Will California’s coronavirus crisis soon look like Italy’s?

Will California's coronavirus crisis soon look like Italy's?
Written by Leon

It starts every day in the early afternoon: Patients rush into hospitals with fever, shaking, chills and breathing problems. In Italy, the latest country most affected by the new corona virus, it has happened that it seems like clockwork.

“It’s really hard to see so many people who are sick at the same time,” Dr. Roberto Cosentini, said a doctor in the northern city of Bergamo near Milan, said in one podcast for doctors in emergency room. “It’s like a regular earthquake every day.”

Is that what’s in California?

More than 2,600 cases of COVID-19 have been confirmed in Golden State and 55 people have died of respiratory disease. It is a far cry from 69,000 cases and 6,820 deaths reported in Italy.

But health officials here have suggested that it is possible.

“We are in a serious crisis,” he warned Dr. Scott Morrow, San Mateo County Health Officer. “Unless everyone is doing their part and following the county’s order of protection on site and Governor’s Safer at Home order, we will face an Italy-type disaster very soon,” he said in a statement released Monday night.

In nearby San Francisco, Dr. Grant Colfax, Head of the Department of Public Health braces for a powerful force in hospitalized patients within the next week or two. “The worst is yet to come,” he said.

California’s first coronavirus infection was confirmed in late January, and COVID-19 cases and deaths have risen exponentially since early March.

On Tuesday, county officials across California announced 395 new cases of coronavirus infection; Last Tuesday, there were only 158 new cases. Similarly, 11 new deaths were reported throughout Tuesday; Last Tuesday, there were three new deaths.

No one can be sure what the future means for California. If residents respect Govin Newsom’s order to stay home as much as possible, illnesses and deaths can be avoided or delayed. On the other hand, if a single asymptomatic person enters the state and becomes a proliferator – which transmits the virus to a large number of people – he or she can ignite a new outbreak.

However, there is good reason to expect the worst to come suddenly, as it has done in Italy.

For several weeks, King County in the state of Washington and the San Francisco Bay area was the hardest hit areas in the United States. Then, apparently out of nowhere, New York Gov. Andrew Cuomo 5,707 new cases of coronavirus on Monday night. The next day there was one another 4,790 cases, giving Empire State a total of 25,665.

“It’s happening in New York right now,” he said Dr. George Rutherford, an epidemiologist and expert on infectious diseases at UC San Francisco. “They resist it.”

In Italy, the sudden rise in deaths was probably due to a combination of bad luck and failure to act quickly, Rutherford said.

In fact, Italy’s death toll is more than twice that of China, the birthplace of the pandemic, even though China’s population is 23 times larger.

The first sign of trouble came on February 20 in the form of a previously healthy man in his 30s with an unusual case of pneumonia that required intensive care. Although he had no history of traveling to China, he tested positive for the coronavirus at Codogno Hospital in the province of Lodi, about 30 miles southeast of Milan, according to a Report in the Journal of the American Medical Assn.

Within the next day, 36 additional coronavirus cases were identified. Even worse, the virus spread quickly among the hospital’s medical staff, says Dr. Maurizio Cecconi, President-elect of the European Society of Intensive Care Medicine and co-author of the JAMA Report.

“Don’t underestimate this. This is not a normal flu. This is serious,” Cecconi said in a interview with the head of the medical journal. “The proportion of patients requiring intensive care services is high.”

An uneven public health response made matters worse. Codogno Area fast-closing companies and many stayed at home, though other communities nearby did not act so decisively. It was not until March 8 – more than two weeks later – that an order directive was ordered for approximately 16 million people in the northern Italy, an area that included Venice and Milan.

The delays proved fatal. Bergamo hit hard; The chapel of the city cemetery must be converted into a cemetery to deal with the dead.

Italy was particularly vulnerable to COVID-19 because of its population skewed older, Said Rutherford. According to the World Bank, 23% of Italy’s population is at least 65. Only Japan’s population is older. (In the US, 16% of the population is 65 years or older; in China it is only 11%.)

In a study of 803 people who died in Italy, about 88% of them were at least 70 years old, according to data Cecconi shared.

Elderly people and those with pre-existing health conditions are at the highest risk of critical illness and death if they are infected by coronavirus officially known as SARS-CoV-2. If the virus sits deep in the lungs, it can prevent the victims from breathing on their own and cause septic shock and multiple organ failure. The immune system’s response to infection can make matters worse by drowning the small air sacs in the lungs that deliver oxygen to the bloodstream.

A medical worker in protective equipment tends to a COVID-19 patient in the intensive care unit of a hospital near Rome.

(Alberto Pizzoli / AFP / Getty Images)

In addition, Italy was supported by a problem known to the United States – the inability to conduct extensive tests. It affected doctors’ ability to make correct diagnoses and distribute patients appropriately, “Cecconi and his colleagues wrote.

Under these circumstances, adding more hospital beds to the ICU is not enough, the authors said. Staying home remedies “may be the only possible way to contain the spread of infections and allow resources to be developed for the time-dependent disease,” they wrote.

Healthcare workers in California have been paying attention to the podcasts from Italy as they support an expected infestation of COVID-19 patients. The podcast with Cosentini described conditions so intense that the medical staff needed the help of a staff psychologist.

One particularly bad day, Cosentini’s emergency department took in 80 patients with pneumonia. With no available beds in the hospital with 800 beds, patients had to wait all over the emergency department, says Cosentini.

It takes time to treat patients with COVID-19. A patient who cannot breathe on his own may need to lie on a ventilator for three to 20 days. ONE study of patients in Wuhan, China, reported that the median time between disease onset to hospital discharge was 22 days. (Those who died lasted 18.5 days after symptoms first appeared.)

“Not only do we fill the beds with people with this disease and those who are suspected of having it, but we can’t move [them] until we’re sure they’re negative, Rutherford said.

Times staff writers Harriet Ryan and Sean Greene contributed to this report.

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