The coronavirus overruns northern Italy

Toomas Hendrik Ilves, who passed this on, is a former president of Estonia, now active in international institutions working on cybersecurity and global health. He is not some kind of alarmist nut.

A thread that needs to be read by all who dismiss COVID-19, call it the flu, or hysteria. Northern Italy is in triage-mode. Northern Italy is also extremely developed, rivaled in the US only by rich urban areas. https://t.co/PDTteswjBb

— toomas hendrik ilves (@IlvesToomas) March 10, 2020

In case readers don't want to work their way through a Twitter thread, here's what follows; I've expanded some places where the writer uses abbreviations:

2/ First, Lumbardy is the most developed region in Italy and it has a extraordinary good healthcare, I have worked in Italy, UK and Aus and don’t make the mistake to think that what is happening is happening in a 3rd world country.

3/ The current situation is difficult to imagine and numbers do not explain things at all. Our hospitals are overwhelmed by Covid-19, they are running 200% capacity

4/ We’ve stopped all routine, all ORs [Operating Rooms] have been converted to ITUs [Intensive Care Units?] and they are now diverting or not treating all other emergencies like trauma or strokes. There are hundreds of pts [patients] with severe resp failure and many of them do not have access to anything above a reservoir mask.

5/ Patients above 65 or younger with comorbidities are not even assessed by ITU, I am not saying not tubed, I’m saying not assessed and no ITU staff attends when they arrest. Staff are working as much as they can but they are starting to get sick and are emotionally overwhelmed.

6/ My friends call me in tears because they see people dying in front of them and they con only offer some oxygen. Ortho and pathologists are being given a leaflet and sent to see patients on NIV. PLEASE STOP, READ THIS AGAIN AND THINK.

7/ We have seen the same pattern in different areas a week apart, and there is no reason that in a few weeks it won’t be the same everywhere, this is the pattern:

8/ 1)A few positive cases, first mild measures, people are told to avoid ED [Emergency Department] but still hang out in groups, everyone says not to panick

2)Some moderate resp failures and a few severe ones that need tube, but regular access to ED is significantly reduced so everything looks great

9/ 3)Tons of patients with moderate resp failure, that overtime deteriorate to saturate ICUs first, then NIVs [Non-Invasive Ventilation], then CPAP hoods, then even O2.

4)Staff gets sick so it gets difficult to cover for shifts, mortality spikes also from all other causes that can’t be treated properly.

10/ Everything about how to treat them is online but the only things that will make a difference are: do not be afraid of massively strict measures to keep people safe,

11/ if governments won’t do this at least keep your family safe, your loved ones with history of cancer or diabetes or any transplant will not be tubed if they need it even if they are young. By safe I mean YOU do not attend them and YOU decide who does and YOU teach them how to.

12/ Another typical attitude is read and listen to people saying things like this and think “that’s bad dude” and then go out for dinner because you think you’ll be safe.

13/ We have seen it, you won’t be if you don’t take it seriously. I really hope it won’t be as bad as here but prepare.

...

At this point, it seems very likely that we in the U.S. are past the point where COVID-19 can be kept from spreading among us. But we can still take sensible precautions, wash our hands, avoid incautious personal contact, and any crowds. If enough of us do these things, we just might be able to keep the pandemic to the lower curve on this graph. Italy is experiencing the great purple spike pictured here.