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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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Geopolitics

What Lula Needs Now To Win: Move To The Center And Mea Culpa

Despite the leftist candidate's first-place finish, the voter mood in Brazil's presidential campaign is clearly conservative. So Lula will have to move clearly to the political center to vanquish the divisive but still popular Jair Bolsonaro. He also needs to send a message of contrition to skeptical voters about past mistakes.

Brazilian votes show a polarized national opinion with two clear winners: former president Luiz Inacio Lula da Silva and sitting president Jair Bolsonaro

Marcelo Cantelmi

-Analysis-

The first round of Brazil's presidential elections closed with two winners, a novelty but not necessarily a political surprise.

Leftist candidate and former president, Luis Inacio Lula da Silva, was clearly the winner. His victory came on the back of the successes of his two previous administrations (2003-2011), kept alive today by the harsh reality that large swathes of Brazilians see no real future for themselves.

Lula, the head of the Workers Party or PT, also moved a tad toward the political Center in a bid to seduce middle-class voters, with some success. Another factor in his first-round success was a decisive vote cast against the current government, though this was less considerable than anticipated.

The other big winner of the day was the sitting president, Jair Bolsonaro. For many voters, his defects turn out to be virtues. They were little concerned by his bombastic declarations, his authoritarian bent, contempt for modernity, his retrograde views on gender and his painful management of the pandemic. They do not believe in Lula, and envisage no other alternative.

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