Claudia Cosmas
In March 2003 Carlo Urbani, the doctor who first recognized and isolated the coronavirus, responsible for the first SARS epidemic, died in Bangkok. “Urbani is the testimony of how courage and dedication, even at the cost of one’s life, can become an example for everyone” (Sergio Mattarella).
In the years of Covid it is not difficult to come across the story or heroic memory of a doctor fighting against a pandemic. The last three years have imposed an enormous sacrifice on each healthcare worker active on the front line in contrasting the spread and symptoms of the virus that arrived from the East. This definition proves to be particularly fitting for an Italian doctor who 20 years ago with great intuition and a hint of determination barred access in time to the predecessor of Covid: Sars.
That doctor was called Carlo Urbani, who died during the 2003 epidemic, remembered on the occasion of the twentieth anniversary of his disappearance by the Head of State and the World Health Organization. Born in Castelplanio (Ancona) in 1956, graduated in Medicine, specialized in infectious and tropical diseases, experiences in Africa and with Doctors Without Borders since 1996 in Cambodia, in 2003 he came across the largest outbreak of atypical pneumonia in Vietnam (as it was initially qualified ) outside the Chinese province of Guangdong.
The concatenation that allowed for the discovery of the new disease and the punctual adoption of countermeasures was significant. At the end of February at the hospital in Hanoi, Dr. Olivier Cattin was amazed by the symptoms observed in an American businessman, Johnny Chen, who had just returned from a trip to southern China. Initially the symptoms led him to think of a case of bird flu. On the other hand, in those days rumors were circulating about an H5N1 outbreak that was developing in Guangdong, amid health concerns and fears mostly based on the nebulosity of the Chinese Communist Party apparatus. Cattin therefore called Urbani, a consultant to the World Health Organization since 1993, who ended up reinforcing his colleague’s doubts. A caution that proved to be well founded (1). Cattin’s and Urbani’s misgivings soon translated into widespread alarm in Hanoi and Vietnam when 10 hospital employees suddenly fell ill with the mysterious pneumonia. Castelplanio’s infectious disease specialist, also at the instigation of Dr. Hoshitani at the time a WHO official stationed in Manila, collected the patients’ biological samples.
From a diagnostic point of view, it was the turning point, but what radically changed the course of the epidemic was Urbani’s decision, supported by the director of the WHO in Hanoi, Pascale Brudon, to contact the Deputy Minister directly between 7 and 9 March Salute Nguyen Van Thuong to urge him to adopt drastic preventive measures: individual protections for health workers, isolation for suspected cases of atypical pneumonia, border surveillance. The exponent of the Hanoi government tried to resist the siege, the conversation according to the reconstructions of the time rather than the soft tones of the confrontation between officials soon turned into a severe rebuke against attempts to stall. So after some sterile objections, based on an unspecified opinion of some local experts convinced that the disease was nothing more than the relatively harmless type B influenza, the deputy minister capitulated and was persuaded by Urbani to adopt vigorous measures. An economically expensive step, but politically even more daring: the Vietnamese government in fact decided to put itself into a bitter conflict with Beijing, which thought well (also) in those days of managing the health emergency as an internal family affair.
The timeliness of Urbani’s intervention, on the other hand, proved to be salvificWith the virus discovered and effective measures in place, the SARS race was greatly dampened by allowing Vietnam to be the first to announce liberation from the virus.
At the same time, however, the victory over Sars came at the steep cost of Urbani’s life. On 11 March 2003, during a direct flight from Hanoi to Bangkok, the doctor of Marche origins was struck by the first symptoms of the infection. He, in turn, placed himself in solitary confinement and, as a further tribute of his life to science, urged his colleagues to take his biological samples so that the working mechanisms of the virus could continue to be investigated. He died in Thailand 18 days later.
“Dr. Carlo Urbani is not only the symbol of the fight against Sars. Urbani bears witness to how courage and dedication, even at the cost of one’s life, can become an example for everyone”, the President of the Republic, Sergio Mattarella, recalled with these words on 29 March (2).
Tribute and recognition were not lacking even from the WHO, through the voice of the director general Tedros Adhanom Ghebreyesus:
“There is no work more rewarding than serving humanity, and sometimes there is no work more painful. Dr. Carlo Urbani’s sacrifice will not be forgotten”.
A promise kept with the inauguration of the museum dedicated to the infectious disease specialist right in his Castelpiano and at the same time with the acknowledgment again by the WHO that his early warnings saved many lives, making Urbani, are still the words of Ghebreyesus, “not only the hero of Castelplanio and of Italy, but of the world” (3).
Claudia Cosma, doctor in specialist training, Hygiene and Preventive Medicine, University of Florence
Note: Photo by Carlo Urbani from ANSA.
Bibliography
- Elena Cherney and Mark Heinzl, Inside the WHO as It Mobilized To Fight Battle to Control SARS, https://www.wsj.com/articles/SB10518264649952700
- Federico Capezzi, Carlo Urbani, “hero of the world”, https://www.rainews.it/tgr/marche/articoli/2023/04/carlo-urbani-eroe-del–mondo-925d6efc-e928-42c1-a821-62f855ab8e64.html
- Talita Frezzi, Castelplanio, ribbon cutting for the Museum dedicated to Carlo Urbani: the man and the hero,