Covid-19: at what should we change?

August 2020

Rimini, Thursday, 20th of August – “Simplifying means striking consciously the superfluous, trivializing means losing unconsciously the essential”. It is with this quote of Aldo Moro that the president of the Foundation for Subsidiarity Giorgio Vittadini has chased up the guests of the webinar “Covid-19: at what should we change? The case of the Lombardy region” dealing with the current medical emergency, focusing on one of the most affected regions. It’s a call that of Vittadini to not trivialize, for political purposes, a problem which is by its very nature a complex issue and from this the speakers didn’t escape. And it is for not trivializing but for understanding deeply what’s taken place in Lombardy.

It’s Carlo Signorelli, Full Professor of Hygiene and Public Health at the University of Parma and at the University Vita e Salute San Raffaele Milano, who opens the betting of the interventions: although Lombardy is the most affected Italian region with the highest number of cases and victims, if you consider some of the index, such as the death rate of the population, you realize that the developments in time are totally in line with the European average. The only exception, the case of RSA, where the number of deaths has been above-average. “It should be recalled that Lombardy was the first to be affected, when we were still unprepared.

The analysis was completed by Paolo Berta, researcher in Social Statistics at UNIMIB in Milan and head of the Health Department at the Subsidiarity Foundation: "Despite the difficulty in reading the data - just think of the number of new cases, which strongly depends on how the packs are carried out - some observations can be made ». One above all, the comparison between regions: "Comparing the variation of the death rate between 2019 and 2020 in the neighboring municipalities between Lombardy and the bordering regions, no substantial differences are observed, except for Veneto, where the data are more encouraging. It is therefore unfair to stigmatize only the Lombardy’s health system. However, we must ask ourselves how to change, how to improve our work and the integration between the various hospitals, perhaps introducing a performance review body.

In the second part of the webinar, there were several testimonies of those who, among doctors, nurses and health institutes, have fought in the recent months at the forefront.

This is the case of the San Donato group, which during the emergency phase dedicated almost 2000 beds to Covid-19 patients. Francesco Galli, CEO of the group, wanted to deal with the title of the Meeting: «If I think of wonder, the eyes of many operators immediately come to me. It was incredible to see the depth of humanity and professionalism of so many doctors and nurses, many of whom have literally reinvented themselves in their jobs ». This was echoed by Elena Bottinelli, CEO of HS Raffaele Milano, who described in more detail the multidisciplinary management of the clinic of Milan, which was able to cope with the emergency thanks to the synergy of the various teams.

Gabriele Tomasoni, head of the Intensive Care Department of Spedali Civili Brescia, is also on the same line: «Not only we adapted, but we have increased the number of beds in intensive care from 26 to 85 in less than two weeks. It was extraordinary how everyone did their utmost. And don't think that the new places were botched: they will continue to be used even in the post-Covid phase for sub-intensive therapy ". Another key aspect was the collaboration network that was created between the various hospitals, in which some experimental treatments were decided that gave positive results, such as the use of cortisone drugs: "A network that has borne many fruits and that I hope it will remain ”, concluded Tomasoni.

The role of nurses is fundamental in the emergency management, as told by Alberto Lucchini, "chief nursing officer General Intensive Care HS Gerardo of Monza. “For the first time, the staff involved in intensive care were afraid of getting sick. The fear of being hit has given us a dedication and care that has also infected our colleagues and hospital staff ». On the other hand, however, the scars left by Covid-19 are deep: "Some colleagues have asked to no longer be assigned to intensive care: too much pain to see so many people die alone, one after another". "On the other hand," said Donatella Parentini, general practitioner in Cremona, "we are human: we have worked a lot, trying to respond to a need greater than us, which has shown us all our fragility".

There were also several questions that the public was able to ask electronically, which allowed the speakers to deepen even more what happened and what is happening today, in an attempt to understand how to change and how to respond to the ever new challenges that a crisis such as that of Covid-19 brings with it.