Until now in our country we have not needed to start such a discussion, as the national health system held up during the first wave of the pandemic. The second wave, however, is — as scientifically expected — more intense, and this is already reflected in all the relevant indicators. Inevitably, then, intensive care units in particular will soon be insufficient, and the difficult ethical dilemmas will begin, initially for the health professionals of these units.
The main concern will be the criteria that will necessarily have to apply when the number of COVID-19 patients requiring intensive care exceeds the available units. Notably, in the Italian areas of Lodi, Bergamo, Brescia and Cremona, during the first wave of the pandemic, there was only one available ICU bed for every 10 patients requiring admission. As a result, around 20,000 lives were lost in that region. During the same period, the Italian Society of Intensive Care issued guidelines setting out the criteria to be used for admitting patients to ICUs.
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