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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In Argentina, A Visit To World's Highest Solar Energy Park

With loans and solar panels from China, the massive solar park has been opened a year and is already powering the surrounding areas. Now the Chinese supplier is pushing for an expansion.

960,000 solar panels have been installed at the Cauchari park

Silvia Naishtat

CAUCHARI — Driving across the border with Chile into the northwest Argentine department of Susques, you may spot what looks like a black mass in the distance. Arriving at a 4,000-meter altitude in the municipality of Cauchari, what comes into view instead is an assembly of 960,000 solar panels. It is the world's highest photovoltaic (PV) park, which is also the second biggest solar energy facility in Latin America, after Mexico's Aguascalientes plant.

Spread over 800 hectares in an arid landscape, the Cauchari park has been operating for a year, and has so far turned sunshine into 315 megawatts of electricity, enough to power the local provincial capital of Jujuy through the national grid.

It has also generated some $50 million for the province, which Governor Gerardo Morales has allocated to building 239 schools.

Abundant sunshine, low temperatures

The physicist Martín Albornoz says Cauchari, which means "link to the sun," is exposed to the best solar radiation anywhere. The area has 260 days of sunshine, with no smog and relatively low temperatures, which helps keep the panels in optimal conditions.

Its construction began with a loan of more than $331 million from China's Eximbank, which allowed the purchase of panels made in Shanghai. They arrived in Buenos Aires in 2,500 containers and were later trucked a considerable distance to the site in Cauchari . This was a titanic project that required 1,200 builders and 10-ton cranes, but will save some 780,000 tons of CO2 emissions a year.

It is now run by 60 technicians. Its panels, with a 25-year guarantee, follow the sun's path and are cleaned twice a year. The plant is expected to have a service life of 40 years. Its choice of location was based on power lines traced in the 1990s to export power to Chile, now fed by the park.

Chinese engineers working in an office at the Cauchari park


Chinese want to expand

The plant belongs to the public-sector firm Jemse (Jujuy Energía y Minería), created in 2011 by the province's then governor Eduardo Fellner. Jemse's president, Felipe Albornoz, says that once Chinese credits are repaid in 20 years, Cauchari will earn the province $600 million.

The Argentine Energy ministry must now decide on the park's proposed expansion. The Chinese would pay in $200 million, which will help install 400,000 additional panels and generate enough power for the entire province of Jujuy.

The park's CEO, Guillermo Hoerth, observes that state policies are key to turning Jujuy into a green province. "We must change the production model. The world is rapidly cutting fossil fuel emissions. This is a great opportunity," Hoerth says.

The province's energy chief, Mario Pizarro, says in turn that Susques and three other provincial districts are already self-sufficient with clean energy, and three other districts would soon follow.

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