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  • Professor Gross.

  • Ellie, what is the situation in nobody today?

  • While the situation is critical because we have a huge number of patients currently being treated in the I C.

  • U.

  • And you know hospitals.

  • I know the situation of the icy use very well, since I am coordinating the network off Cove in 19.

  • I see youse, uh, we now have around 600 patients being treated in the I.

  • C.

  • U in about 50 55 dedicated.

  • I see use.

  • And we have treated the total off more than 700 patients from the beginning of the epidemics.

  • So if you think that in lumber, the total number of I C.

  • U Betts was about 808 50 something like that before the crisis, you can you can understand that it's an incredible stress, for this is what is the age range that you are dealing with.

  • The the the median age of the patients admitted to the H to you is 65 years.

  • This means that half of the patients are older than 65 half are younger than 65 in the last of five days, seven days way.

  • We're seeing an increase in young people.

  • So, for example, way had a patient 20 year old boy who was intubated two days ago.

  • What about Children?

  • Children?

  • We have three or four new units.

  • I think ho tested positive and who have Ah, not so severe disease And Children, as in China, are physically spared, at least from the symptoms.

  • I'm not sure that they're not infected, but apparently they've done gets sick Now, given how incredibly pressured you are, do you have to, in a sense, choose between different patients as to who you country?

  • Tw in other words, do in the end have to say look and I'm sorry if you're over 18 we really can't do anything.

  • No, um what we're doing what we do exactly every day in our life.

  • A cz intensive ists so independent from the Corona virus outbreak when an intensive ist is called to evaluate a critical patient he always has to make a decision about is this patient going toe benefit from intensive care?

  • And this is a complex decision that takes into account several factors not only age, of course, but also I would say biological age is so morbid.

  • It is at the redundancies, past illnesses, current condition, health starters, frailty and so on.

  • So this is something that we do every day.

  • Okay, Clearly, in this situation off, incredible mismatch between the resources we have in the number of patients who should Allocator.

  • We have to be more strict in this.

  • I would not call it selection.

  • I would say triage off the patients.

  • But what we what is driving us always is the consideration that we what we have to do is tryingto grant toe every patient who can benefit from I C.

  • U.

  • And I see you met.

  • And clearly not all the patients will benefit from a nice human.

  • Because if a patient well, I don't very old or with a lot off past illnesses or with a very fragile condition in the beginning gets bed pneumonia and it's a tube and a mechanical ventilator, his chance chances of surviving and of returning tow, an acceptable quality oflife are very low right.

  • But this is a consideration that we do every day.

  • They're clearly now.

  • It's more urgent because we have a huge amount of people in a very limited period of time.

  • But at least now we have been able to grant.

  • I see what mission and intensive treatments to every patient who has been judged the candidate as candidate to those treatments.

  • We have 377 patients on dhe, six dead.

  • Now do you see what we are doing as adequate, or do you look across and say you should be doing what we're doing?

  • No, I don't think that we can compare the nervous because a CZ we've seen also in China, you know, in the Wuhan region they had a huge number of patients and the higher mortality then in the other regions outside Wuhan where they had smaller epidemics, smaller epidemic episodes.

  • So I think that what what happened in lumber is just like a bomb that explodes that exploded, you know.

  • So it's the region has a very high density of population.

  • All those people come and go from Milan every day.

  • They're connected toe every part of Europe, and so the that's where the epidemic started.

  • And then I think that at least for now, surrounding countries are seeing How can I call them metastases of this, but not the center of the disease?

  • That's even even in the surrounding regions.

  • In Italy, the number of patients and the number of critical patients are are smaller than in Lombardy and the number that we have, I'm sure, you know, along with these one off the richest region in Europe.

  • So we have very good health system, very modern, very efficient.

  • So I don't think that the the problem is that it exploded there and before you can realize what's happening.

  • You are like overwhelmed by the massive patients.

  • So hopefully in other countries it's not.

  • It's not behaving like this, but what is very, very, very important for every country.

  • And that's why the real reason why I'm I'm doing this is that everyone must understand that if you don't, if you're not very careful in controlling the spread off the disease, this disease will overwhelm your system, no matter how efficient good modernity is.

  • So the most important thing besides, you know, creating us you bets besides buying new ventilators, which is OK for people who are already sick.

  • But the most important thing is to avoid a lot of people becoming sick.

  • So you have to teach the population that they have to behave in some way in order to avoid the spread of the disease.

  • I don't know where we are.

  • You are now putting in place a lot off severe measurements of containment.

  • And that's the only way that we can try toe deal with this incredible number of patients who are coming to our hospitals.

  • And then the original differences are different.

  • Difficult to explain.

  • I don't know.

  • I'm not epidemiologist.

  • I observed the numbers and the facts and I see that in other countries they have smaller numbers, lower mortality.

  • I have no, basically have no explanation for that.

  • We need to lead the d.

  • D.

  • The average age is very is quite high.

  • So most of the people who die their patients above 80 years old, so patient toh, really I cannot reasonably survived to a severe acute respiratory failure like this.

  • Actually yourself at your explanation to us off the bomb that was in Lombardy.

  • The ingredients were such that you got hit very, very badly on those ingredients.

  • Don't exactly exist necessarily anywhere else.

  • That that that that's one explanation.

  • And also, I mean, the bomb is it's worse than a bomb, but because you know a bomb is that one event limited in diamond in space.

  • This is an event that you know, keeps increasing and it's contagious.

  • So So and and it ended, everything happens very quickly.

  • If one had told me that in two weeks who we would have created 500 less you knew.

  • I see you bets for completely reorganized our hospital system, I would have said, Okay, you're crazy and it's happening now.

  • One more question.

  • Professor Casali, Are your own doctors and nurses being infected?

  • Um, we had a certain number of health care workers infected at the beginning.

  • Ah, when you know everything was starting to happen.

  • So now I think that they are using properly the personal protective equipment.

  • And at this emoluments, anesthesiology is the number of infected doctor's eyes is decreasing.

  • But again, that's another big problem because a certain number of health care workers are affected in those diseases.

  • It like SARS or those corona virus diseases.

  • So another important message for the population is that for the other health care system who are going to face this is tow train your healthcare workers on the use of props on the proper use off P B.

  • Because That's one of the most important thing at this point in the development off this pandemic.

  • Is it possible do you think for Britain to suffer a bomb as you put it?

  • In other words, a sudden explosion off a really intensity off this outbreak possible?

  • It's possible.

  • I I think that you have the advantage of being late compared to tow us.

  • So you're now realizing that this can happen and it can happen in a again in the reach and modern and well organized region.

  • Okay, so it and I think that everyone you know, I mean, I'm being contacted by several people and several from all over the world who are asking us.

  • What are you doing?

  • How did you do it?

  • And the And this is a great advantage for you.

  • So I I hope that in other countries, this is not It's not going to happen because they know that it can happen.

  • And they have to be to get ready to be prepared.

  • Professor Gross.

  • Ellie, thank you very very much for talking to us.

  • I'm good luck and our thoughts are with you.

  • Okay.

  • Thank you.

  • Thank you.

  • Thanks.

Professor Gross.

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