Dr. Daniele Macchini, Treating COVID-19 Patients In Bergamo, Italy, Describes Horrible Situation

Dr. Daniele Macchini
(Last Updated On: March 11, 2020)

Dr. Daniele Macchini is a doctor treating patients in Bergamo, Italy. In this text translated from his Facebook post, Dr. Macchini describes a horrible situation. In it, he called a “Pandemic”.

Here’s Dr. Daniele Macchini:

In one of the constant emails I receive from my health management more than daily these days, there was also a paragraph titled “Making social responsibly”, with some recommendations that can only be supported.

Having thought for a long time whether and what to write about what is happening to us, I felt that silence was not at all responsible. I will therefore try to convey to the people ” not involved in the work” and further away from our reality, what we are living in Bergamo in these days of Pandemic from .

I understand the need not to create panic, but when the message of the danger of what is happening does not reach people and I still hear who cares about the recommendations and people who Group complaining about not being able to go to the gym or be able to play football tournaments shudder.

I also understand the economic damage and I am also concerned about that. After the epidemic the drama will start again. But, aside from the fact that we are literally devastating, even from the economic point of view, our SSN, I would put it to a higher importance of the damage to health that there is a risk in the whole country, and I find it nothing short of “chilling”, for example, that we have not yet established a red zone already required by the region, the municipalities of Alzano Lombardo and Nembro (I should point out that this is pure personal opinion).

I watched with a little amazement the reorganization of the entire hospital in the previous week, when our enemy, the current was still in the shadows: the departments plan plan literally “emptied”, the activities elective interrupted, the intensive therapies liberated to create as many beds as possible. Containers arriving in front of the emergency room to create diversified routes and avoid possible contagion.

All this rapid transformation carried in the corridors of the hospital an atmosphere of silence and surreal emptiness that we still did not understand, waiting for a war that had yet to begin and that many (including me) were not so sure would ever come with such ferocity.

(I open a parenthesis: all this in silence and without publicity, while several newspapers had the courage to say that private health care was not doing anything).

I still remember my night guard a week ago spent unnecessarily without turning a blind eye, waiting for a call from the microbiology of the sack. I was waiting for the outcome of a swab on the first suspicious patient in our hospital, thinking about what consequences there would be for us and the clinic. If I think back, it seems almost ridiculous and unjustified to me that my agitation for only one possible case, now that I have seen what is happening.

Well, the situation now is nothing short of dramatic. No more words come to mind.

The war has literally exploded, and the battles are uninterrupted day and night.

One after another, the poor unfortunate people show up in the emergency room. They have far from the complications of a flu. Let’s stop saying it’s a bad flu. In these 2 years I learned that bergamasks do not come to the emergency room at all. They behaved well again. They followed all the directions given: a week or ten days at home with a fever without going out and risking infection, but now they can not take it anymore. They don’t breathe enough, they need oxygen.

Drug therapies for this virus are few. The course depends mainly on our organism. We can only support him when he can’t take it anymore. It is mainly hoped that our organism will eradicate the virus on its own, let’s face it. Antiviral therapies are experimental on this virus and we learn day after day its behavior. Staying at home until symptoms worsen does not change the prognosis of the disease.

Now, however, has arrived that need for beds in all its drama. One after another the wards that had been emptied, fill up at an impressive pace. The boards with the names of the patients, of different colors depending on the operating unit they belong to, are now all red and instead of surgery there is the diagnosis, which is always the same cursed: bilateral interstitial pneumonia.

Now, explain to me which flu virus causes such a rapid drama. Because that is the difference (now I get a bit technical): in the classical influence, aside from infect a lot less of the population over a period of several months, the cases may complicate less frequently, only when the VIRUS by destroying the protective barriers of our respiratory system allows BACTERIA normally resident in the high way to invade the bronchi and lungs causing more severe cases. The Covid 19 causes a banal influence in many young people, but in many elderly (and not only) a real SARS because it gets directly into the alveoli of the lungs and infects them making them unable to perform their function. The resulting respiratory failure is often severe and after a few days of hospitalization the simple oxygen that can be administered in a ward may not suffice.

Sorry, but to me as a doctor does not at all reassure that the most serious are predominantly elderly with other pathologies. The elderly population is the most represented in our country and it is difficult to find someone who, over the age of 65, does not take at least the pill for pressure or diabetes. I assure you that when you see young people that ends up in the intensive care unit, pronata or worse in ECMO (a machine for the worst cases, which extracts the blood, and re-oxygenates it and returns it to the body, in the expectation that the body will, hopefully, heal her lungs), all of this peace of mind for your young age pass.

And while there are still people on social media who boast of not being afraid by ignoring the indications, protesting because their normal life habits are “temporarily” in crisis, the epidemiological disaster is being carried out.

And there are no more surgeons, urologists, orthopedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us. Cases multiply, we arrive at rates of 15-20 admissions per day all for the same reason. The results of tampons now come one after another: positive, positive, positive. Suddenly the emergency room is collapsing. Emergency provisions are issued: help is needed in the emergency room. A quick meeting to learn how the first aid management software works and a few minutes later they are already downstairs, next to the Warriors who stand at the front of the war. The screen of the pc with the patterns of the accesses is always the same: fever and respiratory distress, fever and cough, respiratory failure, etc…. examinations, the radiology always with the same sentence: interstitial pneumonia, bilateral, interstitial pneumonia, bilateral, interstitial pneumonia, bilateral. All to be admitted. Someone already intubates and goes to the ICU. For others it is late…
Intensive care becomes saturated, and where intensive care ends, more are created. Every fan becomes like gold: those of the operating rooms that have now suspended their non-urgent activity become places of intensive care that did not exist before.

I found it incredible, or at least I can speak for Humanitas Gavazzeni (where I work) how we managed to put in place in such a short time an deployment and reorganization of resources so finely engineered to prepare for a disaster of such magnitude. And every reorganization of beds, wards, staff, work shifts and duties is constantly reviewed day after day to try to give everything and even more.

Those wards that previously looked like ghosts are now saturated, ready to try to give the best to the sick, but exhausted. The staff is exhausted. I saw fatigue on faces that didn’t know what it was despite the already grueling workloads they had. I saw people stop even beyond the hours they used to stop already, for overtime that were now customary. I have seen a solidarity of all of us, who have never failed to go to fellow internists to ask ” what can I do now for you?”or” leave that shelter alone that I’ll take care of.” Doctors who move beds and transfer patients, who administer therapies instead of nurses. Nurses with tears in their eyes because we can not save all and the vital parameters of several patients at once detect an already marked fate.

There are no more shifts, schedules. Social life for us is suspended.

I am separated by a few months, and I assure you that I have always done the possible to see constantly my son also in the days of unmount night, without sleep, and putting off sleep when they are without him, but it is almost 2 weeks that voluntarily I don’t see neither my child nor my family members for fear of contagiarli and to infect his grandmother, the elderly or relatives with other health problems. I’ll settle for a few pictures of my son in tears and some video calls.

Stay tuned.

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