Image Credits: Photo: Getty Images.
One small advantage America has in tackling the coronavirus outbreak is that it didn’t start here. We have the opportunity to see what worked and what didn’t work in China, Italy and other places, and we have the chance to anticipate some of the things that they didn’t anticipate. Italy, in particular, can be very instructive for our medical hospitals and responsible government officials.
There are simple things that only seem obvious in retrospect, like dedicating only a couple of ambulances for coronavirus cases and training the staff so that they whole fleet doesn’t become infected. There are things that require a good bit of time, like transforming medical facilities to maximize bed space or building temporary hospitals. There are best practices for triage, including establishing separate locations for non-coronavirus cases. Italy has learned these hard lessons too late, but we can benefit from their experience.
As things stand there, in the area of worst impact in Lombardy, no one is getting needed intubation if they’re over 60 years old. Virtually no one over 70 is being accepted in Intensive Care Units and, in many cases, people over 80 are not being accepted in hospitals at all. Facilities are not set up to prevent the spread of the virus and their emergency phone lines are overwhelmed.
In normal times, the ambulance service at the Papa Giovanni hospital runs like a Swiss clock. Calls to 112, Europe’s equivalent of 911, are answered within 15 to 20 seconds. Ambulances from the hospital’s fleet of more than 200 are dispatched within 60 to 90 seconds. Two helicopters stand by at all times. Patients usually reach an operating room within 30 minutes, said Angelo Giupponi, who runs the emergency response operation: “We are fast, in peacetime.”
Now, people wait an hour on the phone to report heart attacks, Dr. Giupponi said, because all the lines are busy. Each day, his team fields 2,500 calls and brings 1,500 people to the hospital. “That’s not counting those the first responders visit but tell to stay home and call again if their condition worsens,” he said.
This is what our near-future will look like, and we’re running out of time to mitigate the situation.
“Until three weeks ago, we did everything for every patient. Now we have to choose which patients to put in intensive care. This is catastrophic,” said anesthesiologist and intensive-care specialist Mirco Nacoti.
Dr. Nacoti worked for Doctors Without Borders in Haiti, Chad, Kurdistan and Ivory Coast, and he is one of the few medics in Bergamo who has seen epidemics. Yet, those were diseases with vaccines, such as measles and rubella.
He estimated that around 60% or more of the population of Bergamo has the coronavirus. “There is an enormous number of asymptomatic people, as well as unknown dead who die in their home and are not tested, not counted,” he said. “The ICU is the tip of an iceberg.”
Three weeks is an eternity right now. But it will be three weeks before there is another Democratic Party presidential primary. The country will be in a very different place by then, which is something that Bernie Sanders needs to consider:
Sen. Bernie Sanders (I-Vt.) will spend the next few weeks talking to supporters to “assess his campaign,” his campaign manager said Wednesday following decisive victories Tuesday by former vice president Joe Biden in Florida, Illinois and Arizonathat gave him firm control of the Democratic nominating contest.
“The next primary contest is at least three weeks away,” Faiz Shakir, Sanders’s manager said in a statement. “Sen. Sanders is going to be having conversations with supporters to assess his campaign. In the immediate term, however, he is focused on the government response to the coronavirus outbreak and ensuring that we take care of working people and the most vulnerable.”
He can no longer hope to win the nomination through the primary process, but of course he can still maximize how many delegates he will send to the party’s convention. This would help him have influence over the platform and any rules changes affecting future elections, but the convention probably will take place in strictly virtual space online rather than in a Milwaukee arena as planned. It just seems hard to justify continuing the campaign in these circumstances.
Barring illness, Joe Biden will be the nominee and he should be focused on the campaign against Trump and on assembling a team that can take over in January and get right to work trying to manage one of the worst catastrophes any of us has seen in our lifetimes. If Sanders can be helpful in that effort, that will be great, but he certainly shouldn’t impede Biden by distracting him.
I suspect this will be clear to Sanders soon, and probably long before three weeks have elapsed. But it’d be nice if he made his decision before events force his hand.
Let’s see if I got this right. If you’re over 60 don’t expect much more than a bed in intensive care, over 70 you need to make do with a bed maybe in the hallway and over 80 best go on down to the recycling facility on St Vincent’s and Fifth. Grandma can pick up your ashes there after five. What a world we live in.
Bernie it is past time you woke up.
The premise of this argument is totally specious. Ask Italian doctors how well Italy would have fared under a private healthcare system like the US’s. Ask them.
The US is basically the poster child for medical injustice.
Sanders will start to hurt the progressive cause if he continues to fight. He may get a few more delegates for the convention but that will be outweighed by the enmity incurred with the rest of the party. And continuing to get drubbed in the primaries makes him look weak.
Except he does not care about any of that, including ‘the progressive cause’.
What, in your view, does he care about?
Money.
Lol. OK.
Thanks for the response.
FWIW, I’m not a big fan (or even much of a little fan) of Sanders, but I think it’s pretty clear that if all he cared about was money, he’d have made a lot of different life choices over the past 30-60 years.
‘You can shear a sheep many times, but skin it only once.’
Exactly. It’s his lefty version of right-wing political grift.
he is a pest in my view. He wants a following and he won’t give it up, no matter what prolly bc he thinks only he has the play book.
That might be closer to the mark (imho). That said, anyone who’s spent years running for president—and particularly someone who a month ago looked to be the frontrunner—is going to need a few days to grasp and adjust to the reality that they’re losing, and that there’s no way they’re going to achieve their dream. Here’s hoping Sanders can bring himself to acknowledge and accept that reality, and then do what’s in the best short and long-term interest for the issues and the people he cares about.
Remember when there were 20 republicans running for POTUS in 2015? Most people had no problem seeing that virtually all of them were in it for the grift (aww, the profitability of email lists!) Yet the same people absolutely cannot see it when 20 Democrats run. If you have the right list, you and ‘the people you care about’ are set for two lifetimes.. It also helps to create organizations, which you then keep a super tight grip on. Have you noticed how many Trumpistas, once his campaign was over, moved on to create their own gifting organizations? Learn the… Read more »
Shouty McWaggyfinger is a scold, nothing more. Only when the campaign donations start to dry up, he’ll move along.
If you read this paper you’ll realize that what passes for political discourse in this country is very far from the truth, also that the Sanders candidacy could not possibly have been a referendum on anything because all those things were taken off the table a long time ago (in the 1990s) Officially, its all already been decided. We were all just never notified. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.405.5725&rep=rep1&type=pdf So you can all rest easy, nomatter what happens, commercial healthcare is here to stay, and none of this compassion stuff is even legal unless its the absolute least possible everything, the shortest possible. You’ll… Read more »
Regarding Italy, after seeing some posts in this regard I found confirming statistics that they have substantially more doctors and hospital beds per capita than the US does. They have (had) a robust care delivery system. And it broke in a week. I am very concerned about our country.
Barring illness, Joe Biden will be the nominee and he should be focused on the campaign against Trump and on assembling a team that can take over in January and get right to work trying to manage one of the worst catastrophes any of us has seen in our lifetimes. If Sanders can be helpful in that effort, that will be great, but he certainly shouldn’t impede Biden by distracting him. That’s not an insignificant bar. This has been a crazy primary season and a crazy-ass year. The whole world could turn upside-down next week–and not in the ways that… Read more »
“…there’s evidence that the progressive left has been significantly, perhaps irreversibly repulsed by the centrist establishment…”
There’s also evidence that the progressive left has made significant inroads on the centrist establishment, with Biden running on what is by many measures the most progressive Democratic platform in decades:
I don’t know that the platform a candidate runs on has much of any influence on what they do once in the office. I would be much more inclined to use Biden’s record as a guide to guessing how he’d be likely to acti in a given situation.
I’m no expert, but political scientists who look at these things (e.g., Johnathan Bernstein) seem to agree that campaign promises actually do have an influence on what politicians do when in office. It’s not a 100% correlation obviously, but most pols do try to accomplish much of what they say they want to accomplish. As for Biden’s record, again I’m no expert (on him in particular or politicians in general) but, I think there’s also general agreement among most political scientists who study these things that Biden’s (or any politician’s) record is generally a helpful guide to their future actions.… Read more »
The problem is Biden is making countless promises he absolutely cannot keep because they are for policy space that has been removed from the table by ‘agreements’ such as the one mentioned in my previous post which basically give corporations like the many thousands of corporations registered in one building in Delaware, an insurance policy against governments. Its only because Americans are totally ignorant of this agreement that politicans can year after year make these promises. What they really should be doing is promising to do nothing except get us out of these agreements, because until we do, struggling will… Read more »