The infectious disease specialist summarizes the stages of the pandemic years: “It was risky to look for the culprit, the first few weeks we worked in the dark”. But not everything was a disaster. The mistakes and the successes
There is a “before” and an “after” in evaluation the decisions made by the actors in the field which they dealt with manage the emergency Covid in the early stages of pandemic. He is convinced of it Matthew Bassettidirector of the Infectious Diseases Clinic at the San Martino Polyclinic in Genoa.
What is your assessment on whether to do a judicial inquiry on the management of Covid three years later?
«We were all in the dark in the first two weeks: it is clear that today, with the knowledge acquired, we see it differently, but reviewing the decisions made then is a profoundly wrong. Do we want to read the pandemic in the overall management of the three years? Let’s do it, but not by placing the person who made the decisions in the dock at that moment”.
The investigation also wants to give an answer to the families of the victims and indicate the responsibilities…
“I mourn the victims, but I ask myself: have they only been in Bergamo, why is it where we saw the coffins parade down the street? Are there any Serie A and Serie B deaths? We counted the dead not because someone made a mistake, but because a unknown virus. Putting someone on the grill is wrong and risky.”
In what sense?
«I think he is throwing himself fuel on the fire of deniers and no vaxbecause today they take the survey (of the Bergamo Public Prosecutor’s Office, ed) as a win. I fear this investigation will also encourage “defense medicine”: no one will take the responsibility of deciding in the absence of certainties. I don’t know the virus, so I won’t give any treatment and I won’t make decisions if there is no evidence, for fear of being prosecuted. It’s a dangerous health/medical precedent. In medicine, however, intuitions have changed history».
Is there a before and after in evaluating errors?
«After the establishment of the Bergamo investigation, I am convinced that it is right to make one parliamentary commission bicameral where different scientists and points of view are heard, not on the first 15 dramatic days, however, but on the entire pandemic period. Make an analysis of the processes that led to the choices, to ensure that mistakes don’t happen again more, than to find the culprits”.
What were the mistakes related to the pandemic (after the first weeks of uncertainty)?
«In May 2020 we had very different knowledge about the virus and I have always criticized some choices of the then government. Surely we have been the country with the longer lockdowns of the world, perhaps the closures should have been differentiated: that of schools it has been too long and today we see the effects on our boys. Perhaps we were wrong about the drugs (when they arrived) in not making them easier to prescribe in the context of local medicine, the mandatory outdoor masks for so long … »
Politicians, CTS technicians, administrators: was the chain of command unclear?
«That first Scientific Technical Committee (CTS) was an expression of the technical advisory bodies of the Ministry. It could only be like this, at the beginning, but I express reservations about its “dynamism”: after the first month, CTS members needed to be replaced, perhaps inserting the doctors who had seen the disease. It did not have medical representatives from Lombardy, Veneto, Liguria, Emilia Romagna, Piedmont, who were the first to operate in the field and remained essentially the same until the Draghi government. Then in the choices, the power of the CTS was consultative and the executive power was of the government ».
Compared to a moment like the pandemic, is there a problem related to the autonomy of the Regions in the field of health?
“On an issue like this I think there should be a strong grip of the central government and the ministry. The decision-maker and the programmatic lines must be from the Ministry of Health ».
Where are we with prevention for the next pandemic?
“I think it’s still at zero point, even if I know that Minister Schillaci is working on this, but little has been done even with the previous government. We must not make the same mistake. You need to make heavy investments in tools that can eavesdrop with surveillance systems if you are faced with any problems. Reminding us that we are in a larger community, the European Union. There was too much lack of homogeneity, even between states».
Would the updated pandemic plan have served?
«However, the 2006 one states some rules which, if they had been applied, would have been useful. For example a system of sentinel surveillance which could have intercepted the cases of atypical pneumonia that had occurred before the case of patient 1».
Would the early establishment of the Red Zone in Val Seriana on February 27 have spared the lives of 4,000 people, as claimed by the Bergamo prosecutor’s office?
«
I guess the rating (made by the consultant Andrea Crisanti, ed) is based on mathematical models that start from the spreading capacity of the virus which at that time was very high. No one has a scientific study, however, that can prove the opposite: it is clear that the red zone would have helped to reduce (as it did where it did) the spread of the infection, but the elements that political decision makers had in hand and technicians at that time were sufficient to make that decision? Let’s not forget that the red zone in Codogno had been established a week earlier and the positive results on the number of deaths had not yet been seen. I also believe that there was a different perception of the state of things then: perhaps in Rome or in Southern Italy there was an underestimation of the extent of the problem».
Was it a mistake not to swab everyone, as some claim?
«In the first phase, the swabs were all sent to the Istituto Superiore di Sanità (ISS), then things changed, we organized ourselves: are we sure that, even if we wanted to, we would have had to swab everyone? With what resources? We were ready? No».
Were there any errors on the vaccination campaign?
«Throughout the course of the pandemic, I believe that for us the high point was there vaccination campaign coordinated by General Figliuolo, a flagship for Italy. The hubs worked, the people who wanted were vaccinated. Another excellence of Italy was the scientific production by researchers. We were the first country in Europe, between 2020 and 2021, and the fourth in the world in the drafting of scientific articles on Covid. We were the first to use heparin, remdesivir, a helmet instead of intubation… That’s why I’m sorry that theimage that passes from the Bergamo investigation is that of an Italy comparable to the Brancaleone army at work and I don’t like this because the cross is thrown at those who, with their bare hands, have found themselves managing, I repeat, in the dark, a new virus”.
What have we (really) learned?
«For 20 years we have said that to live 100 years we should have cured cholesterol, prevent tumors and try to move (roughly speaking, to simplify). Covid has taught us that there is another variable on life span which is infectious diseases. The world of microbes is an enemy always around the corner. The war has not been won. A new virus will come and it is not by not talking about it that problems will be avoided. The population must always be informed.