But now the virus is raging again through Europe and through Italy with a tip that again hits the north, but this time also the south. In Campania, which includes Naples, the daily number of new cases discovered is five times greater than the March peak.
So the question becomes whether Italy bought itself enough time.
Compared to six months ago, there is more room for critical patients in southern Italy. There are several fans. Many hospitals in the south are still understaffed and have fewer beds per ward. Inhabitant than those in the north. They could reach a breaking point if the number of critical patients increases.
The regional governor of Campania has ordered a school closure in late October and threatened a lockdown if the number continues to rise.
“Are we dramatizing it?”
During the first wave, Lombardy – the northern region that includes Milan – accounted for about a third of all infections. Now it accounts for one-sixth, although it has also seen cases resume sharply. Lazio, the area around Rome, has the highest number of people hospitalized with covid-19, the disease caused by coronavirus; Lombardy and Campania are next behind.
Perhaps most surprising is how quickly the virus has risen in the South. Some regions went for several days during the summer without discovering a single case. By mid-June, Campania had 125 people known to be infected with the virus. Now it has more than 13,000.
Over the past six months, southern Italy has been trying to prepare for the virus – and compensate for years of poor hospital management and financial cuts.
In Puglia, the large region that is the heel of Italy’s boot, the government has dedicated specific hospitals and buildings to handle incoming coronavirus patients – a means of reducing the risk of contamination. Puglia has three times the number of fans it did in the spring, said Pier Luigi Lopalco, an epidemiologist who has consulted the region about its response.
But, Lopalco said, even though Puglia has the laboratory capacity to process 15,000 coronavirus tests a day, it only has enough healthcare workers to administer 5,000 or so daily tests. The region has struggled to recruit doctors and nurses. It recently attempted to hire 30 nurses and could only find six.
“So many of these young nurses are now working in these [northern] regions with a very good contract, ”said Lopalco, who will soon be the health director of the Bulgarian government. “It’s not that simple to convince these people to come home again.”
Campania has made its own preparations, including opening accommodation units for people who are discharged from the hospital but who are still positive about the virus. Such facilities give the region a better chance of keeping hospital beds open to the most critical patients.
But Giuseppe Galano, the head of a regional anaesthesiologists’ association, noted that Campania’s health care system had for years dealt with poor management and running costs – only to then be placed under external administration, which froze employment.
“Campania still lacks at least 200 to 300 anesthesiologists,” a job required for intubations, Galano said. “This is a big handicap.”
Walter Ricciardi, an adviser to the World Health Organization of the Italian Ministry of Health, said the south is “certainly not ready” for an explosion of coronavirus cases.
“They had to invest money in improving staff, systems, and in some cases they did not do enough,” said Ricciardi, who said officials in some regions were complacent and underestimated the risk of the virus re-emerging.
“This is very sad,” he said. “For some southern regions, if there is a similar epidemic wave, the consequences will be more severe.”
So far, hospitals have not yet reached a critical point. The number of patients in intensive care nationwide is one-seventh of the total number from the peak in March. But Italy’s National Health Institute has warned that about half of Italy’s regions – both north and south – could see at least 30 percent of their ICU beds occupied by covid-19 patients within the next month.
“I think we get more and more [hospitalized] cases, ”said Lopalco, who said it was still possible that restrictions could slow the infection and prevent the situation from germinating. “The risk we run is that we will have to close the normal hospital activity. That is the risk we are trying to avoid. ”
Italy last week prescribed mask-wearing even outdoors, and this week limited hours at bars and restaurants. Officials say the goal is to ward off the need for another, inevitably bruised, national lockdown. But they say localized or even regional lockdowns may be necessary.
A few small towns, after seeing cases skyrocket, are already sealed. One, Galati Mamertino, a city in Sicily, had recorded zero cases of coronavirus during the first six months of the pandemic.
Then the first person became ill and tested positive, said Mayor Antonino Baglio. The city carried out several cotton swabs and quickly realized that 122 people – among 2,600 in total – carried the virus. The vast majority were asymptomatic, but several nights ago, a 50-year-old who appeared to be in good health was rushed to the hospital with difficulty breathing. The man’s father was also hospitalized.
Police and army are now located by roads into the city and control access. About 600 people are isolated after being in contact with famous people who are known to be positive.
“We thought we were free,” Baglio said. “Then suddenly you are thrown into the thick of it and realize the tragedy and its magnitude. You reconsider everything. You realize that it is very important to have a vision and not to think that we are immune. That what you see on TV is completely real. And very, very much a burden. ”