Authorities in Italy announced the drastic measure that elderly patients may not receive intensive care has shocked many across the country. One doctor told the Daily Mail that a patient’s fate “is decided by age and by health conditions”. The doctor added: “This is how it is in a war.”
Work is now underway on a new field hospital in Milan with a structure normally used for sports being converted into a makeshift intensive care wing.
The emergency plans for cutting medial aid to the elderly was being proposed by the Prime Minister Giuseppe Conte in Turin.
The plans drawn up by civil protection officials warn that, “it will be necessary to apply criteria for access to intensive treatment” if there are too many patients.
A document released by the Italian government proposes that the criteria for those to be place in intensive care will only apply if the patient is “less than 80”.
The document added: “Should it become impossible to provide all patients with intensive care services, it will be necessary to apply criteria for access to intensive treatment, which depends on the limited resources available.”
Doctors have already described making life-or-death decisions about who can be treated and who may effectively be left to die.
A patient’s other health conditions will also be taken into account when beds in intensive care are allocated, according to the planning document.
Doctors will also consider whether they are likely to recover from resuscitation if they are taken to hospital in an emergency.
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Officials acknowledge that the plans will force hospitals to ‘focus on those cases in which the cost/benefit ratio is more favorable for clinical treatment’.
Italian medics have already described how hospitals have been ‘overwhelmed’ by the health crisis, with Italy suffering the worst outbreak in Europe.
A doctor in Italy has recently spoken how medics there are being forced to ration care to patients in the wake of the coronavirus outbreak with elderly patients being denied care based on their age and whether they have other conditions.
The consultant anaesthetist and intensive care specialist, who works at the Sant’Orsola-Malpighi Hospital in Bologna, described to the Independent newspaper the relentless influx of coronavirus patients she has experienced entering intensive care units there.
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The medics there are working around the clock and being forced to make difficult decisions.
She has warned UK hospitals to plan now for the influx in patients stressing some of those who became sick and needed care were young and healthy.
Official guidance to doctors in Italy have said only patients “deemed worthy of intensive care” should get it and decisions based on a “distributive justice” approach balancing the demand for care versus available resources.
The anaesthetist said: “Covid-19 is changing everyone’s life in Italy.
“Doctors are working with a lack of evidence based protocols, a lack of resources and a real risk of being infected.
“Healthy people at home can’t go out, can’t go to school, and can’t even meet relatives.
“School is changing as well, my nephews are attending lesson at home via Skype.
“The whole country is on standby.”
Describing the difficulties caring for patients she said: “We are making difficult choices.”
“I know from talking to colleagues in Lombardia, the most affected region in Italy, that they are using a cut off of 65-years-olds in case of pre-existing comorbidities.
“In Bologna, we are working with 80-years-old as our cut off, but between 65 and 80-years-old we still consider comorbidities.”
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