is any of this actually true? Likely not.
An Interview with an Italian ICU Physician
The Journal of the American Medical Association (JAMA) did us all a great favor by interviewing a leading Italian ICU physician in the middle of the worst area of Italy on March 13th. The video is below and I highly recommend you watch it:
Sometimes the video gets into “doctor speak” but it’s pretty clear on a number of points that everyone should be able to follow:
- The number of ICU beds and ventilators is keeping up with demand, although they are concerned about not being able to keep up if demand spikes
- There has been NO rationing of ventilators or ICU beds
- The Italian healthcare system is strained but has figured this out and is responding
First, this is when Italy was reporting about four thousand cases a day and since then cases climbed to about six thousand and now are back down to five thousand. Hence, an updated interview would be helpful.
Now make no mistake, this doctor explains being blindsided by this crisis and how they acted swiftly to get it all together. He also describes the difficulties and the personal toll this crisis takes on healthcare workers and how this disease is different from the flu in that it requires much more intensive ventilation (helping people breathe with a machine). Meaning he is describing something that US hospitals desperately need to get ready for and also is telling US doctors how to do that.
On another note, what’s the mean age of people in Italy’s ICUs? 65 years of age. Hence, Italy has a mix of the mostly older people in critical condition, but there are young people in those beds as well.
The Media and This Crisis
If covering this crisis as a blogger has taught me one thing, it’s cemented my belief that the primary purpose of our media is to sell eyeballs for advertisers. Yes, they can serve a critical role in helping to expose wrongs, but on balance, it’s their job to sensationalize what’s happening. This crisis and threat is VERY real and this virus will overwhelm our health system if we don’t shut it all down to flatten the curve and then smartly manage the situation. However, listening to this leading Italian ICU physician speak does one thing clearly, it shows how the media has taken some truths about Italy and blown them up into something that is not recognizable.
The upshot? I was floored by this interview. PLEASE TAKE 10 MINUTES AND WATCH IT NOW FOR YOURSELF. Also, we need to maintain our current shutdown and begin to call out states that are not getting with the program. Why? Like Italy, we need to have our own cases peak and come down the other side. We also need to prepare our ICUs and restructure how we care for the sick while we continue to ramp up testing. However, we also need to recognize that it’s the media’s job to sell us stuff and we all need to take everything reported with a BIG grain of salt.
(1) Worldometer. COVID-19 CORONAVIRUS OUTBREAK. https://www.worldometers.info/coronavirus/ Accessed 3/19/20.
(2) Unacast. Social Distancing Scoreboard. https://www.unacast.com/covid19/social-distancing-scoreboard Accessed 3/25/20.