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Chapter 1161 Yunhe Experience

Chapter 1161 Yunhe Experience
The exchange between Sun Lien and Professor Enrico lasted for more than an hour.

I have to say that Professor Enrico is obviously much more professional than the previous guy who didn't know who he was.Many of his questions were very specific.

More importantly, Professor Enrico really needs help.Most of his questions are related to practical operation and specific treatment experience.Especially for protection, Professor Enrico is obviously... overly nervous.

According to Professor Enrico, his Niguarda Hospital is the best general hospital in the entire Milan metropolitan area.As the largest medical institution in Milan and the most prestigious medical institution in Italy, Niguarda Hospital has the best transplant center in Italy, a national designated center for rare diseases, a key burn treatment center and other institutions.

This is a very strong general hospital, but they are almost at a loss in the face of the new coronavirus.Medical staff lack protective equipment, let alone experience in using it.They lack the treatment means to deal with the new coronavirus, and they don't even have experience in dealing with large-scale respiratory infectious diseases.In contrast to these "deficiencies", there are huge medical needs.

The total number of beds in Niguarda Hospital is about 1100, but so far, they have admitted more than [-] confirmed patients.Doctors and nurses are doing their best to care for patients, but a lack of protective equipment and inexperience has led to at least three nosocomial infections.Two nurses and a cleaner were diagnosed with pneumonia caused by the new coronavirus.

The occurrence of nosocomial infections is a huge blow to the morale of healthcare workers.Professor Enrico was eager to find out how this damned infection happened—whether there was a problem in the use of protective equipment by the medical staff in the hospital, or the protective equipment itself could not provide enough protection.

Sun Lien asked Professor Enrico to show the protective equipment they used, and then frowned.In his view, the matter is actually very simple-the level of protective equipment they use is not enough.But how to say this... makes him a little uncertain.

"When you enter the red zone and leave the red zone, the main protective measure is to wear this kind of plastic sheet like a bathrobe?" Sun Lien thought about it, and decided to say something—preferably To be more direct, "This plastic sheet can only cover the body part - your necks are still exposed!"

"Can this virus be transmitted through skin-to-skin contact?" Professor Enrico asked in shock, "It wasn't mentioned in the WHO report!"

Sun Lien covered his face and sighed, "Skin contact with the virus will not cause infection, but the virus may stay on the skin and then be brought into the rest area. Even if you don't enter the rest area, your medical staff are leaving the red zone and entering the shower You can’t take a shower with a mask on during your free time, right? The process of taking off the mask may lead to infection.”

Just looking at the anti-epidemic materials displayed by Professor Enrico, Sun Lien began to worry—these materials were...too crude.

It is not an exaggeration to say that the security guards in any community in Yunhe currently have more anti-epidemic equipment than these Italian counterparts.One-piece protective clothing plus N95 masks, as well as goggles and gloves.

The Italians don't even have goggles—they just have a splash-proof clear visor.

"This kind of protective equipment is not enough." Sun Lien searched around the room and found Director Huang Wenhui who was hiding in the corner and playing with his mobile phone, "Director Huang, please talk to Professor Enrico first, I will go out Get a PPE set and show them."

There are four people in this conference room, a network communication staff member from Xiangbei Province, his own dean and the director of the Department of Respiratory Medicine.It's not easy for Sun Li'en to order anyone to get things, so it's better to take the initiative and run out to get things.

While Director Huang Wenhui and Enrico were exchanging views on ventilator settings and ambroxol usage, Sun Lien trotted all the way to North Fifth District, took a full set of protective clothing, and then appeared in the conference room.He was panting and sat on a stool beside him, and it took him a long time to catch his breath.

There was nothing wrong with the process of unpacking and displaying. Sun Lien showed Professor Enrico very carefully and slowly all the equipment usually worn by Yunhe's front-line medical staff, and explained the significance of this process in detail.

"We will train all medical staff in advance. It will take at least two days to let them enter the red zone after putting on and taking off the protective clothing more than ten times." Sun Lien was already sweating profusely after demonstrating the steps of taking off the protective clothing. Sitting in front of the table, he said to Professor Enrico, "Our protective clothing can effectively prevent liquid splashes and at the same time prevent fine particles from contaminating the body."

Professor Enrico made no secret of his shock and envy.After he looked at it for a long time, a string of Italian words suddenly came out of his mouth.

The simultaneous interpreter first translated a few sentences, and then suddenly realized that Professor Enrico was probably not talking to Sun Lien, so she quickly explained, "Professor Enrico is talking to the staff of the Italian Red Cross. .”

Although Sun Lien couldn't understand Professor Enrico's long series of words, it did not prevent him from feeling the other party's intense emotions clearly and clearly.

"If it's convenient for you, maybe I can translate what he's talking about with me? That's enough." Sun Lien was really curious after listening for a while, so he asked, "Why is he so excited?"

The lady translator hesitated for a moment, and then said, "Professor Enrico asked the staff of the Red Cross to come to China to purchase relevant materials immediately. He said that he could not use these things, but other doctors and nurses are at least worthy of such a suit. Clothes designed to prevent infection."

At present, the lack of supplies throughout Italy is not just protective clothing.In fact, they lack everything.

As the most famous hospital in Italy, Niguarda Hospital's position in the Italian medical system is almost at the same level as that of Tongxie Hospital in China.In such a top hospital, the hospital has a total of 120 six ventilators, four ECMOs, and 25 dialysis machines and CRRT equipment.

Their hospital has two CTs, two MRIs, and four DRs.This is all their diagnostic imaging equipment—the number of B-ultrasounds is not mentioned in the information.

This level of resource allocation is probably similar to that of an ordinary tertiary hospital, and it still feels like a district-level tertiary hospital under a prefecture-level city.Although the Fourth Hospital does not have as many ECMOs as other hospitals, the number of ventilators and CTs far exceeds several times.

The dire situation at Niguarda Hospital is also reflected in the severe strain on the medical staff.Two hundred patients need at least two hundred medical staff to care for and treat them 24 hours a day, which directly makes it difficult for hospitals that also undertake other treatment tasks to continue.In order to keep the situation under control, the Italian government has signed an order requiring retired doctors to return to their posts and start working.

Italy is a developed country with very strong medical capabilities.But in the face of the epidemic, the SNN free public medical system and hierarchical medical system they are proud of are as vulnerable as paper.

"Doctor Sun, I'm sorry." After yelling for a while, Professor Enrico calmed down a little, "Other problems can be solved, but there is one thing that puzzles me—why is the death rate in Italy so high? High? Our case fatality rate is almost double that of yours."

"Strictly speaking, the death rate in Italy is 50 times that of ours." Sun Lien sighed, "The death rate in the Yunhe area is high because we have experienced a period of no understanding of the new coronavirus before. Pressure on the medical system. If you look at the data from regions other than Yunhe, the fatality rate of this disease is not too high. With sufficient medical intervention and medical resources to deal with it, its fatality rate will not exceed 1 %."

According to the judgment of the experts attending the meeting, the reason for the abnormally high fatality rate in Italy is simple-the number of infected people in Italy should be several times higher than it is now.

Sun Lien, on the other hand, has reservations about this judgment.The new coronavirus is indeed highly contagious, but it does not seem to be so contagious.Italy currently has more than 1 confirmed patients. If the death rate is to be reduced to 0.16%, the overall number of infections must increase to more than 50.

This data is so large that it makes people intuitively feel that it is unscientific.

"What are the reasons for the patients who died?" Sun Lien decided to start with Yunhe's experience and help Professor Enrico study the reasons. "We have summed up some experience, maybe you can use it."

According to Yunhe's experience, the high-risk groups for death from novel coronavirus pneumonia mainly have the following characteristics-male, over 65 years old, have underlying diseases, have a history of smoking, and have a BMI level over 30.Such people are at a much higher risk of death than other groups of people after being infected with the new coronavirus.Among them, the effects of smoking history, high BMI level and male gender are the most significant.

As Sun Lien's explanation continued, Professor Enrico's expression became more and more ugly.In the end he even started covering his head and sighing.

"Among the patients we currently accept, 70% are men. More than half of them are around 28 years old." Professor Enrico's voice sounded a little trembling, "The smoking rate of Italian men is 40%, and these Among people born in the 50s, the smoking rate may be more than [-]%."

"For such a patient group, to reduce the mortality rate, we must move forward the threshold." Sun Lien said with a sigh, "Please be sure to advance all the treatment thresholds. Use glucocorticoids in advance to prevent inflammatory storms, and use ventilators in advance. And oxygen inhalation therapy to relieve ARDS, these are very critical treatment contents.” Speaking of this, he said helplessly, “Chinese doctors have written a lot of related research reports, and all of them have been published in international journals. You should Take a look."

"Last question." Professor Enrico seemed frustrated, but he still tried to find a safe path for his compatriots. "The current situation of Yunhe has improved a lot. How did you do it?"

"Strong isolation measures." Sun Lien replied, "We completely blocked a city with a population of 1000 million. Then we used the power of the whole country to support the city. Everyone stays behind closed doors. This way is the biggest Reduce the transmission speed of the virus to a certain extent. All symptomatic patients are admitted and all their close contacts are isolated for medical observation. PCR testing is carried out on a large scale to ensure that all positive patients can be admitted for treatment.”

"I...I don't know if Italy can do this." Professor Enrico rubbed his face, and then said, "I hope we can take the same measures, and I hope the Italians can implement this kind of measures." .”

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The main impression Italians give people is "romantic".The "romantic" Italians are not the kind of people who can especially abide by the epidemic prevention regulations.

According to Italy's current epidemic prevention regulations, everyone needs to stay at home and self-isolate, but they can travel for work, health or returning home and other economic reasons.Foreign citizens in the Schengen area can still return to major airports in Italy and take normal flights back home.

In Lombardy the situation is a little more restrictive.As the main city of Lombardy, Milan is also the hardest hit area of ​​this epidemic.The Italian side announced that people are prohibited from entering or leaving Lombardy.But after the ban was announced, many people rushed to "flee" Lombardy before the blockade.

Among these people, it is not known how many are infected or virus carriers.

Although lockdown measures have been taken, it is unclear whether such measures will be effective.After all, throughout Italy, planes and trains are still operating normally.Restaurants and coffee shops in the quarantine zone can even operate normally from [-]am to [-]pm - as long as customers sit one meter apart.

More importantly, there is no "wearing a mask" item among the relevant suggestions and measures of the Italians.Italians seem to be very resistant to masks, and they have no intention of wearing them universally at all.You know, in the early days of the Yunhe epidemic, even if you didn't have a mask, you had to find something to cover your mouth and nose.Even so, people have not been successful in stopping the spread of the virus.

As of two days ago, dozens of confirmed cases of the new coronavirus imported from Italy had been reported across the country.Even in this case, Italians are still not going to wear masks.

Sun Lien sympathizes with Professor Enrico, but at the same time he is very pessimistic about the effect of Italy's epidemic prevention measures.In Sun Lien's view, although such epidemic prevention measures can be called "strict", they are still cunning and clever.But in the face of the new coronavirus... any cleverness may directly lead to death in the end.

They have not yet realized how terrible this disease really is.

(End of this chapter)

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