Everything will change

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Socialist Review spoke to Giovanna Moretti, a Sicilian doctor, who has been living amid the coronavirus in Italy for a month.

Socialist Review: Tell us about this tragedy that has been shaking Italy for more than a month.

Giovanna Moretti: The time of the interview, there are about 35,000 positive people mainly in Northern Italy in Lombardy and the city of Bergamo is paying the highest price. But the virus has now spread to Liguria and Emilia Romagna.

In Bergamo, the most affected province in Italy, the coffins are transported by military trucks. It is heartbreaking. Patients die alone. Sometimes after a video call to family members.

Around 4,000 have died and unfortunately the peak of mortality has not been reached yet also because the peak of contagion has not yet been recorded. Already on the numbers, however, there is discrepancy and confusion: the data are not homogeneous, as there is no policy aimed at testing everybody.

If this new wave does not subside, the health system could go towards collapse: triggered by what we can only compare to a natural catastrophe.

Given the large number of people who need intensive care in Lombardy, the Lombard health system, one of the best in Italy, if not the best, is collapsing. This is because it was the first to receive many serious cases and all of them at the same time.

This happened for various reasons. The virus was allowed to circulate during the month of February and the first days of March In those days people carried on a normal lifestyle—going to work and to the shops, attending schools, using public transport etc.

The virus, which often causes mild infections or scarce non-specific symptoms (fever, cough, sore throat), was transmitted with great speed by those without symptoms or only a few symptoms—children for example. It was also spread by people with the virus who went to their family doctor or hospital emergency rooms.

The social distancing measures took place initially with a “softer” approach and then became increasingly stringent.

Covid-19 was not known before but now we know that the incubation period varies from a few days to 14, although some Chinese studies go up to 21 days.

There are a minority of patients with bilateral interstitial pneumonia—more aggressive fever, respiratory distress, chills, persistent cough. It is necessary to hospitalise them and in extreme cases to use ventilators.

The therapy is slow and beds in intensive care occupied by those patients remain occupied three times longer than the time necessary—in general—to cure patients with regular pneumonia. Among severe cases, patients with serious respiratory complications and organ failure usually die.

The situation is so severe that the state has contacted retired doctors, recent graduates and doctors who are not specialists in intensive care to help the most affected regions.

The problem could be huge in large urban centres: what will happen if the virus breaks out in Milan, Rome, Naples?

I am a mum and a doctor. After work shifts (albeit not in the front line for Covid-19) I arrive home, say hello to my son from afar and I spend 40 minutes in the shower and after that I go and greet him.

Our social life has totally changed. You stay away from family members, friends and neighbours.

You don’t want to joke with your colleagues and you live in a constant state of alert and concern. Cities are completely empty. The silence is deafening.

There are queues for shopping, everyone looks at each other with suspicion and every now and then from a distance a few words are exchanged—of amazement and reassurance.

You constantly wonder if the measures adopted have been useful for us in Sicily. Here the number of cases is still relatively low: 275 patients were hospitalised, including 55 in intensive care, 321 in home isolation, 26 recovered and eight deceased.

But the Sicilian health system is not as well-equipped as the one in Lombardy. The main problem is we need to new intensive care beds that we hope will not have to be used, but that must be ready for immediate use and managed by competent personnel.

Socialist Review: Why do we see these numbers in Italy? And why the high mortality rate?

Giovanna: It has been suggested that this is a result of the relatively high age in Italy and the climate and the smog of Lombardy.

However, in my opinion, the numbers are distorted: the whole population is not tested so only the serious ones are counted as infected.

In South Korea and China, they have tested everyone and in Germany they are doing the same.

And finally—and not less importantly—the health system has been regularly dismantled and underfunded for several years.

Socialist Review: What do you think of Boris Johnson’s reaction to the coronavirus?

Giovanna: When I heard about “herd immunity” I thought it was the typical English humour. But then I realised that it wasn’t and seeing scenes of people living a “normal life” made me afraid.

Herd immunity develops only with vaccines, not by infecting a huge proportion of the population.

It doesn’t work. The most important immunologists, infection diseases experts disease and epidemiologists say so.

Socialist Review: Amid the tragedy is there anything hopeful about the situation?

Giovanna: The show of solidarity between ordinary people—long it may last—and the fact that you no longer hear about Matteo Salvini and his tweets. One thing is certain, after this crisis we will all have changed.

Everything will be different—hopefully for the best.