The heat that puts a strain on the health of the elderly, the ordinary hospital internship, Covid-positive patients. Emergencies that are intertwined and are bringing various healthcare facilities in Italy to the verge of tilt these days. The latest alarm comes from Milan. After days of scorching temperatures, the Città Studi Clinical Institute is on the “third or fourth alert launched to all the authorities. Two of these were very distressed SOS,” Pasquale Ferrante, health and scientific director of the facility, told time.news Salute. The numbers explain the situation better than anything else: “Today we have something like 85 medical patients, of whom 28 are Covid-positive, for a hospital that is accredited for only 59 medical beds. At the beginning we wanted write to the prefect, I also got the email address “.
Then, he continues, “looking at the Areu report we realized that among the hospitals in the metropolitan area of Milan there are many that have problems with overcrowding and are in crisis like us. So we said to ourselves: let’s wait for tomorrow and the day after tomorrow. to see how it goes and, if the emergency persists, eventually we write to the prefect that he is the only authority that can close an emergency room. But we would not want to do this. We would just like to be able to restart the mechanism by which we discharge and hospitalize . Now, however, we are unfortunately stopped at the stage of hospitalization with an enormous difficulty in resigning “.
Ferrante analyzes how we got to this point: “Today we have two emergencies. One is quite frequent and structural in our Milanese society, and that of truly remarkable access to the emergency room for patients, most of whom are from the medical area. , internist. In particular in some areas such as the one served by our hospital, which is inhabited by many elderly people. They are patients who have respiratory or cardiological diseases, we see many decompensations, exacerbations of chronic bronchopneumopathies. This type of patients in this period is constantly increasing and this trend is probably affected by the great heat of these days. Just yesterday we received an alert from the Ats, which announced that there will be a super influx linked to high temperatures, but in fact the temperatures are already high for a couple of weeks and this has probably already brought many elderly people to the hospital.There is another problem that continues ua under the radar, which is that of Covid-positive patients “.
In these days, Ferrante reports, “we have a very important and significant increase in Covid-positive patients. I think this is also happening to other hospitals, but certainly in ours: we have gone from 4-5 patients a month ago to the situation we see today. 28 hospitalized with the virus, three in the emergency room waiting to have a bed and one in intensive care. Many are patients who had even mild respiratory disorders, tested positive for the swab. Others are positive elderly, who came to the hospital for falls that I do not exclude have occurred following the first generic symptoms of Covid itself. Other patients, currently 6 or 7 out of 28, have come for other causes and are positive “.
“We then – he continues – also a number, at the moment limited, but to be kept under surveillance, of hospitalized patients who are positivized. We have tried to make an analysis on this and the idea that we have made is that there could be a risk that relatives visiting the sick carry the virus, given the enormous frequency of positivity that there is in this period in Italy. Also because we often find them without masks in the rooms and we cannot carry out sweeping checks. We have limited the visits to two time slots of 45 minutes each, and to one person per patient but unfortunately we have this suspicion “.
The overabundance of hospitalized patients who find it hard to discharge is reflected in the emergency room, Ferrante observes: “Many patients are arriving. Since ours is an emergency room not so large, we can put the Covid positives in a small area and for now we can to keep them isolated albeit with difficulty. But then there are the other patients, the non-Covid ones. The consequence is that, having now saturated the Medicine beds we have, we are unable to hospitalize them and this implies a persistence in the emergency room. 24 hours we are able to hospitalize, in the meantime a new cohort of Covid positive and negative medical patients who need hospitalization has already been recreated “.
The effect of having so many patients with internal expertise, 85, is also that “we have enormous stress on our operators. This really puts us in difficulty: we have a staff measured by other numbers (the 59 accredited beds in the medical area ), not for 113% more as it would seem to be now “, Ferrante specifies. What could unlock the jammed mechanism, but is missing instead? “In my opinion, there is a lack of intermediate or even lower care facilities, such as hotels, that can take Covid patients – the expert reasons – No one probably expected such a rebound, but this means that we do not discharge Covid patients, except for very rare cases. And the system is clogged. Very often the Areu calls us because we hold the stretchers still for too long, begging us, forcing us to release them. But freeing them is almost impossible when all the stretchers in the emergency room and adjacent facilities are already occupied by patients “.
The beginning of the difficulties and the reports dates back to “at least 15-20 days ago. Now this overflow has stabilized, which is not manageable, as we do not have the ability to discharge, in particular Covid-positive also given the many problems of families, which are increasing. With the continuing heat we fear a worsening. It is a critical situation. I believe that the burden on hospitals and emergency rooms is really excessive, because at the moment the territory is not made for the elderly “.
Ferrante also explains the reason why he toyed with the idea of launching a stronger SOS: “I always remember the chronicles of some time ago from a hospital in the south. And I say: we cannot put patients on mattresses on the floor, it’s an indecent thing. The situation is really critical. And when we have so many yellow and red codes, which take precedence, the waits get longer “. The response to the alerts launched was “that all hospitals are in distress. So I wonder why some kind of emergency is not declared? Something that allows us to work more. Today we have the minimum number of nurses possible, and so a almost all hospitals, even public ones. Care becomes really complicated this way – assures the director – and treatment paths lengthen if there are too many patients for few doctors and nurses “.