In the event of a new pandemic, Italy would be in trouble again. And not because there is no updated pandemic plan, but simply because little or nothing has been done to secure the national health system. Epidemiologists, doctors on the front line during the emergency and even institutional sources do not revolve around it: the guidelines that the ministry puts in black and white serve to give an address, that is to outline the chains of command, but then resources and funding. The problem is that all of this is up to the Regions.
Covid, the chats and the new accusations: “Lombardy like Wuhan”. But the premises remained open
And there is the risk (concrete according to the experts) that only some will have the economic possibilities to intervene, while others will remain hopelessly behind. Not only. The coup de grace to the system that must protect citizens will be dealt by the Autonomy.
THE DOCUMENT
After the controversy over the failure to update the pandemic plan stopped in 2006, an official document now exists: the national strategic-operational plan for preparation and response to an influenza pandemic (PanFlu) 2021-2023, drawn up by the Ministry of Health and approved by the Conference State-Regions, essentially indicates how to “be as prepared as possible to implement all measures” to contain the emergency on a local, national and global level. Basically, first of all what is needed is a network of assistance that is able to respond to the health services required by the pandemic emergency and then surveillance and sequencing systems, and obviously adequate safeguards in the area. So your to-do list is ready. At least on paper.
«The pandemic plan is indispensable and takes stock of the elements that need to be put into a system – explains Massimo Andreoni, scientific director of the Italian Society of Infectious and Tropical Diseases and professor of infectious diseases at the Tor Vergata University in Rome – the problem is that the usual problems still remain. First of all, the Italian health facilities are lacking both structurally and in terms of employed health personnel. Then it is necessary to reinforce the chronically deficient areas, such as intensive care. Both medical and nursing health personnel are still greatly reduced. But the situation, unfortunately, does not seem destined to improve. «These problems – adds Andreoni – cannot be solved in a very short time, we need planning in perspective. As regards the laboratory and surveillance network coordinated by the Istituto Superiore di Sanità, we have structures capable of functioning well, but it is important that it be reinforced. Finally, the great problem of territorial medicine remains ». So what’s the point of a pandemic plan if no one puts it into practice? According to Pier Luigi Lopalco, Professor of Hygiene at the University of Salento, the document drawn up by the ministry «allows at least to activate the chains of command. And it’s already a step forward. The problem, however, is that in order to function well, a plan needs maintenance. In essence, the way forward is indicated, but then everything else is left to the Regions: it is clear that in this way some will have the resources to implement it, while others will not. In short, if we want to prepare ourselves to face a new pandemic in the best possible way, we need special funding, which means, for example, increasing the national health fund, instead of definancing it. The Covid emergency has taught us a lot of theory, we know how to deal with emergencies from a technical and organizational point of view. But on the rest we did not emerge stronger and more united: the fact that today rather than making this reasoning in view of the future, we are looking for the culprits of the pandemic, is proof of this ». In essence, the plan is there, but obviously it’s not enough.
EMERGENCIES
“Compared to emergencies, we must also take into account backlogs of healthcare services, which lead to long waiting lists – recalls Carlo Signorelli, full professor of Hygiene at the Vita-Salute San Raffaele University in Milan -. And they cannot be resolved soon due to the known shortage of doctors. Let’s not forget that the specialist takes 10 years to train. Only 2 years ago enough new entrants were admitted. This means that before 2030 we could not have a situation that normalizes. Even on the ground, then, the situation is still critical. Few doctors, everywhere ». Meanwhile, we are working on exercises in the chain of command. “One was recently made simulating an emergency event – confirms a ministry source -. In essence, coordination is trained and the networks are brought together, as if there were even the slightest alert. Let’s not forget that pandemic plans must always be up to date. But – he admits – if one has the pandemic plan only on paper, that is, without special funding, it is clear that in the end it will only work on a theoretical level.
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