The death toll from the coronavirus outbreak in Italy has jumped in the last 24 hours by 196 to 827 as a top Italian doctor said intensive care wards should place an age limit on beds.
Rather than admit patients on a ‘first come first served’ basis, hospitals should swap to ‘catastrophe medicine’ guidelines – typically used in war zones and during natural disasters – where those with the greatest chance of survival are given priority.
The guidelines should apply to all patients needing intensive care treatment and not just those suffering from coronavrius, according to guidance published this week by the Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SAARI).
If a limit on beds is implemented it could mean elderly patients with no signs of coronavirus being turfed off ICU wards to make space for younger patients who have longer left to live.
It comes as a rise in cases of 31 per cent was reported today by the Civil Protection Agency, the largest increase in absolute numbers since the contagion came to light on February 21.
The total number of cases in Italy, the European country hardest hit by the virus, rose to 12,462 from a previous 10,149, an increase of 22.8 per cent.
However, the agency said some 600 new cases were confirmed on Tuesday but only reported on Wednesday.
The head of the agency said that, of those originally infected, 1,045 had fully recovered compared to 1,004 the day before. Some 1,028 people were in intensive care against a previous 877.
Italy announced 200 deaths from coronavirus on Tuesday in the largest daily rise yet, as infections spiked to more than 12,000.
Medics have warned that the UK and US are approximately two weeks away from facing the same scenario.
The entirety of Italy has since been placed on lockdown, with medics in badly-hit regions saying they are struggling to cope with a huge spike in patients.
In a booklet on coronavirus published on Friday, SAARI lays out its recommendations for a worst-case scenario.
While all efforts should be taken to ensure everyone gets care, doctors say it is likely that multiple hospital will be stretched beyond their limits ‘in the next few weeks’.
Around 10 per cent of coronavirus cases in Italy have so far developed serious complications, they note, requiring extensive treatment with ventilators which are in short supply.
In the event that they run out, SAARI says: ‘It may be necessary to place an age limit on admission to intensive care.
‘This is not a value judgment but a way to provide extremely scarce resources to those who have the highest likelihood of survival and could enjoy the largest number of life-years saved.’
Doctors should also take into account how many other conditions patients are suffering from when deciding whether or not they deserve access to intensive care, medics say, and not simply base their judgement on age.
They warn that this will lead to an increase in deaths from people who are not suffering directly from the virus, but who can no longer be treated.
The guidelines have not yet been adopted, but provide a blueprint of what Italy could do should the situation spiral out of control further.
On Tuesday, the World Health Organization officially declared coronavirus a pandemic after the number of patients struck down by the killer infection across the world surpassed 112,000 and the death toll neared 4,500.
The boss of the UN agency said it was ‘deeply concerned by the alarming levels of spread and severity’, with outbreaks continuing to spiral out of control.
Dr Tedros Adhanom also warned inaction by governments across the planet has fuelled the crisis, adding: ‘We have called every day for countries to take urgent and aggressive action.’