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Doctors, Lombardy, Italy, Covid-19 Epicenter transcript

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Mar 9th, 2020
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  2. Transcript of two WhatsApp audio files from Lombardy, epicenter of the COVID19 outbreak
  4. Doctor 1, male:
  6. Guys, here's the status.
  8. They closed down entire wards, reduced the number of beds in traditional wards,
  10. They stopped all operations, closed all clinics so they could call in all GPs so they can come in and be COVID ward doctors.
  12. They come in every day, exponentially.
  14. They tripled ICU beds. They wanted to close our CICU, I don't know how many were closed.
  16. So, even the STEMI heart attack network was closed. They're decentering everything.
  18. Niguarda hospital is bursting, it's got 30 COVIDs in ICU.
  20. All resuscitations are full, they're thinking about a triaging number…
  22. of ICUs to distribute the beds and decide who to intubate, and who to let die.
  24. They don't have COVID patients in Cardiology yet,
  26. But COVID is very devious to identify,
  28. Because you don't notice, you don't spot them. We had a cardiogenic shock in the CICU, for 5 days.
  30. EPA scan, and yesterday - after I did it every day - the infectologist didn't say shit.
  32. The radiologist - "stasis and pulmonary circulation congested"
  34. I phoned the radiologist and said "listen, in my opinion he's got pneumonia" - and he had it.
  36. Now they tested him, but he's surely a COVID patient, I'm willing to bet.
  38. You can't recognize it, but most of all…
  40. You have no idea - they don't say this on TV
  42. of how many YOUNG people, I mean even 20 years old, need CPAP and have HORRIBLE pneumonias, with no comorbidities.
  44. How many 70s-born have pneumonias. A TON. It's unimaginable.
  46. Doctors aren't even - there aren't even any devices - even quarantined or screened with a test anymore.
  48. They tell you "If you had a contact but with no symptoms, come at work. If you have symptoms, you get the decision to work or stay home."
  50. It's TRAGIC. Now they're hiring all non-specialized med graduates from Policlinico for exempla - that's where my girlfriend is -
  52. At Policclinico there's only one out of three or four wings that is not for COVID patients. 50 pneumonias expected A DAY. The situation is dramatic, and people don't know.
  54. We absolutely need people to understand this.
  57. Doctor Martina:
  59. Hello everyone - ladies, gentlemen, I don't know, but Cate asked me to send her an audio message explaining what's happening.
  61. My name is Martina, her cousin, cardiologist in intensive care, Milan,
  63. So, the situation is very serious, in the sense that this circulating virus is extremely contagious.
  65. It's true, some have no symptoms, some come through without too many problems, but it's also true that a lot of people develop what's called a bilateral interstitial pneumonia
  67. that, fundamentally, needs assisted breathing. We don't have drugs, as antibiotics don't work against viruses,
  69. We're giving them a cocktail of drugs used against viruses like AIDS, but experimentally - we don't know if they'll work or not.
  71. The only thing you can do in these cases is intubate the patient, so as to make the machine breathe, rest the lungs, waiting for his immune system to defeat it.
  73. It's true, most deaths are old with existing conditions but there's a lot of young people in the ICUs - our youngest is 38 with no comorbidities.
  75. The real problem is that a lot of people need assisted breathing, and there are not enough ventilators for everybody.
  77. Already yesterday I got a call - I'm in intensive care in cardiology - asking for one of my ventilators - we only have two now.
  79. I gave it to them, and one patient that went out of intensive care the day before,
  81. Normally in these cases you keep the ventilator near, because they can go into a crisis and need to be re-intubated - if she does, there's no ventilator there.
  83. Fundamentally they told us starting from now we'll have to choose who to intubate, priority going to the young or no comorbitities,
  85. At the Niguarda, the other big hospital, they don't intubate people older than 60, which is really, really young
  87. So the situations is very serious, it's very contagious - 14 days of completely asymptomatic incubation, and can infect an incredible amount of people,
  89. So the concept is the only way for it to not be a massacres is to have the least amount of infected, and if they are, for them to be on a long time scale.
  91. That way, if I have 10,000 people who need ventilators infected all at the same time, we have 3,000 in Italy and 7,000 die.
  93. If I can slow down the contagion, when the new people get sick, presumably the old will have freed the ventilator for them.
  95. The only thing you can do are the things they're already saying: stay home, true, no cinemas, no exhibits, no walks, few malls as possible, closed school, no soccer in the evening, no dinners outside,
  97. Avoid contact with other people as much as possible, wash your hands, soap works, so do alcohol solutions,
  99. The virus resist on surfaces a bit for 30-40 minutes, the only way to clear surely is washing with bleach and leaving bleach on contact for 30 minutes,
  101. Fundamentally, you guys in Rome are like we were in Milan 10 days ago, and really, in 10 days there was an incredible escalation,
  103. Lombardy collapsing when it's the best in healthcare terms, so I don't dare think what would happen in less efficient regions.
  105. Children; no grave cases, there are some positives, but like with all viruses (chickenpox, measles), if they get it it's much less aggressive than adults,
  107. But they're crazy carriers, because the kid gets it with no symptoms, he goes to his grandparents, and fundamentally kills them. So avoid contact between them.
  109. So, no panic but you can't underestimate this. If you can, stay home and don't meet anyone. If you have questions, I'm here, still going to the hospital and I will keep you up to date through Cate on the situation.
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