These days I feel like this is the only thing that's happening and that everyone on every platform has said something about it, so here are my two cents.
I am not a specialist in viruses, statistics, infectious diseases or microbiologic research, I am not the one to tell you the exact percentages of what's happening, I can't tell you how the virus was born and how it behaves and what will happen after. However, I am the specialist they call in when your virus-infested lungs give up the ghost and your butt can no longer breathe.
I am an anesthesiologist/intensive care specialist and I live and work in north Italy, about 40km away from one of the two main starting points of the Italian infection, Vo' Euganeo.
I saw from the front lines how the 'it's just a simple flu' phase turned into a 'fuck, not the flu' phase and then snowballed into the 'zombie apocalypse' phase. So let me tell you a couple of things and then you can decide yourself if you going outside (and acting like everything is fine) is in your best interests or not.
- Like John Snow, we know nothing. And by we I mean everyone; you, your leaders, the people that will treat you. We know more or less how it spreads and we base our therapies on how other viruses like this one behave but we don't know anything for certain. So we try and try and try. And so far I haven't seen one therapy that works visibly better than others. When the vaccine is ready, if I still hear anti-vaxxers yapping, I'm going to suffocate them with my bare hands. There are hundreds of protocols (organized ways to treat people) being tried every day but let's face it, we are far slower than the virus'. The Coronavirus takes about a week to bring you to the ICU and my request for "that particular experimental drug that maybe works" has been uploaded to the computer ten days ago and it's still being evaluated.
- The virus is and is not like the flu. Maybe in 100 years, when we have the vaccine and enough people have caught it and developed/passed down immunity then yes, it will be exactly like the flu. Right now it's still 'like the flu', but it's the one that the Europeans brought to America the first time they went. The kind that killed everyone because they've never been exposed to that sickness before. It's *THAT* flu now.
- You think the government changing idea every two days is ridiculous? Honey, the hospitals have about two to three summits every day and every day they change placement of the infected ward, change the origin of the supplies, change shifts, change everything. So be kind to your local hospital, they're doing their best with what they're got and right now it's not much.
- I'll be a little patrioctic here. A lot of countries (especially the european kind) downplayed the situation even after the virus spead in Italy because they downplayed Italy. Italy has all these problems because it always been the deadlast, the 'poor one' and, aside from tourist locations, we have little of interest. Bitch, we don't have life expectancy of 82 years old because we pass the time collecting Roman coins and dusting churches' altars, we live to that age because we have a health system that is free and available for everyone and, even though it might have been severely cut down because of public debt, we are good at what we do and, more importantly, we're masters in the art of getting by. Decathlon scuba mask turned into a ventilator interface anyone?
- This virus is a little bitch. Some people get it and it's like when you leave your hair to airdry in winter; a tickle in your throat and a cold neck (but you still spread it like Nutella on bread). Others get it and it's high fever, cough and in one week you're in my ward, getting air in your lungs from a machine and being turned on your front, then on your back, then on your front, until your face gets so bloated with water that we are very tempted to force your kidneys to pee just to make you go back to normal. (You go back to normal on your own, it's just a matter of waiting. But boy, you ugly in the meantime.)
- Movies teach us that when you're suffocating your lips turn blue and then you die. First, no, they turn pale, *then* they turn purple-ish. But in this case no, I have seen people with saturations of 80-85% (normal person has 98-100%, smokey person usually has 94-96%) with cherry red lips. They come in, complaining of having breathing difficulties and you almost don't believe them because yes, they're struggling a bit but... They don't look like they're suffocating. And I have seen my fair share of people close to death, gasping for breath and so on. These people look normal until you look at the gas test on their blood. And then you're like, 'Ok, get me a tube, any tube'.
- Everyone is susceptible. You, your grandma, your children. And everyone can get sick, not just the elderly and the frail. One of my colleagues got it from a patient and she spent 14 days intubated in the ICU and then another two weeks in a hospital ward to recover. She is a healthy 35yo woman, her only sin is one or two sigarettes each day after coffee and having a couple of extra pounds. And by couple, I literally mean 2 or three.
- I am going to spend a point on this because it's very important and very relevant and I don't care if it offends people. I am not looking to fat-shame anyone but obesity is a very relevant factor in your survival if you catch this virus. If you're obese, your lungs are already struggling to oxigenate your whole body and. You. Just. Have. No. Reserves. You're going to need intubation far earlier than other people, you're going to be harder to ventilate, and one of the techniques we use to help you oxigenate, 'prone positioning' (the 'turn you on your back/front' from earlier), we won't be able to use, because pronating an intubated patient is already a dangerous maneuvre, doing it on an obese patient can easily kill them. (Your saturation goes so low you don't oxigenate anything, you go into cardiac arrest and there's no time to turn you back and *get* you back.) And, being a patient with such low reserves, you'll be at the same level as an older patient if we were to decide who to let go and who to keep on fighting for. Because...
- There's not enough resources for everyone. No matter how rich the country, there are not enough ICU beds, ventilators and (especially) specialists who know how to operate them and treat these patients in the right way. So there are two scenarios: *YOU* chose to stay inside and be careful when you go out, not many people get sick and there's a bed for everyone OR, you go out, do whatever and then when there are too many patients to treat and not enough beds *WE* chose who lives or dies.
- Do not make the mistake to think deciding to stop treatment on someone is easy. Do not look at the number of deaths and think that everyone was a painless decision and just something that happened. It's never easy, no matter how old or ill the person might be. But it's a choice us intensivists have been trained our whole life to make. An ICU bed does not make miracles, but it helps to 'gain time' where there's time to gain and 'give time' where there's time to give. If you still have time to live and you just need a bit of time, I am going to let you in. But with this virus, a lot of people still have time to live, and yet we don't have enough time to give to everyone, so we need to decide who has more time, who has more chance and to those we're going to give time.
These are my two cents, I realize I have been a bit harsh but some things need to be said loud and clear. People need to realize this is not a joke and yes, unless it hits you or your family, this virus is just an annoying drag, but if you want it to stay that way and not become a personal tragedy, you better start keeping yourelf and others safe.