Italian coronavirus patients who are 80 or older will not receive intensive care if the crisis worsens, under emergency plans being proposed in Turin.
The plans drawn up by civil protection officials warn that ‘it will be necessary to apply criteria for access to intensive treatment’ if there are too many patients.
The document, seen by the Daily Telegraph, proposes that these criteria ‘must include age of less than 80’.
Doctors have already described making life-or-death decisions about who can be treated and who may effectively be left to die.
One doctor said a patient’s fate ‘is decided by age and by health conditions’, adding: ‘This is how it is in a war.’
Emergency: A health worker wearing a protective suit and mask wheels a patient on a bed at a hospital in Brescia in northern Italy
A map showing the number of cases across Europe, with Italy still the worst-affected country. The dots show small countries such as Andorra and San Marino
A patient’s other health conditions will also be taken into account when beds are allocated, according to the document.
Doctors will also consider whether they are likely to recover from resuscitation if they are taken to hospital in an emergency.
‘Should it become impossible to provide all patients with intensive care services, it will be necessary to apply criteria for access to intensive treatment, which depends on the limited resources available,’ the document says.
Officials acknowledge that the plans will force hospitals to ‘focus on those cases in which the cost/benefit ratio is more favorable for clinical treatment’.
Italian medics have already described how hospitals have been ‘overwhelmed’ by the health crisis, with Italy suffering the worst outbreak in Europe.
Turin is part of the Piedmont region, which neighbours Lombardy where the largest number of cases have been found.
Many cases in Lombardy have been in small towns, but there have been fears of a major spread into Milan which would leave hospitals even further stretched.
Lombardy governor Attilio Fontana said the situation in areas around Milan was only ‘getting worse’.
‘We are close to the point where we will no longer be able to resuscitate people because we will be out of intensive care unit beds,’ Fontana told Sky TG24.
‘We need those machines (doctors) use to ventilate lungs, artificial respirators that unfortunately we cannot find,’ Fontana said.
Treatment: A hospital worker tends to a patient lying in bed in a temporary structure outside the hospital in Brescia where medics are handling suspected virus patients
Milan mayor Beppe Sala said he had managed to secure shipments of surgical masks from China to help cover a growing shortage.
‘Milan has always had excellent relations with the main Chinese cities and I made a few phone calls over the past few days in search of masks,’ the Milan mayor said.
‘The first shipment arrived (Friday) and we will now distribute them to doctors, to our staff.’
The European Commission also announced the imminent delivery of one million masks from Germany.
Some medics have been working from makeshift facilities, with tents springing outside hospitals to allow patients to be tested for coronavirus.
There are also fears that the poorer south of Italy would be unable to cope if the virus spread as rapidly as it has in the wealthy north.
Italian premier Giuseppe Conte has warned that some people are continuing to travel south despite an unprecedented nationwide lockdown.
”Things like people leaving Milan on weekends to spend time with their family or at their residences in the south must absolutely stop,’ the prime minister said.
‘We can no longer afford behavioural errors,’ Conte told the Corriere della Sera newspaper.
The virus ‘is our most important challenge of the past decades,’ he said.
Italy has confirmed 24,747 virus cases and 1,809 deaths in the worst outbreak outside China.
The governor of Venice’s Veneto region also called on ‘everyone to remain in isolation’ to avoid putting hospitals under further strain.
‘If you do not follow the rules, the healthcare system will crash and I will have to impose a curfew,’ Veneto governor Luca Zaia warned.