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As COVID-19 Starts To Spiral, A Grim View From A Doctor In Turin

Grueling shifts, grave warnings and the spectre of having to choose between the living and the dead.

Coronavirus tests at the Molinette hospital in Turin
Coronavirus tests at the Molinette hospital in Turin
Andrea Rossi

TURIN — How are you? "So-so ..." A flat, exhausted voice replies. The young doctor speaking has come from an intensive care unit in Turin, dragging herself slowly and methodically, as if to give shape to her weary frame.

"We're doing grueling shifts; I've lost count of the hours. And more and more people are coming. More and more," she says. "This contagion must be slowed down at all costs. But it doesn't depend on us, it depends on all of you. Get this message across: It's the only thing that matters." We're trying.

So here we are at this special Covid-19 hospital, facing the flood of victims of the new virus, hoping there will not be too much water because if the wave of patients mounts too high, there is no system that can withstand it. "We have reorganized the spaces and the people: the departments used for normal surgical operations have been transformed into intensive care, the operating room staff has moved to emergency services."

The new set-up faces a much more complex tide than it might seem from what you read. The doctor explains: "It is not true that there are only elderly people. There are many young people too. And it's not true that you can get infected only by being in close contact; sometimes a dinner is enough."

There are choices a doctor never wants to make.

This is why the waters are rising, and it's beginning to require choices a doctor never wants to make. "We can only respond with available resources." The ICU doctors received a document: 15 pages with a title that might send shivers down your spine: Recommendations of clinical ethics for admission to intensive treatments, and for their suspension in exceptional conditions of disparity between needs and available resources. It is the same protocol that regulates disaster medicine, the doctor explains. "You have to be pragmatic. The means are scarce — in some hospitals they're already running low, in others they will be soon."

Sometimes pragmatic means ruthless; We're talking about distributive justice. "If beds and doctors become scarce, the criterion no longer will be taking care of the first patient who arrives or of the one in more critical condition, but favors the greatest life expectancy." Age, type and severity of illness, pre-existing conditions, compromised organs.

"The availability of resources does not usually go into the evaluation of cases until resources become so scarce that they do not allow us to treat all patients," explains the doctor. "The shifts are exhausting. Our life has no sense of space or time. We are putting our families out, and we are also putting them in danger: Asking our parents to look after the children while we are at work means asking them to put their health at risk."

This is also why it is important that this great collective sacrifice is not done in vain or lead us to an inhuman choice, such as letting go of one life to save another one more "probable" to survive. "Again, it doesn't just depend on us, unfortunately," the doctor repeats. "We are working hard, but limiting the contagion depends on what happens outside of here. On all of you."

For the coming weeks, Worldcrunch will be delivering daily updates on the coronavirus global pandemic. Our network of multilingual journalists are busy finding out what's being reported locally — everywhere — to provide as clear a picture as possible of what it means for all of us at home, around the world. To receive the daily brief in your inbox, sign up here.

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FOCUS: Israel-Palestine War

Two-State v. One-State Solution: Comparing The Two Options For A Palestinian Homeland

For decades, the Israeli-Palestinian conflict has been left unresolved. Hamas's recent attack has forced politicians to confront facts: the conflict needs a definitive solution. Here's a primer on the two possible scenarios on the table.

Two-State v. One-State Solution: Comparing The Two Options For A Palestinian Homeland

At a art event in Gaziantep, Turkey, aimed at expressing solidarity with Palestinians in Gaza.

Samy Magdy

CAIRO — The Israel-Hamas war in Gaza has once again focused the world’s full attention on the Palestinian cause.

For the latest news & views from every corner of the world, Worldcrunch Today is the only truly international newsletter. Sign up here.

Beyond the outrage and anger over the toll of Israel’s war in Gaza and the Hamas attack of October 7, there is a quieter international consensus that has been revived about forging a lasting settlement that includes the establishment of a Palestinian state alongside the Israeli one.

Naturally, there are the eternal (though largely resolvable) details of how that settlement could be achieved. Yet the so-called two-state solution is very much back in the conversation of international diplomacy.

At the same time, there is another scenario for the Palestinians to have a homeland: to share in a single state with Israelis — the one-state solution. There are supporters and opponents of the two solutions on both sides.

Here’s a look at what’s on the table:

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