COVID-19 and Italy: What Should Have Been Done
Looking back as the next big wave strikes
In-depth investigations conducted by the “Noi denounce” Committee on the structural-organizational inadequacies of the Italian government in managing the first phase of the COVID-19 pandemic that hit hard the Lombardy region were revealed by lawyer Ms. Consuelo Locati during a virtual press conference hosted in the Milano Foreign Press premises. Locati represented the Committee that deals with the defense of families who have lost hundreds of relatives during the first pandemic phase which has recorded a higher number of deaths in Europe – and in the Western world.
What Italy should have done and in reality has not done has been recorded in a dossier prepared for the World Health Organization (WHO) that was prepared by some university professors. They included Walter Ricciardi and was updated weekly, certifying that Italy had a single outdated pandemic plan dating back to 2006 and was never updated.
The dossier refers to a document published on the WHO website on May 13, 2020 and which was mysteriously eliminated within 24 hours from the website. The “We will denounce” Committee brought it out said Attorney Locati and made it public at a press conference on September 11, 2020.
The WHO dossier reads verbatim: “Despite the availability on paper of a WHO National pandemic plan, albeit obsolete, Italy has been hit by what is considered the greatest crisis since the Second World War in a few weeks and that the threat of COVID-19 was not easily recognizable making it more difficult to make real-time decisions to avoid the crisis.”
Apart from its general principles, the operational framework of the National Plan, for example: “definition of roles and timing of actions,” was not followed but was not feasible either. This means that even in the worst-case scenario, a pandemic plan had to be envisaged; even if it was obsolete it could not be implemented.
How and why
As established by the European Parliament in 2013 and subsequently in the guidelines of the WHO, a pandemic plan is effective and adequate when it is verified and when exercises are carried out to test the effectiveness of the forecasts and scenarios envisaged in the pandemic plan, which in Italy was never done.
In the dossier, again it is noted, (and it is very important) that the pandemic plan is structured in six phases specifying that the objectives and actions to be undertaken in each phase including the guidelines for the formulation of regional operational plans ordered are with the aim of identifying, confirming, promptly reporting, and minimizing and limiting mobility and mortality by reducing the overall impact of the pandemic on health and social services.
The fact that it is said that this is the pandemic plan with all these purposes, still the Italian one restructured in 6 phases attests to Italy’s unpreparedness for an adequate pandemic plan, because starting from 2013, the WHO changed the approach to the pandemic based on risk management and envisaged not six but four phases requiring states to prepare and adapt their pandemic plans, to count the places in intensive care, to buy personal protective equipment, and to foresee the methods of immediate isolation and case tracking.
Italy did none of this because it did not provide for the timing and methods of transmission of data by the regions to the ministry and did not count the number of beds in intensive care. It then did not increase them adequately as done by Germany which had doubled the number of beds as expected.
Italy has not taken steps to stockpile personal protective equipment and has not done exercises to test the tightness of the preventive or adequate system to address an epidemic need.
This was witnessed by the diversity of approaches in managing the infections and in their treatment that as reported in the dossier is a decentralized healthcare system in the Italian context. The responsibility for failing to the entire management chain is attributed to starting from the government to the regions, each for their own part. No stocks of devices have been made, not even the regions have counted the number of beds needed in intensive care. Case isolation, virus containment, and subsequent tracking in Lombardy have failed miserably as the pandemic occurred. Each region had a different system because there was no common guideline valid for all regions. This is because no one observed the WHO guidelines.
The distribution in Lombardy of the few personal protective equipment
The directives for the supply of protective helmets suffered due to forgetfulness. The lack of an adequate pandemic plan then led to another consequence: the country had to undergo a lockdown as an extreme measure of blind behavior which involved (Prof. Ricciardi also confirms) the serious loss of life and the dizzying collapse of the economy whose recovery will probably take place over decades.
In addition to the primary government shortage, Lombardy in the absence of a pandemic plan (which still does not yet exist) does not currently have the regional prevention plan it was in possession of from 2014 to 2018 which extended to 2019 and provided for the immediate isolation of people in the first case of transmission of the virus. In the first phase of the pandemic, the closure of cities would have prevented the spread of the virus.
What happened in the second phase
The cities considered hotbeds are Milan, Brianza, Varese, and they have not been closed which has brought all of Lombardy back into the red zone with further sacrifice of economic activities. Artisans, restaurateurs, and small businesses that have invested in the last five months to comply with the regulations have undergone further closure and sacrifices due to the lack of common sense in implementing multiple decisions and measures (decrees) also because the President of the Lombardy region did not have the courage to intervene in the 15 days of October and those between February and May to close the outbreak cities and prevent the transmission of the virus that became uncontrollable in May and recently despite the fact that the legislation provided for this decision by the regional governors to whom it is delegated the power.
The persecution of the culprits
Regarding the investigation, Francesco Locati, Manager of the Asst of East Bergamo; Roberto Cosentino, General Health Director; Aida Andreassi, Director of the General Welfare Association of the Lombardy region; Marco Salmoiraghi, Deputy Health Director of Lombardy responsible for procurement; and Luigi Caiaffa are under investigation for being culpable of the epidemic for having contributed to mortality. Francesco Locati and Roberto Cosentina, the first former General Manager and the second former Health Director of Asst Bergamo Est, were accused of false ideology because of falsified documents relating to the sanitation of the Alzano Hospital and declaring its perfect sanitation according to protocol.
Informed of the facts, Dr. Ranieri Guerra, has been wrangled with regarding the failure to adhere to the pandemic plan and the removal of that document from the WHO website.
The prosecutor, Attorney Consuelo Locati, concludes and has acknowledged all the complaints filed with the Committee. The Bergamo prosecutor’s office sent them to the competent prosecutors in the area for their action. In the province of Bergamo and Lombardy, reference is made to the total closure of the Arsago Hospital by other prosecutors and a pandemic plan with what has not been achieved which will be referred to as the absence.