Letter from Swindon, UK:
Each country has to take the really difficult decision

Sugato Nag

In UK, several ITU Consultants throughout the country have described the situation in their units - they are full of patients below the age of 50. The same is true for France. Over 100 health care workers have died in Italy, nearly 60 of them doctors. At least 20 health care workers have died in UK so far, at least 10 of them doctors. I lost one of my Medical colleagues 3 days ago. None of these were elderly, and definitely not economically destitute.

In UK, the NHS has suffered from at least 10 years of financial cuts, leaving it very vulnerable to such crises. However, the NHS has not yet been overwhelmed and no one has died because of the lack of ventilators yet. Still there were 881 deaths in hospitals alone from this virus, yesterday. The stats show that 50pc of ventilated patients are dying, irrespective of age and not predictable beforehand, despite ITU management.

Italy is the country that has reported the largest death toll so far, and most of the casualties have been reported from the Lombardy region, which happens to be the richest part, having the best health care facilities in that country.

Unfortunately, the knowledge about this disease is sparse as it's fairly new. Most of the early ideas - eg, elderly people and people with co-morbidities are mainly at risk - were based on reports published from Wuhan and Hubei province, where it originated. It has not followed exactly the same pattern everywhere else, for reasons yet unknown.

Admittedly, it will be foolish to be angry, hateful or critical about the behaviour of a virus, simply because the virus doesn't care about our emotions. It is perfectly understandable, though, to be afraid of the disease which has reportedly killed nearly 100,000 people in the world within a space of 3 to 4 months. For any intelligent, mature and sensible person it will indeed be foolish not to admit the existence of the problem, not to be wary and careful about it and not to consider taking appropriate action to try and minimise the damage.

Different countries are frantically trying to find ways of tackling the problem as best as they can. Most European countries have gone for some sort of "lockdown" - presumably following the lead from China that had success reportedly from "locking down" Wuhan and Hubei for 76 days. Recent figures have shown possible positive results in Italy and Spain.

Obviously, each country has to take the really difficult decision - whatever it might be - on the basis of their own situation and available resources. In a crisis situation, this decision has to be taken on the basis of "what is here and now". It will be our collective responsibility to come up with various alternatives when we have managed to get over the immediate crisis.

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Apr 13, 2020

Dr. Sugato Nag

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