Does anybody remember when, almost a year ago now, they were telling us that the lockdown and self-isolating were just temporary measures not so much intended to beat the pandemic as to “flatten the curve”, namely to prevent or keep under control the spike in the numbers of new contagions, so that, by spreading new cases over a longer time, the health services would have had a better opportunity to cope with the situation?

If this was not entirely a lie, it was at least a half truth: the “temporary” measures have become permanently imposed ones, and there is a lot of talk of a “new normal” to make us get used to it and stop complaining.

I’m reporting here, without commenting on them, the words of an Italian doctor, Dr. Maria Grazia Dondini, general practitioner in Monterenzio, in the province of Bologna, from the first part of an interview she gave to LNBQ website, while the rest of it will be covered in my next post (all emphases added):

We general practitioners, every year, usually from October to March, see cases of interstitial pneumonia, atypical pneumonia. And every year we treat them with antibiotics. These are patients who come to the clinic with flu-like symptoms – cough, fever, then “a sense of breathlessness” appears – which do not go away within a few days. The patient’s evaluation and clinical evolution indicate bacterial forms; they are given a macrolide antibiotic (and in the most complicated cases cortisone) and, within a few days, they recover very well with complete resolution of the symptoms.

This year it did not go like this. On 22 February this year, the circulation of a new coronavirus was announced.

The Ministry of Health sent an ordinance to all of us general practitioners, essentially telling us that we were facing a new, unknown virus, for which there was no therapy.

The paradoxical thing is that up to that day we had managed the same patients successfully, without crowding hospitals and intensive care departments; but from that moment it was decided that everything we had done until then could no longer work.

A clinical/therapeutic approach was no longer possible. Since then, we, general practitioners, had to delegate to the Department of Public Health, which does not perform clinical work but epidemiological surveillance; we could only see patients if we were in possession of an FFP2 mask, which I was able to collect from the ASL [local health unit] only on March 30th.

But there is something more serious.

In the ministerial circular, the Minister of Health gave us the following indications on how to approach the sick: isolation and reduction of contacts, use of various PPE, disincentives to patients’ initiative to resort to health services, first aid, general practitioners.

Thus, people who were ill were isolated; and, what is even more serious, the public helpline number provided did not respond.

All the patients complained that no one answered; I myself have tried to call 1500 without success. Does a Health Minister preparing to deal with a health emergency expect public help numbers not to respond?

A disaster.

In short: the atypical pneumonias were no longer treated with antibiotics, the patients were left alone, abandoned to themselves at home. Obviously after 7-10 days, with the cytokine cascade and the amplification of the inflammatory process, they arrived at the hospital dying. Then, mechanical ventilation did the rest.

I have continued to do what I have always done, also risking complaints for culpable epidemic, and I have not had a death or an intensive care hospitalization. I spoke to a colleague from Bergamo and another colleague from Bologna, who have continued to work in the same way, and none of us have had deaths and hospitalizations in intensive care. The WHO also gave problematic indications: in the early stages of the disease it provided only home isolation, in the second and third phase, therefore conditions of moderate and high severity, the only therapeutic approach envisaged was oxygen therapy and mechanical ventilation. In my view, there is also a responsibility of the WHO, because it has not given the doctor the right to clinically evaluate the patient.

The rest of the interview will follow soon.

Photo by Faruk Kaymak on Unsplash