THIS dramatic image of an exhausted nurse tackling the Italian coronavirus outbreak yesterday summed up the country’s battle against the killer bug.

Elena Pagliarini, 40, was snapped slumped at her desk with a keyboard for a pillow and a mask over her face, as she snatched a five-minute break.

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10 Italian nurse Elena Pagliarini passed out on her desk from exhaustion at Cremona Hospital Credit: Twitter

She has been working round the clock shifts at Cremona Hospital near Milan, the heart of the outbreak which has left almost 500 dead.

The hospital hit the headlines earlier this week after shocking images of patients being treated by nurses and doctors in full hazmat suits emerged.

Medics say by treating patients lying on their fronts it is easier to regulate the level of oxygen in their bodies.

Elena’s picture was taken by a colleague at Cremona and posted on the Facebook site of Italy’s Nurse Times.

I was absolutely shattered. I had another hour to go before I finished and I just collapsed." Italian nurse Elena Pagliarini

Underneath was the caption “Thanks for what you do”, with the snap getting thousands of likes and shares.

Yesterday Elena said: “I hadn’t finished my shift yet when the photo was taken. It was just before 6am and I was absolutely shattered.

“I had another hour to go before I finished and I just collapsed.

“That night had been really tough but we are all working together.

“If we manage to help and save people then it’s because we are all working together as a team.”

10 Elena, pictured, said she was 'absolutely shattered' after round-the-clock shifts Credit: Twitter

10 Medics treat coronavirus patients in intensive care at Cremona Hospital, northern Italy Credit: Reuters

10 Patients lie face-down in Cremona Hospital, northern Italy Credit: Reuters

10 Doctors face having to choose who to treat based on survival chances Credit: Reuters

The whole of Italy has today been put under lockdown as authorities desperately fight to stem the spread of the deadly bug.

Italy has the highest number of confirmed Covid-19 cases outside of China at 9,172, with its death toll standing at 463.

And beleaguered doctors have warned they are being “overwhelmed”.

Dr Daniele Macchini, who works at Humanitas Gavazzeni hospital in Bergamo, northern Italy, wrote on Facebook: "The war has literally exploded and the battles are uninterrupted day and night.

"The results of the swabs now come one after the other: positive, positive, positive. Suddenly the emergency room is collapsing."

Doctors now face having to make life-or-death decisions about who to treat, with medics told to consider a patient's age and their chances of survival.

'LIFE OR DEATH'

Dr Christian Salaroli told the Brussels Times: "If a person between 80 and 95 years old has severe respiratory failure, it’s likely we will not go ahead.

"If they have multi-organ failure, with more than two or three vital organs, it means that their mortality rate is 100 per cent."

Lombardy has been scrambling to increase its ICU capacity, converting operating and recovery rooms into isolation wards and cobbling together 150 more beds in the last two weeks.

It also expects to pull together another 150 in the coming week – but it may not be enough.

Dr Massimo Galli, head of the infectious disease unit at Milan’s Sacco Hospital, told SkyTg24: “Unfortunately we're only at the beginning.”

10 The emergency triage section of a Hospital in Brescia, Lombardy Credit: Avalon.red. All rights reserved.

10 Medics assess a patient ahead of treatment in northern Italy Credit: Avalon.red. All rights reserved.

He said the numbers of infections registered in Lombardy last week were similar to those in Wuhan, China, in late January.

Shortages have also seen reports of vital medical supplies being looted as chaos grips the country.

Marco Damonte Prioli, director of a hospital in the Liguria region of Italy, told the Wall Street Journal: “These are episodes of looting…at a time when these health devices are so important.”

Italy’s fatality rate is running at five per cent and six per cent in Lombardy – far higher than the three to four per cent in other countries.

Italy on lockdown Italians told to stay home and “limit social contact as much as possible”

All public events banned, with sporting matches including Serie A games suspended

Weddings and funerals cancelled, with cinemas, gyms and pubs closed

Travel only allowed for “urgent, verifiable work situations and emergencies or health reasons”

Public and private companies encouraged to put their employees on leave

Mortgage payments suspended, with debt moratoriums offered to small firms and households

Dr Giovanni Rezza, head of infectious disease at the National Institutes of Health, attributed the high rate to the fact that Italy has the world’s oldest population after Japan.

The median age of Italy’s virus-related dead is 80.

Over the weekend, 16million people in the country's north were placed under lockdown to try and contain the spread of Covid-19.

But Italy's PM has now extended the strict quarantine measures to the entire country as it struggles to contain the outbreak.

Giuseppe Conte said people would only be allowed to travel for work or family emergencies.

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He said the drastic measures had been introduced because the country had "no time left".

The move will see all public events banned, cinemas, gyms and pubs closed, funerals and weddings cancelled and sporting matches including Serie A games suspended.

Within minutes of the announcement, supermarkets and late night stores across Italy reported a surge of panic buying.

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10 The lockdown announcement sparked a wave of panic-buying across Italy Credit: EPA

10 Emergency vehicles apparently blast out warnings to stay indoors Credit: Twitter ValerioEsposito