Lombardy hit-hard
Italy virus disaster is lesson for world
ROME, April 27, (AP): As Italy prepares to emerge from the West’s first and most extensive coronavirus lockdown, it is increasingly clear that something went terribly wrong in Lombardy, the hardest-hit region in Europe’s hardest-hit country.
Italy had the bad luck of being the first Western country to be slammed by the outbreak, and its official total of 26,000 fatalities lags behind only the U.S. in the global death toll. Italy’s first homegrown case was recorded Feb. 21, at a time when the World Health Organization was still insisting the virus was “containable” and not nearly as infectious as the flu. But there also is evidence that demographics and health care deficiencies collided with political and business interests to expose Lombardy’s 10 million people to COVID-19 in ways unseen anywhere else, particularly the most vulnerable in nursing homes.
Virologists and epidemiologists say what went wrong there will be studied for years, given how the outbreak overwhelmed a medical system long considered one of Europe’s best, while in neighboring Veneto, the impact was significantly more controlled.
Prosecutors, meanwhile, are deciding whether to lay any criminal blame for the hundreds of dead in nursing homes, many of whom don’t even figure into Lombardy’s official death toll of 13,269, half of Italy’s total.
By contrast, Lombardy’s frontline doctors and nurses are being hailed as heroes for risking their lives to treat the sick under extraordinary levels of stress, exhaustion, isolation and fear. One WHO official said it was a “miracle” they saved as many as they did.
Here’s a look at the perfect storm of what went wrong in Lombardy, based on interviews with doctors, union representatives, mayors and virologists, as well as reports from the Superior Institute of Health, national statistics agency ISTAT and the Organization for Economic Cooperation and Development, which advises developed economies on policy.
CAUGHT UNPREPARED
Italy was the first European country to halt all air traffic with China on Jan. 31, and even put scanners in airports to check arrivals for fever. But by Jan. 31, it was already too late. Epidemiologists now say the virus had been circulating widely in Lombardy since early January, if not before.
Doctors treating pneumonia in January and February didn’t know it was the coronavirus, since the symptoms were so similar and the virus was still believed to be largely confined to China. Even after Italy registered its first homegrown case Feb. 21, doctors didn’t understand the unusual way COVID-19 could present itself, with some patients experiencing a rapid decline in their ability to breathe.
LOST WEEKS
Two days after registering Italy’s first case in the province of Lodi, sparking a quarantine in 10 towns, another positive case was registered more than an hour’s drive away in Alzano in Bergamo province. Whereas the emergency room of the Lodi-area hospital was closed, the Alzano ER reopened after a few hours of cleaning, becoming a main source of contagion.
By March 2, the Superior Institute of Health recommended Alzano and nearby Nembro be sealed off as the towns in Lodi had been. But political authorities never implemented the quarantine recommendation there, allowing the infection to spread for a second week until all the Lombardy region was locked down March 7.
“The army was there, prepared to do a total closure, and if it had been done immediately maybe they could have stopped the contagion in the rest of Lombardy,” said Dr. Guido
Marinoni, head of the association of doctors in Bergamo. “This wasn’t done, and they took softer measures in all of Lombardy, and this allowed for the spread.”
INDUSTRIAL LOBBYING
Unions and mayors of some of Lombardy’s hardest hit cities now say the country’s main industrial lobby group, Confindustria, exerted enormous pressure to resist lockdowns and production shutdowns because the economic cost would be too great in a region responsible for 21% of Italy’s GDP.
On Feb. 28, a week into the outbreak and well after more than 100 cases were registered in Bergamo, the province’s branch of Confindustria’ launched an English-language social media campaign #Bergamoisrunning, to reassure clients. It insisted the outbreak was no worse than elsewhere, that the “misleading sensation” of its high number of infections was due to aggressive testing, and that production in steel mills and other industries was unaffected.