Something went terribly wrong in Lombardy, the hardest-hit region in Europe’s hardest-hit country, and virologists and epidemiologists say it will be studied for years.
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.
Doctors treating pneumonia in January and February didn’t know it was the coronavirus because 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.
Italy was forced to use home care in part because of its low ICU capacity: After years of budget cuts, Italy entered the crisis with 8.6 ICU beds per 100,000 people, well below the Organization for Economic Cooperation and Development’s average of 15.9 and a fraction of Germany’s 33.9, the group said.
The Lombardy doctors’ association issued a blistering letter April 7 to regional authorities listing seven “errors” in their handling of the crisis, key among them the lack of testing for medical personnel, the lack of protective equipment and the lack of data about the contagion.The regional government and civil protection agency defended its efforts, but acknowledged that Italy was dependent on imports and donations of protective equipment and simply didn’t have enough to go around.
Lombardy has one-sixth of Italy’s 60 million people and is the most densely populated region, home to the business capital in Milan and the country’s industrial heartland. Lombardy also has more people ages 65 and older than any other Italian region, as well as 20% of Italy’s nursing homes, a demographic time bomb for COVID-19 infections.
“It was a huge error. They should have taken the example where the first cluster was found,” said Giambattista Morali of the metalworkers’ union in the Bergamo town of Dalmine. “Keeping factories open didn’t help the situation; obviously it worsened it.” The national civil protection agency opposed the plan, arguing it could never equip it with ventilators or personnel in time. Instead, the agency, which reports to the rival 5-Star-Democratic government in Rome, preferred smaller field units set up outside hospitals and a program to move critically ill patients elsewhere.
Lombardy has more nursing homes than any other region, housing at least 24,000 elderly, and it registered more dead at those facilities than others too. Of the 3,045 deaths from Feb. 1 to April 15 in the region, 1,625 were either positive for the virus or showed its symptoms, according to preliminary results from a survey by the Superior Institute of Health.
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