Daniela De Rosa, a 43-year-old veterinarian in Italy's southwest Campania region, made a video message over the weekend as she was hospitalized with COVID-19. Her video plea has gathered much attention in Italy, which has just surpassed China in the number of reported deaths from the new coronavirus.
"I've been in isolation in a hospital room for so many days I've lost count," she says. "I have no contact with anyone other than doctors twice a day."
"Very few people understand what's happening. I want people to see I'm suffering," De Rosa continues.
"Every single individual must stay home and not endanger the lives of others," she insists.
Since the video was shared on Facebook last Sunday, it has racked up more than 11 million views.
As of Thursday afternoon, Italy has registered 41,035 diagnoses of the coronavirus and 3,405 deaths. The death toll is now higher than China's known COVID-19 deaths of over 3,200. Earlier this month, Italy became the first Western country to launch a nationwide lockdown to contain the outbreak, but despite strict measures, the number of cases continues to rise.
Italy has a universal health care system. But now, its hospitals and medical staff are overwhelmed, prompting anguished debate.
The Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care has issued guidelines for what it calls a "catastrophe medicine"-like scenario. The college put it starkly: Given the serious shortage of health resources, patients with the "best chance of success and hope of life" should have access to intensive care, the organization says.
"If you have an 99-year-old male or a female patient, that's a patient with a lot of diseases. And you have [a] young kid that need[s] to be intubated and you only have one ventilator, I mean, you're not going to ... toss the coin," says Carlo Vitelli, a surgeon and oncologist in Rome.
He's speaking just a few hours after operating on a perforated appendix of a young man who had been in contact with a person from northern Italy, where the virus has hit the hardest in the country. It was "an emergency operation done on somebody who was in quarantine," Dr. Vitelli says, "don't know if he's going to develop. I don't think so. But, you never know."
Italy is treating the coronavirus pandemic like a wartime emergency. Health officials are scrambling to set up more beds. In Milan, the old fairgrounds is being turned into an emergency COVID-19 hospital with 500 new beds; across the country, hospitals are setting up inflatable tents outdoors for triage.
Other countries can learn important lessons from Italy, says Dr. Giuseppe Remuzzi, co-author of a recent paper in The Lancet about the country's dire situation. The takeaways include how to swiftly convert a general hospital into a coronavirus care unit with specially trained doctors and nurses.
"We had dermatologists, eye doctors, pathologists, learning how to assist a person with a ventilator," Remuzzi says.
Some question why Italy was caught off guard when the virus outbreak was revealed on Feb. 21.
Remuzzi says he is now hearing information about it from general practitioners. "They remember having seen very strange pneumonia, very severe, particularly in old people in December and even November," he says. "This means that the virus was circulating, at least in [the northern region of] Lombardy and before we were aware of this outbreak occurring in China."
He says it was impossible to combat something you didn't know existed.