Doctor issues dispatches from Italian front

Special to Western News

The escalating COVID_19 situation in Italy motivated Dr. Fabio Salerno, a nephrologist and PhD Candidate at Schulich Medicine & Dentistry, to return to his home country last week to help care for patients and support his health-care colleagues.

Editor’s note: Visit the official WesternCOVID-19 website for the latest campus updates.

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It has been described as a war zone. On the front lines of the coronavirus outbreak in Italy, intensive care units are overwhelmed, ventilators are in short supply and regional health authorities have been imploring retired health-care professionals to return to work.

It’s this escalating situation that motivated Dr. Fabio Salerno, a nephrologist and PhD Candidate at Schulich Medicine & Dentistry, to return to his home country last week to help care for patients and support his health-care colleagues.

Working at a hospital in northern Italy’s Lombardy region, he is now at the epicentre of Europe’s COVID-19 outbreak.

His message for Canadians? Be responsible and stay home.

“The biggest challenge of this pandemic is sensitizing people to the gravity of the situation,” he wrote in an email update.

For his PhD studies, Salerno is working with the Department of Medical Biophysics and the Kidney Clinical Research Unit, co-supervised by Dr. Christopher McIntyre and Grace Parraga. His research is focused on understanding the pulmonary determinants of chronic dialysis-related symptoms. With approval from the School of Graduate and Postdoctoral Studies, he is now on academic leave.

Salerno started working at Monza San Gerardo Hospital in Monza, Italy, on March 23. Read his periodic updates from Italy at the Schulich website.

Tuesday, March 24

Six-hour shifts, except for the night shift which is 8 p.m.-8 a.m. We (doctors and nurses) get changed once, wearing all the personal protective equipment available to us. No, not that very nice ‘space suit’ that you see in the movies, or in pictures from some other countries.

Then we enter the ‘dirty zone’ until the shift ends. We visit, talk to the inpatients, deliver oxygen and medications, draw blood, write, call their relatives, without changing. Everything we touch there is potentially infectious. Hard to keep your head straight when rebreathing your air inside the mask for six hours straight.

Once we are out, we are out.

Most of us working in the ‘dirty zone’ are young and healthy; we will be fine. Older and retired physicians are usually held back, but some volunteer, nonetheless. Several senior general practitioners, the first line against COVID-19 since the very beginning, have died of the disease.

On the upside, Italy’s curve seems to be slowly flattening.

Military trucks carrying the bodies of COVID-19 victims for cremation

Sunday, March 22

I kept my phone on last night – I usually don’t. Not much sleep, melatonin didn’t help. Now reading about London declaring a state of emergency after further evidence of community-based spread.

Meanwhile, here Italian Prime Minister Giuseppe Conte announced that all non-essential businesses are to be shut down; it is essential to minimize further disease exposure after a recent surge in newly diagnosed cases.

The worst affected hospitals are in dire need of staff, hospital and ICU beds, ventilators, personal protective equipment, drugs. Two of the most promising medications at the moment, Remdesivir (an antiviral medication) and Tocilizumab (an anti-IL6 monoclonal antibody, to control lung inflammation induced by SARS-CoV-2), are either unavailable or in severe shortage. This leads to prioritizing the best care options to younger patients.

The photo shows military trucks carrying the bodies of COVID-19 victims for cremation. This is from Bergamo, not far from here. People there are known to work hard and never complain.

Tomorrow, first day at the hospital – fingers crossed.

Empty Italian parks

Saturday, March 21

Due to the rapidly increasing diagnosed COVID-19 cases (6,557 new cases today, for a total of 53,578) and deaths (793, for a total of 4,825), the Italian government imposed further limitations: parks will be closed, and people will be allowed to exercise only around their neighbourhood, provided they respect a minimum safety distance of one metre.

The call for social distancing is reinforced daily. We call it the #stayathome campaign. Italians are currently allowed out only due to work, essential reasons (e.g. shopping for groceries and medications) and health-related issues and must provide a written statement if stopped by the police. Notable exceptions are jogging and walking dogs, provided that social distancing is observed.

Streets and parks used to be noisy and busy. At the moment, birds chirping, and music is pretty much all you can hear from home.

Please be responsible, #stayathome.