But now the virus is raging again, through Europe and Italy, with a thorn that is hitting the north again, but this time to the south. In Campania, which includes Naples, the daily number of new cases detected is five times higher than the peak in March.
So the question is whether Italy has bought enough time.
Compared to six months ago, there is more accommodation in southern Italy for critical patients. There are more fans. Yet many hospitals in the south remain understaffed and have fewer beds per capita than those in the north. They could reach a tipping point if the number of critically important patients jumps.
The Campania district governor ordered the school to be closed by the end of October and threatened to block if the number continues to grow.
“Are we dramatizing it?”
During the first wave, Lombardy – the northern region that includes Milan – accounted for about a third of all infections. It now accounts for one-sixth, although there has also been a sharp recovery in cases. Lazio, the area around Rome, has the most people hospitalized with covid-19; Next are Lombardy and Campania.
Perhaps the most shocking aspect is how fast the virus has grown in the south. Some regions lasted for days during the summer, without finding a single case. In mid-June, there were 125 people in Campania known to be infected with the virus. It now has more than 13,000.
For the past six months, southern Italy has tried to prepare for the virus – and make up for years of poor hospital management and financial cuts.
In Puglia, the large region that covers the heel of the Italian trunk, the government has dedicated specific hospitals and buildings to dealing with incoming patients with coronavirus, a means of reducing the risk of contamination. Puglia has three times more ventilators than in the spring, said Pier Luigi Lopalco, an epidemiologist who has consulted with the region about his response.
But, Lopalco said, while Puglia has the laboratory capacity to process 15,000 coronavirus tests a day, there are only enough health workers to conduct about 5,000 daily tests. The region is struggling to hire doctors and nurses. He recently tried to hire 30 nurses and found only six.
“So many of these young nurses are working in them now [northern] regions, with a very good contract, “said Lopalco, who will soon become the health director of the Puglia government. “It’s not so easy to convince these people to come home.”
The campaign has made its own preparations, including opening homes for people who have been discharged from the hospital but are still positive for the virus. Such facilities would give the region a better chance of keeping hospital beds open to the most critical patients.
But Giuseppe Galano, head of the regional association of anesthesiologists, noted that Campania’s healthcare system has been dealing with mismanagement and running costs for years – only to be placed under an external administration that froze hiring.
“There are still at least 200 to 300 anesthesiologists missing in the Campaign,” a job needed for intubation, Galano said. “That’s a big drawback.”
Walter Ricciardi, an adviser to the World Health Organization at the Italian Ministry of Health, said the south was “definitely not ready” for an explosion of coronavirus cases.
“They had to invest money in improving staff, systems, and in some cases they didn’t do enough,” said Ricciardi, who said employees in some regions were complacent and underestimated the risk of the virus reviving.
“It’s very sad,” he said. “For some southern regions, if there is such an epidemic, the consequences will be more severe.”
So far, hospitals have not reached a critical point. The number of patients in intensive care across the country is one-seventh of the total number of peaks in March. However, the Italian National Institutes of Health has warned that about half of Italy’s regions – both north and south – can see at least 30 per cent of their beds in the intensive care unit occupied by covid-19 patients next month.
“I think we will have more and more [hospitalized] cases, “said Lopalko, who said restrictions could still delay infection and prevent the situation from spiraling. “The risk we are exposing is that we will have to close normal hospital activities. This is the risk we are trying to avoid. “
Last week, Italy forced the wearing of masks even outdoors, and this week it limited hours to bars and restaurants. Officials say the goal is to prevent the need for a second, inevitably bruised national blockade. But they say local or even regional blockades may be needed.
Several small towns have already been sealed after the cases skyrocketed. One, Galati Mamertino, a city in Sicily, registered zero coronavirus during the first six months of the pandemic.
Then the first man fell ill and received positive results, said Mayor Antonino Baglio. The city took more smears and soon realized that 122 people – out of a total of 2,600 – were carrying the virus. Most of them are asymptomatic, but a few nights ago a 50-year-old man who looked in good health was taken to a hospital with breathing problems. The man’s father was also hospitalized.
Police and the army are stationed on the roads to the city, controlling access. About 600 people are isolated after contact with certain positives.
“We thought we were free,” Baglio said. “Then suddenly you throw yourself into the woods and realize the tragedy and its dimensions. You’re reviewing everything. You realize that it is very important to have a vision and not think that we are immune. That what you see on TV is absolutely real. And a lot, a lot of weight. “