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Italy's Hospital Backlog Risks 20,000 New Deaths

In a intensive care unit in a hospital, Bologna, Italy
In a intensive care unit in a hospital, Bologna, Italy
Alessio Perrone

MILAN — In March, the first coronavirus outbreak in the West put Italy's hospitals under unprecedented strain, with health authorities facing what they described as a "tsunami" of new patients. As intensive care units filled with COVID-19 patients, hospitals scrambled to convert other wards, freeing up corridors and operating theaters for patients of the potentially fatal virus. All non-essential surgeries and appointments were canceled.

Today, the outbreak has been gradually brought under control, with the number of coronavirus patients in Italy in need of intensive care below 500 for the first time since early March. Still, hospitals are far from returning to a "normal" pre-coronavirus life. Indeed, the huge backlog of postponed surgeries and appointments means that a new crisis looms large, according to a new study by consultancy firm Nomisma, while a top health care official warned of the risk of 20,000 deaths if urgent surgeries cannot be performed in time.

Since early March, hospitals in Italy postponed some 75% of all surgical operations, reports state broadcaster Rai News. That means hospitals now have some 410,000 surgeries to catch up with. One example of the backlog, according to the Nomisma study: For a coronary bypass or coronary angioplasty operation, waiting times that are usually around 20-25 days are now four months long, the authors of the report told the Quotidiano Sanità, a news website specializing in health care.

The number of postponed checkups and appointments stands at 11 million.

Carlo Palermo, national secretary of a national union of health professionals, confirmed to La Stampa that waiting times will be long. "Considering that our hospitals perform four million surgeries a year, and that we will only be able to increase our activity by 20%, at most, it will take at least six months to go through the backlog."

COVID-19 serological tests in Milan — Photo: Marco Passaro/IPA/ZUMA

"Postponing check-ups and surgeries in operating theaters for so long could cost us 20,000 deaths by the end of the year for cardiovascular diseases alone," Palermo said. Specialist clinics — which have remained closed or only partly open during the outbreak — are also facing a huge backlog. Antonio Magi, the president of the union of specialist clinics' staff, puts the number of postponed checks and appointments at 11 million.

This adds to existing pressures. Medical staff have already canceled their holidays and worked overtime to respond to one of the world's most severe coronavirus outbreaks, which has cost the lives of more than 33,000 Italians, including at least 165 doctors. The coronavirus also forces hospitals to work more carefully around bookings and sanitizing equipment. The way out, for some, would be to hire more doctors and nurses, perhaps on six-month contracts. Even then, it's unlikely the medical staff that have been hailed as heroes during the outbreak will be able to go any sun this summer.

Consider that even non life-threatening conditions need care as quickly as possible. Right now, for example, for a hip transplant, waiting times have doubled to at least six months.

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The Problem With Always Blaming Climate Change For Natural Disasters

Climate change is real, but a closer look at the science shows there are many factors that contribute to weather-related disasters. It is important to raise awareness about the long-term impact of global warming, but there's a risk in overstating its role in the latest floods or fires.

People on foot, on bikes, motorcycles, scooters and cars navigate through a flooded street during the day time.

Karachi - People wade through flood water after heavy rain in a southern Pakistani city

Xinhua / ZUMA
Axel Bojanowski


BERLIN — In September, thousands of people lost their lives when dams collapsed during flooding in Libya. Engineers had warned that the dams were structurally unsound.

Two years ago, dozens died in floods in western Germany, a region that had experienced a number of similar floods in earlier centuries, where thousands of houses had been built on the natural floodplain.

Last year saw more than 1,000 people lose their lives during monsoon floods in Pakistan. Studies showed that the impact of flooding in the region was exacerbated by the proximity of human settlements, the outdated river management system, high poverty rates and political instability in Pakistan.

There are many factors that contribute to weather-related disasters, but one dominates the headlines: climate change. That is because of so-called attribution studies, which are published very quickly after these disasters to highlight how human-caused climate change contributes to extreme weather events. After the flooding in Libya, German daily Frankfurter Allgemeine Zeitung described climate change as a “serial offender," while the Tageszeitung wrote that “the climate crisis has exacerbated the extreme rainfall."

The World Weather Attribution initiative (WWA) has once again achieved its aim of using “real-time analysis” to draw attention to the issue: on its website, the institute says its goal is to “analyse and communicate the possible influence of climate change on extreme weather events." Frederike Otto, who works on attribution studies for the WWA, says these reports help to underscore the urgent need for climate action. They transform climate change from an “abstract threat into a concrete one."

In the immediate aftermath of a weather-related disaster, teams of researchers rush to put together attribution studies – “so that they are ready within the same news cycle," as the New York Times reported. However, these attribution studies do not meet normal scientific standards, as they are published without going through the peer-review process that would be undertaken before publication in a specialist scientific journal. And that creates problems.

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