Abandoning The Elderly
"To see [an] entire generation of Bergamo residents taken in this way-- it is unthinkable."Hospital Pope JohnXXII doctor"The psychological impact on the elderly population has been dramatic.""To say you will be sacrificed in ICU because there are more elderly victims and you have less of a chance of making it, well, that is an alarming situation."Eleonora Seivi, spokesperson, Senior Italia Federanziani association for the elderly"We decide depending on their age and the condition of their health. That is not me saying that, but the medical procedure manuals.""If a patient aged 80 to 95 has massive respiratory problems, plus organ failure, then it's all over."Christian Salaroli, 48, Italian doctor
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| Claudio Furlan / LaPresse / AP |
"...[T]he Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) has published guidelines for the criteria that doctors and nurses should follow as these already extraordinary circumstances worsen. The document begins by likening the moral choices Italian doctors may face to the forms of wartime triage that are required in the field of 'catastrophe medicine.' Instead of providing intensive care to all patients who need it, the authors suggest, it may become necessary to follow 'the most widely shared criteria regarding distributive justice and the appropriate allocation of limited health resources'."
Draft plans drawn up for the next phase of the coronavirus that has hit Italy so badly it is regarded as the second most dire national tragedy after China's, are that the elderly coronavirus victims aged 80 or more, or in poor health, could be left to die -- medical intervention withheld -- as a reflection of the lack of equipment to deal with the impact of more people being diagnosed with COVID-19 than the health system of the country can cope with.
According to a new regional protocol from the government's crisis management unit in Turin, elderly and those with severe health problems will be denied access to intensive care should the immense pressure on beds and medical personnel increase from the present. Precisely which patients would receive intensive care treatment and which not has been coldly specified, in reaction to the fact that there are insufficient spaces for the growing numbers to be medically tended to.
Monday marked the death of 2,158 people, while 27,980 had been infected in Italy by the novel coronavirus; representing the second highest number of reported deaths in the world behind China, with a rate of death seen to be higher as a result of the nation's large elderly population. Within the Bergamo cemetery, the epicentre of the Italian outbreak, the Ognissanti Church has been converted to an emergency mortuary.
In Bergamo, 71 of the region's doctors, nurses and health-care workers tested positive for the virus, adding to the pressure on intensive care capacity. Many of the health workers are now themselves in crowded wards wearing oxygen helmets and hooked up to respiration tubes. The lack of available breathing machines and beds were forcing doctors to make devastating decisions, whom to save and who to allow to die, based on age and condition of health.
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| People wait at a bus stop in Rome on March 9. Italy announced a sweeping quarantine in a bid to halt the new coronavirus's march across Europe. (Roberto Monaldo/LaPresse/AP) Wearing masks, but crowded together.... |
“Informed by the principle of maximizing benefits for the largest number, the allocation criteria need to guarantee that those patients with the highest chance of therapeutic success will retain access to intensive care.”“It may become necessary to establish an age limit for access to intensive care.”“In case of a total saturation of resources, maintaining the criterion of ‘first come, first served’ would amount to a decision to exclude late-arriving patients from access to intensive care.”“The presence of comorbidities needs to be carefully evaluated. [This is in part because early studies of the virus seem to suggest that patients with serious preexisting health conditions are significantly more likely to die. But it is also because patients in a worse state of overall health could require a greater share of scarce resources to survive]: What might be a relatively short treatment course in healthier people could be longer and more resource-consuming in the case of older or more fragile patients.”“These criteria apply to all patients in intensive care, not just those infected with CoVid-19.”Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI)
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| Children walk past an image of Mona Lisa with a protective face mask after more cases of the coronavirus were confirmed in Barcelona (Nacho Doce/Reuters) |
Labels: Crisis Management, Elderly Patients, Italy, Novel Coronavirus, Triage Decisions
posted by Pieface @ Wednesday, March 18, 2020
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