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As virus surges anew, Milan hospitals under pressure again

MILAN (AP) — Coronavirus infections are surging anew in the northern Italian region where the pandemic first took hold in Europe, putting pressure again on hospitals and health care workers.

At Milan’s San Paolo hospital, a ward dedicated to coronavirus patients and outfitted with breathing machines reopened this weekend, a sign that the city and the surrounding area is entering a new emergency phase of the pandemic.

For the medical personnel who fought the virus in Italy’s hardest-hit region of Lombardy in the spring, the long-predicted resurgence came too soon.

“On a psychological level, I have to say I still have not recovered,’’ said nurse Cristina Settembrese, referring to last March and April when Lombardy accounted for nearly half of the dead and one-third of the nation’s coronavirus cases.

“In the last five days, I am seeing many people who are hospitalized who need breathing support,” Settembrese said. “I am reliving the nightmare, with the difference that the virus is less lethal.”

Months after Italy eased one of the globe’s toughest lockdowns, the country is now recording well over 5,000 new infections a day — eerily close to the highs of the spring — as the weather cools and a remarkably relaxed summer of travel and socializing fades into memory. Lombardy is again leading the nation in case numbers, an echo of the trauma of March and April when ambulance sirens pierced the silence of stilled cities.

So far, Italy’s death toll remains significantly below the spring heights, hovering recently around 50 per day nationwide, a handful in Lombardy. That compares with over 900 dead nationwide one day in March.

In response to the new surge, Premier Giuseppe Conte’s government twice tightened nationwide restrictions inside a week. Starting Thursday, Italians cannot play casual pickup sports, bars and restaurants face a midnight curfew, and private celebrations in public venues are banned. Masks are mandatory outdoors as of last week.

But there is also growing concern among doctors that Italy squandered the gains it made during its 10-week lockdown and didn’t move quick enough to reimpose restrictions. Concerns persist that the rising stress on hospitals will force scheduled surgeries and screenings to be postponed — creating a parallel health emergency, as happened in the spring.

Italy is not the only European country seeing a resurgence — and, in fact, is faring better than its neighbors this time around. Italy’s cases per 100,000 residents have doubled in the last two weeks to nearly 87 — a rate well below countries like Belgium, the Netherlands, France, Spain and Britain that are seeing between around 300 to around 500 per 100,000. Those countries have also started to impose new restrictions.

This time, Milan is bearing the brunt. With Lombardy recording more than 1,000 cases a day, the regional capital and its surroundings account for as many as half of that total. Bergamo — which was hardest hit last time and has been seared into collective memory by images of army trucks transporting the dead to

As virus fills French ICUs anew, doctors ask what went wrong

PARIS (AP) — Over the course of a single overnight shift this week, three new COVID-19 patients were rushed into Dr. Karim Debbat’s small intensive care ward in the southern French city of Arles. His service now has more virus patients than during the pandemic’s first wave, and is scrambling to create new ICU beds elsewhere in the hospital to accommodate the sick.

Similar scenes are playing out across France. COVID-19 patients now occupy 40% of ICU beds in the Paris region, and nearly a quarter in ICUs nationwide, as several weeks of growing infections among young people spread to vulnerable populations.

Despite being one of the world’s richest nations — and one of those hardest hit when the pandemic first washed over the world — France hasn’t added significant ICU capacity or the staff needed to manage extra beds, according to national health agency figures and doctors at multiple hospitals. Like in many countries facing resurgent infections, critics say France’s leaders haven’t learned their lessons from the first wave.

“It’s very tense, we don’t have any more places,” Dr. Debbat told The Associated Press. His hospital is converting recovery rooms into ICUs, delaying non-urgent surgery and directing more and more of his staff to high-maintenance COVID patients. Asked about extra medics to help with the new cases, he said simply, “We don’t have them. That’s the problem.”

When protesting Paris public hospital workers confronted French President Emmanuel Macron this week to demand more government investment, he said: “It’s no longer a question of resources, it’s a question of organization.”

He defended his government’s handling of the crisis, and noted 8.5 billion euros in investment promised in July for the hospital system. The protesting medics said the funds are too little and too slow in coming, after years of cost cuts that left France with half the number of ICU beds in 2020 that it had in 2010.

ICU occupancy rates are considered an important indicator of how saturated the hospital system is and how effective health authorities have been at protecting at-risk populations.

And France’s numbers aren’t looking good.

It reported more than 18,000 new daily cases Thursday, and virus patients now occupy 1,427 ICU beds nationwide — a figure that has doubled in less than a month. France’s overall ICU capacity is 6,000, roughly the same as in March, according to national health agency figures provided to the AP.

For comparison, Germany entered the pandemic with about five times as many intensive care beds as France, which has a similarly well-developed health care system and slightly smaller population. To date, Germany’s confirmed virus-related death toll is 9,584 compared to 32,521 in France.

Getting ICU capacity right is a challenge. Spain was caught short in the spring, and has expanded its permanent ICU capacity by about 1,000 beds. Britain expanded ICU capacity by building emergency field hospitals. Because they were barely used, the so-called Nightingale hospitals have been mothballed. However, the British government says they can be utilized again