Health care systems across the globe are struggling to cope up with the wave of COVID-19 patients caused by the Coronavirus pandemic. No other country has seen the devastation caused in the wake of the Coronavirus disease as much as Italy.?
Learning from the experience, doctors in the country believe that the long established health care system has failed in the situation and needs a drastic revamp, one where patients are treated at home instead of hospitals.
Almost a dozen physicians in Italy have appealed to their counterparts in other countries to take the health care to the communities instead of limiting the treatment to established hospitals. The suggestion stems from a study published by Mirco Nacoti, Luca Longhi, and their colleagues at Papa Giovanni XXIII Hospital in Bergamo, Italy.
A humongous challenge for the health care officials at this point is to manage the available medical resources optimally to save as much lives as possible. Doctors have had to choose between patients to save at hospitals, citing limited number of critical life saving equipment like ventilators.
A similar condition is observed at the Papa Giovanni XXIII Hospital, a new state-of-the-art facility which is staggered under the COVID-19 caseload. ¡°Our own hospital is highly contaminated, and we are far beyond the tipping point: 300 beds out?of 900 are occupied by COVID-19 patients. Fully 70% of ICU beds in our hospital are reserved for critically ill COVID-19 patients with a reasonable chance to survive,¡± the paper written by the team of physicians mentions.
It further adds, ¡°the situation here is dismal as we operate well below our normal standard of care. Wait times for an intensive care bed are hours long. Older patients are not being resuscitated and die alone without appropriate palliative care, while the family is notified over the phone, often by a well-intentioned, exhausted, and emotionally depleted physician with no prior contact.¡±
With the overburdened medical resources, even regular medical services like pregnancy care and child delivery have been affected like never before as hospitals near collapse. The paper paints a grim picture of the reality in Italy.
Another big challenge is that the novel Coronavirus disease might be spreading in hospitals from patient to patient. Reports of the disease being spread among the occupants of a hospital are coming to light and in such a case, hospitals can be considered as a hotspot and a possible source of transmission to the healthy, in the worst-case, to the health workers.
The physicians urge their counterparts in the US to learn from Italy¡¯s condition and adapt an invariably different approach to treating patients with Coronavirus. They suggest the medical forces in the US to decentralise the health care system needs and focus on community interventions instead.
That might mean a home centred care for Coronavirus patients i.e. something like doctor house calls. The practice can possibly reduce the community spread of the disease by reducing the exposure of the COVID-19 patient to the outside world.
Interestingly, doctors mention that the treatment of COVID-19 at home is very much possible as no special medical equipment is required in most of the cases. Optimum nutrition through diet, steady breathing and Oxygen provision in case the patient has breathing difficulties is all that is required for most of the cases.
In bringing these remedial measures to the patient, a whole lot of chances of transmission of the disease can be avoided. In addition, such patients will not burden the already overburdened hospitals any further.
For patients that need more intensive care, dedicated Coronavirus medical centers should be used to deliver care.
The paper provides a thorough insight on the ground reality and how a key aspect in the equation can be modified to our benefit. With COVID-19 dedicated centres being set up in various hotspots around the globe, the idea might already have been brought to practice and should yield its results soon.