As Italy's Coronavirus Deaths Pass China's, Hospitals Strain To Keep Up The country has universal health care. But now, fighting tens of thousands of coronavirus cases, Italian hospitals and medical staff are overwhelmed, prompting anguished debate.

'Every Single Individual Must Stay Home': Italy's Coronavirus Surge Strains Hospitals

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Italy hit a grim milestone today. More people have died of COVID-19 there than in China. The number of cases continues to rise, and that is despite draconian measures the Italian government imposed this month. As NPR's Sylvia Poggioli reports, the country's national health system is overwhelmed.


DANIELA DE ROSA: (Speaking Italian).

SYLVIA POGGIOLI, BYLINE: Daniela De Rosa lives in the Campania region, south of Naples. In this video posted on Facebook, she's breathing through the ventilator she calls the friend who saved her life. She's a 43-year-old veterinarian who enjoyed excellent health until she was infected by the coronavirus. Today's the first day she's been able to speak.


DE ROSA: (Speaking Italian).

POGGIOLI: "I've been in isolation in a hospital room for so many days I've lost count," she says. "I have no contact with anyone other than doctors twice a day." She wants to send a message.


DE ROSA: (Speaking Italian).

POGGIOLI: "Very few people understand what's happening. I want people to see I'm suffering. Every single individual," De Rosa says firmly, "must stay home and not endanger the lives of others." Over three days, the video was viewed by more than 11 million people.

Italy has a very good health system, and every citizen has access, but now hospitals and medical staff are overwhelmed. This has prompted an anguished debate. The Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care has issued guidelines for what it calls a scenario similar to catastrophe medicine, in which it says starkly, given the serious shortage of health resources, patients with the best chance of success and hope of life should have access to intensive care.

CARLO VITELLI: If you have a 99-year-old male or female patient that's a patient with a lot of diseases and you have a young kid that need to be intubated and you only have one ventilator, I mean, you're not going to toss the coin.

POGGIOLI: Dr. Carlo Vitelli is a surgeon and oncologist in Rome. He was speaking just a few hours after operating on a perforated appendix of a young man who had been in contact with a person from the virus epicenter in Northern Italy.

VITELLI: An emergency operation done on somebody who was in quarantine. Don't know if he's going to develop - I don't think so, but you never know.

POGGIOLI: By Thursday evening, Italy, with a population of 60 million, overtook China, with a population of 1.5 billion, in numbers of deceased from COVID-19. That brings the death toll here to more than 3,400. Italy is treating the epidemic like a wartime emergency.

Dr. Giuseppe Remuzzi is the co-author of a recent article in The Lancet that paints a bleak picture.

GIUSEPPE REMUZZI: We will reach, in four weeks from March 11, when the paper was published, 40,000 patients infected and that we would need 4,000 additional beds in the intensive care unit.

POGGIOLI: Health officials are scrambling to create them. In Milan, the old fairgrounds is being turned into an emergency COVID-19 hospital with 500 new beds. And across the country, hospitals are setting up inflatable tents outdoors for triage. Other countries, Remuzzi says, can learn important lessons from Italy. These include being able to suddenly convert a general hospital into a COVID-19 hospital and specialized training for doctors and nurses.

REMUZZI: And we had dermatologists, eye doctors, pathologists learning how to assist a person with a ventilator.

POGGIOLI: Some question why Italy was caught off guard when the virus outbreak was revealed on February 21. Remuzzi says only now is he hearing new information from general practitioners.

REMUZZI: That they remember having seen very strange pneumonias, very severe, particularly in old people in December and even in November. It means that the virus was circulating at least in Lombardy before we were aware of this outbreak occurring in China.

POGGIOLI: That's why, he says, it was impossible to combat something you didn't know existed.

Sylvia Poggioli, NPR News, Rome.

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