As morgues overwhelmed, coffins piled up and mourners grieve in isolation: ”. It is part of bittersweet ”
ROME – at around midnight on Wednesday, Renzo Carlo Testa, 85, died in hospital in the northern Italian city of Bergamo. Five days later, he was still sitting in a coffin, one of score line up head-to-toe in the local cemetery church, which itself is closed to the public.
His wife of 50 years, Franca Stefanelli, wanted to give him a proper funeral. But the traditional funeral services are illegal throughout Italy now, a part of and exit have been put into place to try to stem the spread of the coronavirus. In any case, she and her children could not attend anyway, because of their own illness and in quarantine.
“It’s a strange thing,” Ms. Stefanelli, 70, said, struggling to explain what he is through. “It’s not anger. That’s impotence in the face of this virus. “
coronavirus epidemic has left 60 million Italian basically under house arrest. There is to keep people alive. There are kids who hung a picture of a rainbow from their windows and.
But the key metrics of pandemics and plagues are bodies they leave behind. In Italy, with the oldest population in Europe, with more than 2,100 deaths, the most outside of China. On Monday alone, more than 300 people died.
And the corpses piled in, especially in the province of Bergamo. By 3760 the number of cases reported on Monday, an increase of 344 cases from the previous day, according to officials, it is in the center of the outbreak.
No funeral homes flooded Hospital. Mayor of Bergamo, Giorgio Gori, issued a regulation which closed the local cemetery this week for the first time since World War II, although it is guaranteed that the bodies will still receive the casket. Many of them have been sent to the Church of All Saints in Bergamo, is located in a closed cemetery, where dozens of wooden coffins terrible wax forming lines for cremation.
“Unfortunately, we do not know where to put them,” said Brother Marco Bergamelli, one of the priests at the church. He said that with hundreds dying every day, and with every body took over an hour to cremate, there is a backlog of awful. “It takes time and a lot of dead people.”
An emergency national law issued last week, including the cemetery, to prevent the spread of the virus. Officials have allowed the priest said prayers at the funeral was attended by only a few of the bereaved. In a brief prayer to the family members, who often wears a mask, Brother Marco said that he tried to provide comfort and hope and people are urged to be close, if allowed, to those who are alone. “This tragedy reminds us to love life,” he said.
In the nearby village of Zogno, local priests have decided to ring the death bell only once a day, to keep it from ringing all day. In another city, Casalpusterlengo, Rev. Pierluigi Leva said believers take “no” funeral particularly difficult.
Can you see me? No, I thought.
I can not see you, but I can hear you. And I think I can hear you -. Ah, now I can see you
OK. Sorry for my English. I do not know if my English will be enough to podcasts. But then you will decide, OK?
This is incredible. And I’m really grateful that you make time for us.
So, where are you now?
Now, I’m at home. After three weeks, this day, in the afternoon, I was at home, because I have a big family with three children. And I decided to come back home one day.
So you have not been home in three weeks?
Three weeks, yes. I have in my hospital every day, ranging from the crisis, Friday, February 21. And since then, it is a total mess. It’s like a war, to be honest.
From the New York Times, I’m Michael Barbaro. This is “The Daily.”
This is how the Italian case has grown now for the last month – slowly at first, but now faster. This text books epidemic curve.
Italy is quickly becoming the new epicenter of the pandemic, with nearly 30,000 infections and over 2,000 deaths, the numbers jumped from day to day, even after the government there took extreme measures to lock in many countries.
We are at a critical inflection point in this country.
Monday, the US surgeon general warned that the United States is now in a very similar path.
Folks, we where Italy was two weeks ago in terms of our numbers. And we have a choice to make as a nation. Do we want to go in the direction of South Korea and really being aggressive and reduce mortality we? Or do we want to go in the direction of Italy?
Today, a conversation with a doctor in Bergamo, north of Milan, one of the areas hardest hit Italy.
This Tuesday, March 17.
Can I just ask you to just say your full name for me?
OK. My name Fabiano Di Marco. I am a professor at the University of Milan and the head of the respiratory unit of Papa Giovanni XXIII Hospital of Bergamo, a city close to Milan.
Can you give me a sense of, and may be? paint a picture, what it was like at the hospital now, what you’re dealing with
I have now – my environment has totally changed. There is nothing like before. I’ve been in my hospital every day for 14 hours or 15 hours a day -.
– to try to deal with an outbreak of coronavirus infection
What has been the story of what has happened in your hospital last few weeks? Because I think people in the US who are desperate to understand what you see, and what people have told you, and what it looks like. You describe it as a war. So we want to understand what you mean.
OK. Every day we receive, on average, between 50 to 70 patients with severe respiratory failure due to coronavirus infection. Every day. And to illustrate my reality, my hospital, at least in Europe, a major hospital with 1,000 beds. But to receive each day between 50 and 70 patients with severe pneumonia because coronavirus, it is not possible. You should change your organization day to day.
And tell me what you mean. How do you have to change the organization you are dealing with people who are in severe respiratory conditions like that?
So we changed it, normal wards, especially the surgical ward, because the operating activities has been reduced at least 80 percent off. And we change it, as far as five surgical ward for patients with coronavirus. Now we have between five wards and emergency rooms, at least 350 patients with respiratory failure due to coronavirus infection.
Today is the first day in which we have more than 50 percent of the hospital dedicated to patient coronavirus. To set this up, we must teach cardiologists, dermatologists, rheumatologists – specialist of something very different from respiratory failure – how to treat these patients. You try to find a solution. But day after day, it’s no longer enough. So I can tell you that my colleagues, both doctors and nurses, they cry every day.
I’m 47. I do not, so old to be a ward head, at least in Italy. But I had with my 20 colleagues respiratory physician, with many colleagues. They are 27, 30. So for me, it is a huge responsibility. And I’m afraid they could get sick. WELL? But we cry every day. And now, we have today, 460 nurses at home because they are sick. And I think we have –
Yes .. It’s a very large number.
You have 460 nurses who were in a hospital in the middle of this crisis, which is home because they are sick?
Yes, today. This is the result of today.
And is that because they are sick with coronavirus?
There are some sick, some with a total burnout for the situation, and other contacts of the patient, so that they stay in quarantine at home.
The doctor, you say you are angry, you might even cry every day. And I wonder if there is an experience, maybe a story or a patient, which makes you angry?
The main issue for us is to treat our colleagues. As physicians, we are used to treat patients. And for us it was normal. There are not so emotional, fortunately, because we are used to treat other people. But this is difficult when your patients colleague. And we now have recognized dozens of colleagues or the nurses, the people you meet every day in your life.
Your colleagues now your patients because they have contracted the virus.
Absolutely. For example, yesterday, the head of my department came to the emergency room to be with low levels of oxygenation. He had bilateral pneumonia due to coronavirus.
Wow. Forgive me.
There are very severe. But he is someone who tries to organize the hospital to deal with this infection three days ago. And we went out for dinner with my wife and his wife a week ago.
I do not know. We are afraid because on Friday, just in my hospital, we had 20 deaths.
Yes. For coronavirus. In one day.
It was incredible.
Yes. So another important thing, we have not had the opportunity to allow relative to come to the hospital for two reasons. First, it is a danger to them and to others, obviously, because in 80 percent of cases, they are infected. The second reason, which is not easy to understand if you are not in this situation, is that we do not have enough personal protective equipment – masks in case of infection, something to cover shoes, and dresses. It is impossible to find is now Europe, not only in Italy.
So you run out of them and you can not get them anywhere, in the area or anywhere in Europe. You just can not get them.
Yes. Impossible to find.
If I let one or two relative to come to the hospital, I had to give them this. But we did not have this to us.
Right. You need them to doctors.
Yes. They can not accept a relative in the hospital. So the patient alone. And they die alone. We – it’s difficult for us. We tried to call, every day, relatively. But I must tell you that sometimes, in the confusion of the new organization with a dermatologist who tried to treat patients with severe respiratory failure, and maybe cry a doctor, and – no one remembered to call a relative. So it happens that the relative call the hospital – ..
And the dead
We will soon be back.
The doctor, you’ve mentioned a lot of choices that you and your staff have to make now that this is a terrible situation. And I wonder how you make decisions about who gets what treatment, and who has the best chance of survival. How do you make decisions?
This is, for us, an important point, because we have hundreds of very ill patients. But we have dozens I.C.U. bed.
The problem is that you can find a lot of the value of gravity. But this value of gravity has been thought for some other reason. OK?
And when you say the value of gravity, you mean, basically, the type of calculation that requires the greatest?
Absolutely. So for example, if you are 80, you have severe respiratory failure, and I do not know, you have also failed kidney, I have to admit you are in I.C.U. that because you are very severe. And you have a very high probability of death. WELL. I have to admit you are in I.C.U .. But now we need another score, a score that helps us to understand the possibilities you for the interest I.C.U. the bed. And we do not have this score. OK?
It is not yet made.
Absolutely. We tried to do this now, for example, age, for all stages of severity, the higher is the age, the higher the score. But when you have a few beds for many people, age is completely opposite. If you are 85, I give the bed to one another are 45.
Due to 45 years are more likely to benefit from I.C.U. the sleep of 80 years. So you’re saying all the normal rules should be thrown out the window.
Absolutely. We need new tools we did not have, because so far, the difference between the number of patients, number or bed, is something totally new for us. WELL? And not only for us, all countries will have to deal with this. But it was hard to tell people that if you are 80, you will never I.C.U. sleeping.
But so far, if you do not have a chance to build new hospitals with 1,000 beds, like in China, we need a tool that is terrible, because it is the selection tool
Right – .. of the living and the dead
Yes. And this is why it was important. If you do not reduce the number of patients who are sick, it is not possible to deal with this disease. Impossible. You have to reduce the rate of infection. And the only way to reduce the rate of infection is to change people’s lives really. Now, in Italy, everyone in the house. This is a tragedy for the economy. Nothing worked. Nothing worked. But it’s the only way. There is nothing in between.
It sounds like you’re saying that once you are in the hospital as a doctor, see a room full of people with this virus, overwhelmed, it was too late. That the role of the countries that have not been inItalian place is to make sure they never get to where it never gets to the point of pain you are in. And to do anything to not be there.
Absolutely. You have two options. You decide not to close all activities, close to people in their homes, and you will receive thousands of beds. Otherwise, you must shut down all activity. There is no choice in between. I know it’s hard to have this approach, as well as in Italy, if you talk to my colleagues in other cities, it is quite difficult to understand this. Because a lot of people, including many doctors, this has not been this perception. Because in fact, all normal. It’s hard to be afraid of something that you do not have perception. WELL? So I can understand that in other countries, it was the same. But trust us, or, as in Bergamo, every family will have relatives or friends who died. This is the situation in Bergamo. This is not a disease that you can discuss it on TV, or you would have this perception in your family, in your relative, in your city. This is something that is very aggressive, very aggressive.
I want to know, as a doctor, what advice you would give doctors in the United States that may have to do what you have to do and make the kind of tough decision you have to make now.
I think that it is best to talk with us to analyze the situation of Italy. It could be something important. Because you have to be prepared for this. It was the only thing I would suggest to my colleague. Because also in Italy, I have some colleagues in other parts of Italy were not ready. And I talked to them. They do the same thing we did three weeks ago. It’s incredible. This new reality we live began on February 23, three years ago. WELL? Three weeks ago. After three weeks, we live in another dimension. For me, it’s hard to think of my life before this
No one can be prepared for this – .. Maybe
I want to know, just last question here. At the beginning of our conversation, you said you finally go home after three weeks. And I wonder what it’s like to come home to your family. What do you tell them? And how do you feel?
My kids at home now for three weeks. Schools were closed. Fortunately there are three, so that they can remain together. But we are trying to create a normal situation at home. For me, it was difficult, because it turns out, I have a higher risk of infection than compared to others. So I had to decide what to do at home. If you live with a mask –
sorry. And I decided to live normally, without a mask.
It sounds like this is a difficult decision.
Yes, because I had to find a solution between to protect the best, uh, my wife and not scare my children. WELL? The only good news is that the children and the boy or girl is not affected. It is the only consolation for us. And I decided that I changed my approach to my children. WELL? I noticed my hand. I noticed my towel. WELL? But I decided not to wear a mask because it will be difficult for them to see the father who is a respiratory physician at Bergamo with those kind of cases, hundreds of it. Similarly to this, it is really difficult to decide what is best. And then I spoke with my wife. And we decided to do this.
It sounds like above all the difficult decisions you have to make, you have to go home and make the decision more difficult, this mask.
The doctor, I really want to thank you very much for giving us your time. And I want to wish the best of luck, you and all your colleagues, doctors and nurses in hospitals. We will think about you a lot in the coming days.
Thanks. thanks. It’s been a privilege. I hope, indeed, to be useful for some of my colleagues and to you.
We will soon be back.
Here’s what else you need to know today.
This afternoon, we announced new guidelines for every American to follow during the next 15 days. As we fight the virus, each and every one of us has an important role to play in stopping –
On Monday, President Trump issued sweeping guidelines for a new health for Americans, encouraging them to work from home, restaurants avoid, bar, and a food court, and discretionary travel, and meeting the limit to 10 or fewer.
If everyone is making these changes or critical changes and sacrificesKR now, we will rally together as one nation. And we will defeat the virus. And we’ll have a big celebration all together.
But the guidelines are not mandatory. And the president stopped explicitly ordered the American to stay at home, such as some countries in Europe and some US counties now conduct. On Monday, health officials in the Bay Area of California instruct nearly 7 million people to remain in their homes, with some exceptions, to slow the spread of this virus.
The new orders directing all individuals to take shelter where they live and keep a social distance of at least 6 feet from other people when outside their homes. We know we need to do this. And we know that we need a regional approach.
US health officials are now predicting that the US outbreak is likely to last for months.
That’s it for “The Daily.” I’m Michael Barbaro. See you tomorrow.
The family members were spirited away and, because of the danger of contagion, often die in isolation hospital without family or friends around. local association in the northern city of Brescia has started to collect donations from the tablet to be given to the hospital so that patients coronavirus can stay in touch – or say goodbye -. for their families back home
Mr testa death notice appeared on Friday in the local paper ,. The paper typically have a one-page death notice. On Friday there are 10 pages, and the rest is dedicated to destroying the virus Bergamo.
“For us, it is trauma, emotional trauma,” said Alberto Ceresoli, who edited the paper. “These are people who die alone and was buried alone. They do not have someone holding their hands and funerals should be small, with a quick prayer of priests. Lots of close relatives are in quarantine. “
Giorgio Valoti, mayor of the nearby Cene, died Friday. He was 70. His son, Alessandro, said that 90 people were killed on the same day at Bergamo’s main hospital. Virus “who slaughtered this valley, every family lost someone dear to them,” he said. “In Bergamo, so many corpses pile up they do not know what to do with them.”
In Fiobbio, a small village just outside Bergamo, an ambulance coming to collect Carrara Luca’s father, 86, on Saturday. On Sunday, another one came to her mother, 82. Mr. Carrara, 52, could not visit them in the hospital and stay at home in quarantine, where he has started to show symptoms of the virus. On Tuesday, his parents died. Their bodies were held in the hospital morgue awaiting cremation.
“I am sorry that they are still there,” he said. “Still.”
Luca di Palma, 49, said her father, Vittorio, 79, died on Wednesday night, and that he called a funeral home told him that they had no room for the body. Instead, they were sent to his coffin, some candles, crosses and refrigerator morgue so he could lay his father in the living room. He said no one came to terms of salary, for fear of infectious disease, even though his father had died before he could be confirmed as a case of coronavirus, and the doctor refused.
On Saturday, Mr. Palma followed a hearse carrying his father’s body to a funeral in Bergamo, where the guards let them in and locked the gate behind. A priest arrived to offer a brief prayer at the top of the hearse, its trunk raised. Mr. Palma said his father wanted to be cremated, but the wait was long. “Painful,” he said.
In a country where a lot to learn in school about who, preceded by ringing a small bell, the body was taken in a cart during the 17th century Milan plague, which collect the dead body seems out of another time.
Alessandro Bosi, secretary of the National Federation of Funeral Home, said that the virus also has captured the bodies of the industry by surprise, with their handling quite dead masks or gloves do not have. While health authorities say they do not believe that the virus can be transmitted posthumously, Mr. Bosi said that the lungs are often released the bodies of the air when it is moved.
“We have to consider them in the way we treat individuals are contagious, and take care of the same,” he said.
‘If we do not who carry away the dead,’ he added, ‘but then they have to call in the army.’
In some parts of southern Italy, where the Roman Catholic tradition that is very strong, funeral rites have been too important for some to let go.
In the Sicilian city of Porto Empedocle, the local authorities say that they have been cited 48 mourners last week to take part in the funeral procession. Mourners risk three months in prison.
Reverend Leopoldo Argento, 59, a priest there, said, “Cemeteries part of our anthropology.” He said he understood the encouragement of mourners gathered but thought it was necessary to suspend the funeral. Typically, 600 to 1,000 people may be present. “In Sicily, the death of someone we love is a moment that is very strong and very important in our social life,” he said.
All the Italian social life has been changed by the virus, most acute in Lombardy.
Giacomo Grasselli, who coordinated response to the intensive care unit at the hospital Lombardy, due to the high number of deaths mostly to elderly residents of Italy. The average age of death, he pointed out, about 80.
He said the medical workers often forced to decide whether or not to take measures to assist breathing invasive very old and sick but that, for now this, every patient receiving treatment.
But, “it will not last forever,” he warned, adding that the capacity to expand care for everyone depending on whether containment measures work. He said he took encouragement from a sharp decline in new infections. “This is the only way to survive this.”
Costantino Pesatori, the mayor of Castiglione D’Adda, one of the cities that were previously quarantined, said that 47 people have been killed there since 21 February, compared with about 50 in all of 2019. He said that although some residents have received diagnosis of pneumonia, hospital officials “send them home without testing them for coronavirus.”
in Bergamo last week, when the ambulance arrived at the apartment of Ms. Stefanelli to her husband, both in bed with a fever. Three nurse came and took Mr. Testa to the hospital and left. That was the last time she saw it. Four days later, he was dead.
He said that he hopes his body can be stored in Bergamo church until she and her children were released from quarantine and were able to attend the funeral. She said her husband thought she was buried without there or should choose who can go unbearable.
“How You can choose between family members? Children should not be there? The wife should not be there? ” he says. “This is part of the bitterest.”
Elisabetta Povoledo contributed reporting from Rome.
Updated March 17, 2020
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