Johns Hopkins-trained nurse in hard-hit Italy has warning for Americans: ‘Stay home’
As of Thursday, Italy had reported more than 33,000 cases of coronavirus with more than 3,400 related deaths, surpassing the death toll in China, where the virus began. Italy, now the hardest hit nation, has put its 60 million residents on national lockdown, and its hospitals, particularly in northern Italy, have been overwhelmed with the sick and dying.
Tanya Castagna is a Baltimore native and nurse on the island region of Sardinia, about 250 miles from Rome. Though Sardinia, with a population of 1.6 million, has so far only a small portion of the country’s coronavirus cases (206) and deaths (two), authorities there are preparing for more.
Ms. Castagna grew up in Little Italy, graduated from the Catholic High School of Baltimore and from Stevenson University, earning a bachelor’s degree in nursing in 2004. She trained at Johns Hopkins Hospital and worked in the operating rooms there for about three years. She met her husband, Antonello Capalozza, an Italian engineer, while he was in Baltimore. They now live with their two children in Sardinia’s capital of Cagliari. Ms. Castanga, 45, works as an O.R. nurse at the University Hospital of Cagliari, where all elective surgery has been cancelled.
In an exchange of emails, Ms. Castagna talked about the national emergency and issued a warning to Americans fearful of a crisis like the one that has gripped Italy.
When did you first become aware of COVID-19?
There were reports on Jan. 31 of two Chinese tourists who were hospitalized in Rome and tested positive, Italy’s first two cases of coronavirus. A week later, an Italian man who recently traveled to Wuhan was hospitalized and confirmed for coronavirus. A cluster of 16 cases were detected on Feb. 16. An additional 60 cases were confirmed on Feb. 22, including Italy’s first reported death. My heart started to sink.
Within the next 10 days, the number of positive cases doubled every two days, including our very first case in Sardinia. On March 4, they closed all schools and universities. As a medical professional, I was finally facing the fact that we could [have] a disastrous epidemic. Human beings have a funny way of avoiding unwanted pain and suffering, especially from something overwhelming like this. It’s called denial. It’s what the entire world had for weeks regarding Wuhan and the coronavirus. For weeks we were thinking that it was not our problem, it was their problem.
I believe with all my heart that it was simply just too big to comprehend. It was easier to be in denial. I’m a nurse and I was the first one to say that it was nothing to be concerned about, perhaps because it was in China and not in Italy. When it arrived in “casa,” things changed dramatically.
What has the state of emergency been like there?
The entire country is at a standstill. The only services available are the supermarkets, pharmacies, banks and the postal system. Everything else is closed. Only a few people can enter [an establishment] at a time while the others have to wait in long lines outside. Food is not a problem for us, just the inconvenience of waiting in line.
The police are roaming the streets and demanding explanations on where we are going and
why. We need to carry documents stating that we are leaving for work or necessities. You can risk being arrested without having a valid reason.
Based on your experiences and observations, what advice would you give to Americans now feeling their daily lives disrupted by the pandemic?
It’s super contagious. It’s a new virus and we have no immunity to it. Ten to 15% of patients will need to be hospitalized and there are not enough beds in the ICU to handle this volume all at once. A normal flu affects many but in a span of four to five months. This virus is transmitting like wildfire in just a matter of weeks.
This is extremely important to understand because it creates an extreme overload in hospitals and its human resources. There are not enough beds in the ICUs to handle this type of flow all at once! We were put on lockdown because we need to slow down the transmission to help the hospitals in desperate need. It’s a medical catastrophe.
Italian doctors and nurses are literally begging the citizens to stay at home. In the north of Italy, doctors are being forced to make extraordinary decisions on who to treat and who not to treat. Those who are too old or too sick to have a high likelihood of recovery could be left to die. The situation in Lombardy seems like a horror story.
The hospitals are being slammed with a tsunami of positive and very critical patients.
I remember studying about epidemics and pandemics in nursing school, but I never imagined in my wildest dreams that I’d see one in my career. We still haven’t hit the peak yet. The situation is horrific.
So, your advice to Americans?
Stay at home as much as possible. You need to have less contact with others to help slow down the transmission. Listen to your government and cooperate to your maximum potential. You can make
a huge impact just by limiting your contact with others and washing your hands frequently.
The sooner we accept what is happening the sooner this madness will stop. In Italian, we say,
which means “I stay at home.” We are taking full responsibility as citizens because we are helping the hospitals, helping our community and, above all, helping our country.
What’s happening at your hospital in Sardinia?
We are only doing emergency cases. All other patients who are healthy and stable must wait. The hospital is slowing down as much as possible not only to prepare for an emergency, but also to decrease the flow of people in and out of the hospital [to have] as little contact as possible for healthcare professionals and patients. I have not physically treated any patients yet. In a matter of days, that will change. I feel honored to be a part of this emergency. It’s exactly why I decided to be a nurse, to help the ill. I’m not scared of getting the virus, I’m only scared of passing it on to another.
Italy’s prime minister, Giuseppe Conte, told the people that we need to stay inside to save our country. He said, “Stay inside today for a better tomorrow.” There are many Italians coming together during this difficult time. I hope the same for all of you. It’s important to find the beauty in all of this sadness.
Beauty?
Being in quarantine has helped me in so many ways. It’s allowed me to stop and to reflect a little on the real importance of life, which is the fact that I am here and healthy. The rest seems useless in these difficult days. …The sooner you cooperate the sooner you will be able to rebuild your life again. There is a famous phrase being said all over Italian social media which is, which means, “Everything will be OK,” and it will be with time.