‘All is well’: Triage and lies await Italy’s critical coronavirus patients

The fight against death pauses every day at 1 p.m.

At that time, doctors in the intensive care unit of Policlinico San Donato phone relatives of the unit’s 25 critically-ill coronavirus patients, all of whom are sedated and have tubes down their throats to breathe, to update the families. Lunchtime used to be for visiting hours at this Milan hospital. But now, as the country grapples with a coronavirus outbreak that has killed more than 2,000 people, no visitors are allowed in. And no one in Italy leaves their homes anymore.

When the doctors make the calls, they try not to give false hope: They know that one out of two patients in intensive care with the disease caused by the virus is likely to die.

As the COVID-19 epidemic expands and the disease progresses, these beds are in increasing demand, especially because of the breathing problems the illness can bring. Every time a bed comes free, two anaesthesiologists consult with a specialist in resuscitation and an internal medicine physician to decide who will occupy it.

Age and pre-existing medical conditions are important factors. So is having a family.

“We have to take into account whether older patients have families who can take care of them once they leave the ICU, because they will need help,” says Marco Resta, deputy head of Policlinico San Donato’s Intensive Care Unit.

Even if there is no chance, he says, you have to “look a patient in the face and say, ‘All is well.’ And this lie destroys you.”

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