As an eruption of coronavirus cases in Italy strains the country's healthcare system past its breaking point and the disease threatens to do the same in other nations, National Institute of Allergy and Infectious Diseases head Dr. Anthony Fauci told Congress Wednesday that "the worst is yet to come" for the United States and the World Health Organization officially labeled the outbreak a "pandemic."
"We will see more cases and things will get worse than they are right now," said Fauci.
The threat of the coronavirus overwhelming the U.S. healthcare system without aggressive containment remains high. News reports from Italy show a nation with hospitals and doctors pushed far past their breaking point, with care providers forced to make difficult decisions on who to treat due to age and health.
"It won't take that much to completely saturate our capacity to provide care for these patients," Indiana University School of Medicine professor of pediatrics Aaron E. Carroll tweeted Tuesday. "Look at what's happening in Italy right now. That's the cautionary tale."
According to Politico:
For now, the marching orders are: Save scarce resources for those patients who have the greatest chance of survival. That means prioritizing younger, otherwise healthy patients over older patients or those with pre-existing conditions.
"Franky, I don't know for how long the health system can cope, I don't even want to think about how it could end," Milan's Sacco Hospital infectious disease department head Massimo Galli told the Financial Times. "We are holding up, but other hospitals are much worse off than us and it is a fact that we will come increasingly under pressure in the coming days."
Shocking stories out of Italy's hospitals highlight the need for strong preemptive shutdowns in US to slow virus spread / ‘This tsunami has overwhelmed us’: coronavirus pushes Italy’s hospitals to breaking point https://t.co/9o5O7CfRvq via @FinancialTimes— Tony Karon (@TonyKaron) March 11, 2020
The Financial Times reported that the outbreak in Italy, which is now the second most affected country by the disease after China, is pushing the government to take extreme measures, such as a full nation lockdown and ramping up production of surgical masks and other medical supplies.
"Some people still think that the measures in place are exaggerated," said Galli. "I would like to say to them to come and see what's going on in our departments."
It's unclear if the lockdown measures will have an effect, as Vice News reported:
Even before regions of the north were placed under quarantine Sunday, before the measures were extended to the entire country Monday night, there were signs of major holes in the approach. When news of the impending quarantine in the north leaked Saturday, thousands of people fled the red-zoned areas, raising fears of fresh outbreaks in the south of the country, where the healthcare system is not as well resourced as the wealthy north.
According to Vox, the damage from an overstressed healthcare system is felt across all of society:
Hidden behind the official Covid-19 numbers is a much broader health crisis, rapidly accumulating across the country. Even greater than the official coronavirus toll may be the collateral damage wrought by an over-stretched health system: The pregnant women and babies, cancer and HIV patients, and children in need of vaccines who are now less likely to get the health care they need.
"Looking at all the signs, and there are many, it would be shocking to me if we didn’t have large numbers of cases undetected, silently transmitting in the community, in multiple countries and regions," O'Neill Institute for National and Global Health Law at Georgetown University director Lawrence Gostin told Vox.
Dr. Daniele Macchini, a doctor in northern Italy, took to Facebook to warn the world of what he was seeing in hospitals. Throwing cold water on statements from European governments claiming there is no need to panic, Macchini described a dire situation in the region where doctors are so overworked and concerned over infection they're forgoing heading home for breaks.
"There are no more shifts, no more hours," said Macchini. "Social life is suspended for us. We no longer see our families for fear of infecting them."
Fred Hutchinson Cancer Research Center scientist Emma Hodcroft, in comment to Vox, warned Americans to pay attention to Italy.
"The Italian situation should be a big wakeup call to the rest of Europe and the U.S.," said Hodcroft.