Because I, a doctor, contest the anti Covid methods
Stefano Biasioli's post, former head of Nephrology-Hemodialysis wards, now retired and freelance in nephrology and endocrinology.
I am a Capricorn, born on Christmas, 77 years ago.
I've been a doctor all my life: 40 years spent in hospital (Assistant, Assistant and Head Physician in Nephrology-Hemodialysis wards) and, as an INPS pensioner, freelance in nephrology and endocrinology.
In my life as a doctor I have seen all the colors: from the beginnings of dialysis to computerized dialysis, from transplants on monkeys (in Lyon) to transplants from cadaver and living; from “homemade” technologies to the world capital of dialysis (in Mirandola).
I learned to face clinical problems, the problems of the patient even in the absence of clear and certain guidelines.
This is why I do not understand and do not accept what is happening with this pandemic, especially in these autumn months.
In spring, therapeutic confusion was justified, due to the strangeness and violence of this virus.
But 10 months have passed since then and there is still uncertainty about the behaviors. No, I'm not talking about virologists / microbiologists, I'm talking about clinicians and the Italian medical world in general. I know I don't make friends, but I've never tried to be in the middle of the stream.
For this I can say and write.
The FNOMCeO-SIAARTI document is incomprehensible and unjustified in which, after many nice words, we come to the conclusion that – in the presence of health critical issues – only patients with a high benefit / cost ratio and with a high probability of clinical success are treated. The others will be entrusted to the "charitable" practice.
I have already written that these choices are not in line with the Hippocratic Oath and with Italian law. Not only that, but what value can a document like the one cited have from an ethical and medico-legal point of view?
On this, there was a heavy letter from Prof. Michele Poerio (President of FEDERSPeV, federation of health care pensioners and their widows) to the President of FNPOMCeO, Dr. Anelli. His answer does not change the substance of things. It is not a trade union problem, but an ethical problem for everyone.
Granted (and we do not admit it) that it is a correct choice, who should “make the selection”? To the doctor on duty? To the Director of the UOC (complex operating unit), to the General Manager, to the Ethics Committee of the ASL?
Problems after problems, which will give work to the lawyers of patients' families, even for lack of valid informed consent! Consensus on what? What "You doctor, you abandon me …"?
FURTHER APPEARANCE
After the National FNOMCeo, a few days ago a document of the Lombardy Regional Federation of Medical Orders (signed by the Presidents of the Lombard Provincial Orders) essentially says that "COVID patients at home should be treated only with antipyretics and that any other treatment, because it is not supported by scientific works… ".
Evidently these:
a) do not read what appears daily in medical literature (Up to date, Medscape etc);
b) they do not know that, as opposed to "not treat" to treat, it is preferable to use a "safe" pharmacological combination: dexamethasone, enoxieparin and azithromycin.
Because?
Because it has been shown – in fact – that this damned virus does not only affect the lungs and that the storm of interleukins massacres (irregularly) various organs and systems (brain, heart, kidneys, etc.) and above all is associated with the danger of a coagulation diffuse intravascular (as demonstrated by D-dimer levels in these patients).
And, then, can I or can't I do prevention at home? And, then, must I wait for things to get complicated – at home – when we now know that we must avoid the patient arriving, LATE, at the hospital?
Especially when it comes to elderly people (like me), cancerous or formerly cancerous, diabetic, immunosuppressed, malnourished, cardiopathic, hypertensive?
Today TV fills us with statements from microbiologists, virologists, statisticians who have never treated a patient in their life. Who do not know what it means to "have people's lives in hand" and "having to decide, for the best". Even if there are no “validated” scientific studies. Studies that, however, will always arrive late.
It's been 10 months … When will we have a "reliable" vaccine? How will it be stored, distributed, administered? How long will its action last? And what syringes will we use?
We have not been able to guarantee the flu vaccine for all our old folks and healthcare workers. How will we be able to administer the anti-COVID vaccine to at least 10-15 million Italians?
And are we going to recover millions of doses of specific immunoglobins or not?
And will we follow the Venetian example of the “regional plasma bank for the healed” or not?
Yes, so much confusion, so much uncertainty. So much fear that grows in people. We have already arrived at the attack of the ambulances …
Of one thing I am certain: that this pandemic has exposed all the rashes of the NHS (born in 1978), with the need to review its bases (principles and practices).
But this task requires different rulers from the present ones.
They navigate between DPCM and pandettes that change every 3 days, because they are unable to launch a Marshall plan for Italy. They have filled us with debts, in a flood of assistance that does not restart the economy of this country.
And, at the top, the Hill is limited to "generic speeches", as if we were not in wartime. Einaudi, where are you?
This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/sanita/biasioli-covid-metodi-medico/ on Mon, 23 Nov 2020 09:45:23 +0000.