The Region with the best health system in Italy (and one of the best in Europe) was brought to its knees by a virus within a few days. Politicians committed to balancing responsibilities between Government, Region and Municipalities. Lockdown for the past six weeks, and there’s still a high number of deaths every day. Why?
Until two months ago, the quality of health-care in the Lombardy Region was defined as the best in Italy and one of the best in Europe. Now, it’s cited as a model not to be followed. But we must not generalize too much, as the centers of excellence always remain the centers of excellence. Rather, the failure of the Lombardy health-care model is the result of the wrong choices of the political class and a general lack of preparedness.
Of course, it’s easy to go behind the scenes and say today what should have been done a month or two ago; it is easy, but those who govern have the responsibility to look beyond and surround themselves with people of value, in order to make the correct decisions. Above all, who governs Lombardy must explain why — after 6 weeks of lockdown — there are still so many new cases and deaths each day.
The causes of the health disaster in Lombardy can be essentially divided into two main causes and is not dependent on the current government of Lombardy because these have occurred only in recent years.
The privatization of Lombardy’s health-care
The first has to do with privatization: about 70% of public hospitals have a first aid service which, on the other hand, is present in only 30% of private hospitals. In other words, in recent years, public health-care has been left with the burden of the emergency and private health-care, with profit determined by the treatment of the chronically ill.
Failure to develop a regional plan to tackle pandemics
In 2010, the Lombardy Region deliberated over a document that laid the foundations for bringing a plan, based on the A/H1N1 influenza pandemic. What was done in order to develop this plan? Precious little, given the consequences we’re now experiencing.
In addition, there’s been a progressive abandonment of territorial care (i.e. a decoupling from the Family Doctors who are the “Sentinels” in the territory and who best of all can inform about possible abnormal increases in the course of pneumonia or serious influenza syndromes). Patients at the very onset of symptoms are not “caught” by the Family Doctor and arrive directly at the ER in (already) serious condition, with the consequences that we (already) know of for intensive care.
Criticisms of Lombardy’s current government
We’ve attempted to assemble a list of what we think are situations that certainly didn’t help to stem the coronavirus pandemic (we’d like to point out that this is our point of view, based on official facts):
- The decision to send the less severe positive patients to RSA-operated nursing homes, to free up places in hospitals had the same effect as a lit match thrown onto a haystack.
- Nembro and Alzano Lombardo were not closed when, already at the end of February, it was clear they were both epicenters. They were closed on March 7th and 8th — only following a Decree of the Presidency of the Council.
- The ubiquity of COVID-19 patients in hospitals, and the lack of adequate protective equipment for health personnel at the beginning of the epidemic, created outbreaks in hospitals which probably justify the high number of sick people and daily deaths.
- Family Doctors were literally “left to their own devices”, and those who did their job well risked their lives and sometimes jeopardized their own lives.
- The Lombardy Region didn’t have its own autonomous policy on swabs, as Veneto and Emilia Romagna did, and has always waited for ministerial instructions; thus arriving late, especially on the checks carried out by Doctors and Nurses.
Veneto, Emilia Romagna and Southern Italy
The situation in Veneto and Emilia Romagna, affected in a similar way to Lombardy, demonstrates that the difference, once again, is the ability to decide by the people who administer the territory.
Our last reflection is for the Regions of Southern Italy. When, on March 8th Lombardy declared that the lock-down would take place shortly afterwards, many people bet on the uncontrolled spread of the epidemic. This was not the case, and we must give appropriate credit to the Governors of the Regions of Southern Italy — and to the citizens who were able to take advantage of the experiences documented in Northern Italy and act accordingly, in order to contain the pandemic.
This post is also available in: Italiano