Coronavirus: Ex NHS doctor in Italy urges UK government to act

A former NHS doctor trapped in coronavirus-hit Italy has begged the UK Government to ‘shut down everything’ in the fight against the killer infection.

Professor Mohamed Abu Hilal, who now works in Brescia, north Italy, urged officials to prepare more beds, doctors and nurses in the NHS in light of the fiasco happening in the worst hit country of Europe. 

He warned it’s not only the elderly who are dying of COVID-19, although figures suggest they are the most vulnerable. 

Italy put full-scale lockdowns nationwide in place on Monday, with court action and fines threatened for people breaking imposed curfews. 

Schools, cafes, hairdressers and restaurants have been closed as 60million residents are told to stay in their homes in ‘social distancing’ measures in order to curb the escalating crisis there.

Mounting pressure has built on the Government to move quickly to impose similar rules because it’s feared the UK is heading the same direction as Italy, where 15,113 cases and 1,016 deaths have been confirmed. 

Prime Minister Boris Johnson will today hold an emergency meeting and is expected to move the ‘battle plan’ into the next stage.  

It follows a surge of 85 in the UK cases yesterday. Now, a total of 460 people have tested positive for COVID-19 nationwide, an eight-fold increase in a single week.  

Total confirmed infections in Europe has topped 23,000 with 951 deaths, according to a new tally which is compiled from official sources.

In Italy a rise in cases of 31 per cent was reported today by the Civil Protection Agency, the largest increase in absolute numbers since the contagion came to light on February 21. 

In drastic moves overnight, Prime Minister Giuseppe Conte announced the latest wave of restrictions would see all shops except pharmacies and food outlets closed in response to the country’s coronavirus outbreak. 

Italy’s grave outbreak of coronavirus has already emptied landmarks and tourist hotspots, leaving streets eerily quiet, and halted flights between the UK and various other countries. 

Professor Abu Hilal, who used to work for Southampton University Hospitals NHS Trust, is now chief of the department of surgery at Poliambulanza Institute Hospital Foundation, Brescia. 

He penned: ‘Form Brescia north of Italy : to my friends accross the glob !COVID19 is serious, feels to be in a war! People are dying, not only elderly. 

‘Beds are full. Goverments must shut down everything, prepare beds, ventilators , antivirals, doctors and nurses. People should stay at HOME! [sic]’

Medics on the frontline in Italy have spoken about their health service struggling to cope with the strain of extra hospital admissions, despite the World Health Organization ranking it second globally for overall performance after France.

It is now being considered to admit patients on a ‘first come first served’ basis, and to use ‘catastrophe medicine’ guidelines – typically used in war zones and during natural disasters – where those with the greatest chance of survival are given priority. 

Giorgio Gori, Bergamo mayor, tweeted: ‘It seems that the increase [in the number of cases] is slowing down, but it’s only because we have no longer beds in intensive care (few are added with great effort). Patients who cannot be treated are left to die’, the Financial Times reported.

Leading UK doctors have already expressed their concern the the NHS will cripple under the pressure of a full-scale coronavirus outbreak. 

The Government have acknowledged the UK will see thousands more diagnosed with COVID-19 and have said they are ‘following the science’ in terms of appropriate restrictions to limit the spread.

But Professor Abu Hilal’s thoughts echo those of other leading medical figures who have criticised the Governments response, such as Richard Horton, chief editor of the prestigious Lancet medical journal.

Writing on Twitter last night, Mr Horton said: ‘The UK Government – Matt Hancock and Boris Johnson – claim they are following the science. But that is not true. 

‘The evidence is clear. We need urgent implementation of social distancing and closure policies. The Government is playing roulette with the public. This is a major error.’ 

Good Morning Britain’s resident doctor, Dr Hilary Jones, said the government should have ‘banned mass gatherings’ a week ago.

Speaking of the significant surge in UK COVID-19 cases, Dr Hilary said: ‘Well I think this was predictable. We were always running containment and delay concurrently in reality, we always knew numbers were going to increase probably double every three to four days. 

‘We are on the same trajectory as Italy, if you look at the Italian situation overnight two hundred deaths nearly, so clearly this is very serious.

‘Having said that the delay phase is critical, people need to socially distance, we should have banned these mass gatherings probably a week ago’.

He added that he didn’t think the Cheltenham Festival should have gone ahead. 

It comes after the World Health Organisation (WHO) declared the crisis a global pandemic after an ‘alarming spread and severity’ of cases across the globe. 

Director-General Dr Tedros Adhanom blasted governments for ignoring repeated WHO pleas to take urgent and aggressive action since the spread outside China rose 13-fold in the space of a fortnight.

UK ministers have – so far – stopped short of shifting the official strategy from the ‘contain’ phase. 

Mr Johnson claims that ‘scientific advice’ suggests the draconian measures are not yet necessary to stop big sporting events and mass gatherings in public places.

But there are reports that schools have been ordered to prepare for closures from March 20 that could last a month, which could cause havoc for millions of parents.

More than 320,000 people signed a petition to urge school and college closures across the UK to prevent the spread of COVID-19 – with 100,000 signatures being the minimum required to secure a debate on the matter in Parliament.

Ministers have already confirmed Britain will not follow Donald Trump’s dramatic overnight move of closing the borders to travellers from mainland Europe. 

Mr Trump blames the EU for failing to stop the killer virus in its tracks – but has exempted the UK and Ireland from his 30-day travel moratorium from midnight on Friday.

Chancellor Rishi Sunak, who yesterday unveiled a huge Budget package to ‘vaccinate’ the economy from the impact of coronavirus, today dismissed the prospect of the UK following the US example. He told the BBC he doesn’t think stopping European flights is the ‘right thing’.

‘The advice we are getting is that there is not evidence that interventions like closing borders or travel bans are going to have a material effect on the spread of the infections,’ he told BBC Radio 4’s Today programme. ‘That is why we have taken the decisions that we have.’ 

Critics including Brexit Party leader Nigel Farage have been arguing for weeks that without a wider travel ban, EU freedom of movement is making the UK far more vulnerable to coronavirus.     

Yesterday the Budget handed hospitals a £5billion fighting fund. As well as this, thousands of firms will be given a business rates holiday to help avert the risk of bankruptcy. 

It followed Parliament facing chaos after five MPs and a cabinet minister went into self-isolation. Health minister Nadine Dorries was diagnosed with coronavirus, she announced yesterday, leading to a frantic search of anyone that came into close contact with her in the days previously. 

‘This tsunami has overwhelmed us’: Doctors reveal the horrors of Italian hospitals where coronavirus ‘war has exploded’ and dying patients have to be left untreated as medics work ‘day and night’ – while experts warn UK and US public are not SCARED enough

Italian hospitals are so ‘overwhelmed’ by coronavirus that strokes are going untreated and elderly patients are not even being assessed, a doctor at the centre of the crisis has said – while another medic said people in the UK and US should be panicking more.

Doctors in Italy have been forced into life-or-death decisions over who should receive intensive care, with virus cases piling up around the country. 

One Italian medic warned that the public may be underestimating the ‘epidemiological disaster’ because of warnings not to panic.

Daniele Macchini said he ‘understands the need not to panic’ but said he ‘shuddered’ because the ‘message of the danger of what is happening does not reach people’.  

‘The war has literally exploded and battles are uninterrupted day and night,’ Daniele Macchini said in a lengthy Facebook post.

‘Cases are multiplying, we arrive at a rate of 15-20 hospitalisations per day all for the same reason.

‘The results of the swabs now come one after the other: positive, positive, positive. Suddenly the emergency room is collapsing.’ 

The surgeon in Bergamo in northern Italy said that doctors on the front line were ‘part of a single team to face this tsunami that has overwhelmed us’.  

He also urged people to abide by Italy’s stringent new quarantine measures. 

‘So be patient too, you can’t go to the theater, museums or gym. Try to have mercy on that myriad of older people you could exterminate,’ he said. 

‘It is not your fault, I know, but of those who put it in your head that you are exaggerating – and even this testimony may seem just an exaggeration for those who are far from the epidemic, but please, listen to us –  try to leave the house only to indispensable things. 

‘Do not go en masse to stock up in supermarkets: it is the worst thing because you concentrate and the risk of contacts with infected people who do not know they are higher. You can go there as you usually do.’

Despite his warning, many Italians have done exactly that today with long queues forming outside supermarkets. 

The virus is spreading so fast in Italy that doctors are making comparisons to wartime triage medics deciding who lives, who dies and who gets access to intensive care.

Another medic in northern Italy told a friend in the UK that hospitals were running at ‘200 per cent capacity’ with operating theatres hurriedly converted into intensive care units. 

Non-coronavirus cases are being sidelined with some medics being given a ‘leaflet’ and told to perform specialist tasks for which they are not qualified, while some patients over 65 are not even being assessed, the doctor said.  

In addition, medical staff themselves are becoming ‘sick and emotionally overwhelmed’ and left ‘in tears’ because they cannot stop people dying, they said.  

The medic’s comments were published in a Twitter thread by UK-based friend Jason van Schoor, an anaesthetist and clinical fellow at University College London.  

The doctor also issued a warning for the UK, saying that the Italian chaos would repeat itself in Britain ‘if you don’t take it seriously’. 

His warning was echoed by a second doctor who suggested people should be more scared, saying that overzealous warnings to remain calm meant ‘the danger of what is happening does not reach people’.  

Experts have suggested that the UK outbreak is around two weeks behind that in Italy, meaning Britain could be heading for a similar nightmare within a fortnight.   

Mr van Schoor said he was passing on a message from a ‘well-respected’ friend who worked as an intensive care medic and A&E consultant in northern Italy. 

‘The current situation is difficult to imagine and numbers do not explain things at all,’ the unnamed medic told Mr van Schoor. 

‘Our hospitals are overwhelmed by Covid-19 [the disease caused by coronavirus], they are running 200 per cent capacity.

‘We’ve stopped all routine, all operating rooms have been converted to intensive care units and they are now diverting or not treating all other emergencies like trauma or strokes. 

‘There are hundreds of patients with severe respiratory failure and many of them do not have access to anything above a reservoir mask. 

‘Patients above 65, or younger with comorbidities, are not even assessed by [intensive care], I am not saying not tubed, I’m saying not assessed.’  

The medic added: ‘Staff are working as much as they can but they are starting to get sick and are emotionally overwhelmed. 

‘My friends call me in tears because they see people dying in front of them and they con only offer some oxygen.’ 

The medic added that Lombardy, the area of northern Italy at the centre of the crisis, was ‘the most developed region in Italy and has extraordinary good healthcare’. 

‘Don’t make the mistake to think that what is happening is happening in a third world country,’ they said. 

Offering advice for the UK, the doctor said: ‘We have seen the same pattern in different areas a week apart, and there is no reason that in a few weeks it won’t be the same everywhere.’

Describing the pattern, the medic said it would start with a few cases – as the outbreak did in the UK – before spiralling into a major crisis where intensive care units are ‘saturated’.

They warned that staff would ‘get sick so it gets difficult to cover for shifts’ while mortality would ‘spike from all other causes that can’t be treated properly’. 

‘We have seen it, you won’t be [safe] if you don’t take it seriously. I really hope it won’t be as bad as here but prepare,’ the doctor said. 

Experts have warned that the UK is following the same trajectory as Italy, and could end up in a similar situation within two weeks. 

University College London biology professor Dr Francis Balloux said: ‘The trajectory of the epidemic in the UK is so far roughly comparable to the one in Northern Italy, but with the epidemic in Northern Italy two to three weeks ahead of the situation in the UK.’

Dr Balloux said that it was possible the UK could face a similar lockdown to the one which has brought Italy to its knees. 

Adam Kay, the bestselling British author and former doctor, warned in a tweet about the crisis in Italy: ‘This is us in a fortnight’. 

Italy has suffered the worst outbreak in Europe and one of the heaviest outside China.

The death toll from the outbreak in Italy has jumped by 168 to 631 today, an increase of 36 cent, the Civil Protection Agency said. The total number of cases in Italy rose to 10,149 from a previous 9,172, an increase of 10.7 per cent.  

Northern Italy has been worst affected, but the government’s drastic quarantine measures have now been extended to the entire country.  

The Italian society of anesthesiology and intensive care has published 15 ethical recommendations to consider when deciding on intensive care admissions. 

The criteria include the age of the patient and the probability of survival, and not just ‘first come first served.’  

‘It’s a reasoning that our colleagues make,’ said Dr Guido Giustetto, head of the association of doctors in northern Piedmont. 

‘It becomes dramatic if, rather than doing it under normal situations, they do it because the beds are so scarce that someone might not have access to medical care.’  

One doctor in Lombardy, Christian Salaroli, told Il Corriere della Sera: ‘If a person between 80 and 95 years old has severe respiratory failure, it’s likely we will not go ahead.

‘If they have multi-organ failure, with more than two or three vital organs, it means that their mortality rate is 100 per cent.’  

The Lombardy government has been scrambling to increase its capacity, converting operating and recovery rooms into isolated wards. 

It has cobbled together 150 more beds in the last two weeks and expects another 150 in the coming week. 

‘Unfortunately we’re only at the beginning,’ said Dr Massimo Galli, head of infectious disease at Milan’s Sacco hospital. 

Speaking to SkyTg24, Galli noted that the numbers of infections registered in Lombardy last week were similar to those in Wuhan, China in late January.