Doctors in Italy were confused: Reports from
China were suggesting a death rate of about 3%
among those infected. But for the first 18 days,
only the dead left the ICU at Bergamo’s large
Pope John XXIII Hospital.
While the toll eventually dropped, 30% of the
hospital’s initial 510 COVID-19 patients died.
After decades in practice, ICU chief Dr. Luca
Lorini thought he knew how to treat the
dangerous kind of respiratory failure -- called
ARDS, or acute respiratory distress syndrome --
first thought to be the main threat.
“Every night, I would go home and I had the
doubt that I had gotten something wrong,”
Lorini said. “Try to imagine: I am all alone and I
can’t compare it with France because the virus
wasn’t there, or Spain or the U.K. or America, or
with anyone who is closer to me than China.”
Only later would it become clear that for
patients sick enough to need the ICU, death
rates were indeed staggeringly high.
By February, China had filed only a limited
number of medical journal reports on how
patients were faring. Lorini’s hospital tried to
fill the data gap by dividing patients into small
groups to receive different forms of supportive
care and comparing them every three or four
days -- not a scientific study, but some real-time
information to share.
The first lessons: The coronavirus wasn’t causing
typical ARDS, and patients consequently needed
gentler ventilation than normal. They also needed
to stay on those ventilators far longer than usual.
“We made big errors,” Villani said, weaning
patients off machines too soon.Image: Luca Bruno