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‘No end in sight’: Death, pain and anxiety in Italy’s hospitals

Names marked with an asterisk* have been changed to protect identities. Turin, Italy – It is 5am and Annalisa Baldi is about to start her shift in a COVID-19 ward at the Cremona hospital, southeast of Milan, in Lombardy. Wearing her usual uniform and a surgical mask, the 34-year-old nurse heads to the dressing area to prepare.…

‘No end in sight’: Death, pain and anxiety in Italy’s hospitals

Names marked with an asterisk* have been changed to protect identities.
Turin, Italy – It is 5am and Annalisa Baldi is about to start her shift in a COVID-19 ward at the Cremona hospital, southeast of Milan, in Lombardy.
Wearing her usual uniform and a surgical mask, the 34-year-old nurse heads to the dressing area to prepare.
She thoroughly washes her hands with special sanitiser and puts a protective suit on top of her clothing. She pulls on a pair of gloves.
“Until the end of my shift, these gloves become my skin,” Baldi told Al Jazeera. “I wash and disinfect them any time I can. I also add more layers of gloves throughout the day.”
Two masks – one for her own protection and the other to shield the patients, scuba-diving goggles and a cap complete her armour.
In her ward today, there are 66 people aged between 50 and 70. There are also some younger patients. 
“This virus doesn’t only affect elderly people with underlying conditions,” Baldi said, adding that the large hospital is mostly dedicated to the coronavirus emergency.
At 5:30am, medical personnel bustle about the wards.
Nurses draw blood, check patients’ oxygen levels and deliver medicine, as doctors start first rounds of inspections. Intensive care specialists arrange consultations and X-ray tests proceed at pace.
To avert contagion, direct contact with patients is avoided where possible.
“One needs to do as much as one can in one go, in their rooms,” Baldi says. “This includes helping patients drink. This might sound a small detail, but when patients wear fixed continuous positive airway pressure [CPAP] devices, spanning helmets and full-face masks, getting a chance to drink is essential.”

Anna Baldi has written ‘Nurse Anna’ on her protective gear so patients can identify her easily [Courtesy: Annalisa Baldi]

Only patients with a high fever and who need significant levels of oxygen support are currently hospitalised in Italy, where so far 6,820 have died from the virus that has infected 69,176 people.
Besides monitoring high respiratory rates and shortness of breath, medical staff review arterial blood gas tests, which measure the percentage of oxygen in the blood.
A patient’s condition can change immensely each day.
Oxygen values might drop very fast, requiring intubation and intubation time for COVID-19 patients that is long – 20 days on average.
“This is a new, different patient. Doctors and nurses are outperforming themselves. It is extremely emotional to witness,” said Baldi.
She believes she has probably had coronavirus, like many of her colleagues on the front lines, but that her symptoms were imperceptible.  
The percentage of health workers infected in Italy is more than double the number registered throughout the epidemic in China – more than 5,000 since the onset of the outbreak in February, in part due to a shortage of protective equipment.
Public health experts say that if all medics were tested, the actual rate of infection could be so high that it would stop hospitals from functioning.
In Bergamo, at least 6,000 citizens are currently infected, making it Italy’s – and the world’s worst-hit province in percentage terms.
Hundreds have died there. Ambulance sirens continuously blare through the silence of the city on lockdown. 
Bergamo’s vast Papa Giovanni XXIII hospital has the largest intensive care unit (ICU) in Europe.
Roberto Cosentini, the hospital’s first aid coordinator, has said the pandemic feels like a “viral earthquake”. 
“It is like we had a new telluric shock every day, with scores of new patients suffering simultaneously. Now the difficulty is to move patients who have slightly improved to make space for those who have more serious conditions,” he told local media.
Patients are like candles that start flickering, before becoming feeble and eventually going out. Wheezing and shortness of breath precedes death.
Enrico*, Italian doctor in Bergamo

Enrico* is a hospital specialist in the coronavirus wards.
Like Baldi, he believes he has had the virus, although showing few symptoms. Medics in the hospital are now provided with necessary protective gear.
“The disease is unpredictable. Patients are like candles that start flickering, before becoming feeble and eventually going out. Wheezing and shortness of breath precedes death. Patients with several underlying conditions are not taken to the ICUs. We do all we can to accompany them gently into their deaths,” he said grimly, adding there was an enormous sadness around them.
“They are afraid, alone and isolated. It is excruciating to see them dying like this. It is devastating to call their families,” he said.
But with some hope, he noted the number of patients being discharged. Nationwide, of almost 70,000 people infected, more than 8,000 have recovered.
Valentina*, an anesthesiologist in an ICU in Milan, said while her team had protective equipment, colleagues in other hospitals in the city were still tending to patients only with surgical masks.
“We are exhausted, both physically and psychologically,” she told Al Jazeera.
“This disease creates such uncertainties that even those most prepared to face extreme situations and take difficult decisions break under the pressure.”
Performing complex procedures such as intubation while wearing protective gear can be exhausting.
“People keep coming in. You already know some of them they won’t make it. Patients die of suffocation. What makes it even harder is that there is no end in sight,” said Valentina.
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Ginsburg’s death punctures Biden’s carefully crafted ‘Seinfeld’ campaign

ANALYSIS/OPINION: The death of Justice Ruth Bader Ginsburg (which has yet to be described as “untimely”) gives President Trump the opportunity he needs to change the subject and focus of the presidential campaign. Whether he can take advantage of it is an open question. At the same time, Justice Ginsburg’s death poses the most daunting…

Ginsburg’s death punctures Biden’s carefully crafted ‘Seinfeld’ campaign

ANALYSIS/OPINION:

The death of Justice Ruth Bader Ginsburg (which has yet to be described as “untimely”) gives President Trump the opportunity he needs to change the subject and focus of the presidential campaign. Whether he can take advantage of it is an open question.

At the same time, Justice Ginsburg’s death poses the most daunting challenge to the Biden campaign’s careful and brilliant strategy. The Biden crew created and has remained committed to a campaign in which the candidate says nothing, surrogates say nothing and the campaign itself consists of very limited interaction of any kind — no door knocks, no field offices — with voters.

Similarly, the campaign has been quiet about its preferred policies, other than its opposition to the current occupant of the White House. It is, in short, the “Seinfeld” of campaigns.

This approach is brilliant. It is predicated on Mr. Trump’s penchant to make everything good, bad or indifferent — about himself. Even in an election in which it is essential to draw distinctions between the candidates and make the campaign a referendum about the challenger, Mr. Trump has been unable to resist the spotlight.

The strategy also accounts for the intellectual and mental fragility of the Democratic Party’s own candidate. Mr. Biden is almost certainly incapable of enduring the physical and psychological demands of a traditional campaign. More importantly, the campaign’s silence throughout the duration of the election season has also enabled Mr. Biden to avoid taking sides in the sub rosa ideological strife incinerating the Democratic Party.

The opinion research about the race confirms the wisdom of the strategy. No matter what else has happened in the world, the race has been static for the last nine months. Mr. Biden retains a reliable 6- to 10-point advantage in nationwide surveys and holds narrow leads in most of the states that will determine the election.

Unfortunately for Mr. Biden, the death of Justice Ginsburg, and the nomination and confirmation of her replacement, guarantees that the internal disagreements among the Democrats will now break into public view. Leaders, most especially Mr. Biden, will be compelled to take positions with respect to institutional changes including ending the filibuster, packing the U.S. Supreme Court and providing statehood to places that may not want it (Puerto Rico) or to places to which the American people may not want to tie their fates.

Mr. Biden’s carefully-curated silence will be pierced. He will have to say something about each of these ill-advised ideas.

That will provide Mr. Trump with a way to expose his rival as what he is — an empty vessel for pink collectivism — rather than what he was — a marginally competent career clubhouse Democrat.

A contest that has been mired in stasis for the last eight months, has finally found its MacGuffin. The only question that remains is whether Mr. Trump can maintain the spotlight on Mr. Biden as he flails in the newly energized and volatile environment of an angry, splintered Democratic Party. That party rightly wants to be sure that all of its leaders are prepared to disrupt governmental institutions to the extent necessary to achieve its goals.

The struggle will clarify the Senate races as well. Sens. Joni Ernst of Iowa, Thom Tillis of North Carolina and Lindsey Graham of South Carolina now have a chance to energize voters on their behalf. Gov. Steve Bullock in Montana will suffer in his Senate campaign, too, as he also is forced to pick sides.

Mr. Trump’s best chance to win reelection is to keep the attention on Mr. Biden for the next six weeks. That’s a tall order for a man like Mr. Trump. At this point, however, it is what remains.

• Michael McKenna, a columnist for The Washington Times, is the president of MWR Strategies. He was most recently a deputy assistant to the president and deputy director of the Office of Legislative Affairs at the White House.

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Death toll rises as wildfires ravage US West Coast |NationalTribune.com

The death toll from wildfires that have ravaged the United States’ West Coast has risen to 33 as the National Weather Service has issued a “red flag warning” amid high winds and dry conditions in Oregon and some California counties. Authorities said the conditions are expected to “contribute to a significant spread of new and…

Death toll rises as wildfires ravage US West Coast |NationalTribune.com

The death toll from wildfires that have ravaged the United States’ West Coast has risen to 33 as the National Weather Service has issued a “red flag warning” amid high winds and dry conditions in Oregon and some California counties.
Authorities said the conditions are expected to “contribute to a significant spread of new and existing fires”, amid days of blazes across the states of California, Oregon and Washington that have destroyed neighbourhoods and forest land, leaving barren and grey landscapes the size of New Jersey.
At least 10 people have been killed in the past week throughout Oregon. Officials have said more people are missing from other blazes, and the number of fatalities is likely to rise. Twenty-two people have died in California since early August, and one person has been killed in Washington state.

‘Unprecedented’ wildfires rage across western US

On Sunday, search and rescue teams, with dogs in tow, were deployed across the blackened ruins of southern Oregon towns. 
At least 35 active fires were burning in the state, as drought conditions, extreme temperatures, and high winds created the “perfect firestorm” for the blazes to grow, Governor Kate Brown told CBS news on Sunday.
Crews in Jackson County, Oregon were hoping to venture into rural areas where the Alameda Fire has abated slightly with slowing winds, sending up thick plumes of smoke as the embers burned. From Medford through the neighbouring communities of Phoenix and Talent, an apocalyptic scene of charred residential subdivisions and trailer parks stretched for miles along Highway 99.
After four days of brutally hot, windy weather, the weekend brought calmer winds blowing inland from the Pacific Ocean, and cooler, moister conditions that helped crews make headway against blazes that had burned unchecked earlier in the week.
Still, emergency officials worried that the shifting weather might not be enough to quell the fires.
“We’re concerned that the incoming front is not going to provide a lot of rain here in the Medford region and it’s going to bring increased winds,” Bureau of Land Management spokesman Kyle Sullivan told Reuters news agency.

In California, nearly 17,000 firefighters were battling 29 major wildfires, according to the California Department of Forestry and Fire Protection (Cal Fire). Improving weather conditions had helped them gain a measure of containment over most of the blazes.
More than 4,000 homes and other structures have been incinerated in the state alone over the past three weeks. Three million acres of land have been burned in the state, according to Cal Fire. 
Air quality
The heavy smoke that has painted California skies orange has also helped fire crews corral the state’s deadliest blaze this year by blocking the sun, reducing temperatures and raising humidity.
The smoke created cooler conditions in Oregon as well. But it was also blamed for creating the dirtiest air in at least 35 years in some places, which the state’s environmental quality spokesperson described as “literally off the charts”.

Took the drone up to show just how smoky it is in Daly City! @RobMayeda @KTVU @NWSBayArea @nbcbayarea @KPIXtv @MaryKPIX @abc7newsbayarea @DrewTumaABC7 @weatherchannel @Weather_West @WeatherNation @SFmeteorologist #CAwx #CAFires #CAfire #ORwx #ORfires #BayArea pic.twitter.com/uiaU2yxrfg
— Antonio Maffei (@AMaffeiWX) September 10, 2020

On Saturday, all five of the world’s most air-polluted cities were on the US West Coast, according to IQAir, with dense smog and ash coating the atmosphere from Los Angeles up to Vancouver in Canada. 
In Portland, residents stuffed towels under door jambs to keep smoke out or wore N95 masks in their own homes.
Role of climate change
The three Democratic leaders of California, Oregon and Washing blamed the states’ dire conditions on climate change.
“It’s maddening right now we have this cosmic challenge to our communities, the entire West Coast of the United States on fire, to have a president to deny that these are not just wildfires, these are climate fires,” Washington State Governor Jay Inslee told ABC’s “This Week” programme.
Meanwhile, Democratic presidential candidate Joe Biden said it was “undeniable” the extreme circumstances were connected to climate change. 

A massive smoke plume – emanating from a ~74,000 acre (~115 square mile) wildfire near Sequoia National Forest in the Sierra Nevada mountains – moves downwind (northward) into central/northern California during the late morning hours on Sunday Sept 13, 2020. #KSwx #COwx #NEwx pic.twitter.com/XKYuNNetE8
— NWS Goodland (@NWSGoodland) September 13, 2020

Trump, for his part, is set to visit California on Monday and meet with federal and state officials.
He has said that western governors bear some of the blame for intense fire seasons in recent years, and has accused them of poor forest management.
“They never had anything like this,” said Trump, who systematically downplays global warming, at a campaign event in Nevada. “Please remember the words, very simple: forest management.”
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John Lewis death sparks calls to rename Edmund Pettus Bridge for late civil rights icon

Calls to rename the Edmund Pettus Bridge civil-rights landmark in honor of late Rep. John Lewis have swelled following the Georgia Democrat’s death Friday at the age of 80. Beatles co-founder Paul McCartney and former United Nations ambassador Samantha Power are among the people who took to Twitter on Saturday to propose naming the bridge…

John Lewis death sparks calls to rename Edmund Pettus Bridge for late civil rights icon

Calls to rename the Edmund Pettus Bridge civil-rights landmark in honor of late Rep. John Lewis have swelled following the Georgia Democrat’s death Friday at the age of 80.

Beatles co-founder Paul McCartney and former United Nations ambassador Samantha Power are among the people who took to Twitter on Saturday to propose naming the bridge for Lewis.

Online petitions created in support of the proposed name change, including some launched weeks before his death, received a spike in signatures over the weekend as well.

Mr. Lewis, a longtime civil rights activist, famously marched across the Pettus Bridge with fellow demonstrators during a 1965 protest that ended in them being viciously assaulted.

A flashpoint during the civil rights movement, the brutal attack was followed days later by the introduction of the Voting Rights Act, federal legislation to combat suppression of voting right of African Americans in the segregated South.

Spanning the Alabama River in the city of Selma, the bridge is currently named for Pettus, a former Confederate general, U.S. senator and Ku Klux Klan leader who died in 1907.

Mr. McCartney remembered Mr. Lewis as a “great leader who fought with honesty and bravery for civil rights in America” in a Twitter post where he endorsed renaming the bridge for him.

Ms. Power, the U.S. ambassador to the UN under former President Barack Obama, similarly encouraged her social media followers to sign a petition in support of the name change.

Two other separate but similar petitions hosted on the website Change.org had been digitally signed a combined total of close to 400,000 times since being created, meanwhile.

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