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Leap in coronavirus cases tests limits of Italy's health system

Thirty-six coronavirus patients have died in Italy over the past 24 hours, bringing the overall number of deaths to 233, the country's Civil Protection Agency has said.
Italy has struggled to contain the novel virus since February 20, when the so-called "Patient n.1" attended a Local hospital within the northern town of Codogno.

Sixteen days later, the country has the very best toll outside China, while number of people suffering from COVID-19 leapt to 5,883, officials said on Saturday.

"The whole system wasn't ready for the emergency, but responded very quickly," Lorenzo Casani, health director of a personal clinic for elderly people near the quarantine area in southern Lombardy, told the Al Jazeera news on Friday.

Senior citizens and folks laid low with chronic and acute diseases are at a greater risk of infection. This worries Casani since all his guests are in danger. For the primary 10 days, he had no time without work in the slightest degree.

"All the personnel should are properly informed and ready just in case of an emergency," he said, stressing that the initial chaos was prompted by the dearth of a unified contingency plan across the regions, comprising both private clinics further as public hospitals.

"The bad luck dropped the bomb, and it exploded in our hands."

Why Italy?
Almost a month before the beginning of the outbreak, the health ministry created a taskforce and suspended all flights to and from China, declaring a state of emergency. But the virus could have arrived in Italy before the travel ban was issued.

Sacco hospital in Milan studied three different genetic sequences found within the northern region of Lombardy, confirming COVID-19 weeks before doctors found "Patient n.1".

"It is plausible that when COVID-19 landed within the country, it had been still in incubation, and also the infection developed into somebody with light or no symptoms in the slightest degree," Massimo Galli, head of the communicable disease department, told the newspaper, Corriere della Sera.

At the top of December, an uncommon number of pneumonia cases received the hospital of Codogno in northern Italy, the pinnacle of the emergency ward, Stefano Paglia, told the newspaper La Repubblica. a number of these patients could carry the coronavirus, but doctors treated them as typical winter diseases.

Unfortunately, a decisive contribution to the spread of the infection was given by the health center itself, because of the quantity of medical staff and attendees researching the compound daily.

"The hospital acted as a multiplier," Walter Ricciardi, executive member of the planet Health Organization (WHO) and consultant for the Italian health ministry, told Al Jazeera.

Ricciardi refuses to contemplate the country as a world black sheep.

"From an epidemiologic point of view, it's not plausible that Italy has stopped the flights from China and accounts for more cases than Germany and France," he said.

Italy has tested over 42,000 people up to now, while other international organisation countries performed significantly fewer controls. This scrupulous search inflated the tally, he said.

"The high number of checks brought the matter to light earlier. Germany and France are now following the identical route."

Drastic measures
To contain the outbreak, the govt. adopted drastic measures, establishing two quarantine zones within the northern regions of Lombardy and Veneto, where the epidemic surfaced.

Schools everywhere the country will remain off limits for college kids until mid-march. Sport events are held indoors. Public events that can't guarantee a distance of 1 metre (3.3 feet) between the attendants are prohibited. And a referendum on cutting the quantity of the members of the parliament has been postponed.

To sustain the health system and reinforce the financial set-up, the govt. has announced an emergency plan of seven.5bn euros ($8.5bn).

"Both the WHO further because the European Commission pledge the Italian reaction as a reference," said Ricciardi, who believes the containment measures were necessary and well-planned.

The weakness lay within the mixed structure of the National Health Service (SSN), with both the central government and also the regional administrations sharing the control of the system.

This approach led to some confusion during the first days of the outbreak when local governors adopted different approaches, sometimes resulting in a clash with Prime Minister Giuseppe Conte.

"A single line of command both in higher cognitive process further as in communication is very desirable in these circumstances," said Ricciardi.

Lack of doctors, wards
Italy built the SSN, its national health service, in 1978 following a "Beveridge structure" as a unified and centralised system with universal access to any or all the patients.

"In case of a plague, this can be the simplest model, because it intercepts and treats all the cases," Francesco Longo, director of the Healthcare sector Observatory at Bocconi University (OASI), told Al Jazeera.

However, concerns arise about the resilience of the SSN.

"The government ensured that the various regions were given new protective devices, like masks, but we are still receiving reports about shortages," Filippo Anelli, president of the National Federation of the Orders of Doctors, told Al Jazeera.

The association of medical directors (ANAAO) sounded the alarm about the dearth of beds in intensive therapy in Lombardy, where 95 percent of them are full.

All over the country, medical aid departments are hosting 567 infected patients, while the national capacity is 5,395 beds.

"If Lombardy struggles along, i'm worried about what happens if the virus reaches the southern a part of Italy, where we lack both personnel and equipment," said Anelli.

According to OASI's latest report, investment publically healthcare accounted for under 6.8 percent of the gross domestic product (GDP), a leg behind countries like France and also the uk.

"This means the system works efficiently, but constantly saturates its productive capacity and has few resources when it involves emergencies," said Longo.

To face such shortages, the health minister arranged for a 50 percent increase of units in medical aid, doubled down the quantity of beds in communicable disease wards and laid the bottom for the immediate enrollment of 20,000 new doctors and nurses.

Doctors from the military and fewer affected areas are being dispatched to the red zone.

In Lombardy, Governor Attilio Fontana asked universities to advance the graduation of this year's nurses and personal hospitals are opening their doors to those in need of urgent care.

"This may be a whole new experience for our system in terms of dimension, intensity and energy required to our SSN," head of Superior Health Institute (ISS) Silvio Brusaferro said.

Longo doesn't doubt the outtakes of the crisis. "An efficient epidemiologic registration system, reserve productive capacity and a singular, authoritative voice: these are the teachings for countries facing such a plague," he said.

The next two months will tell whether this policies will help Italy in overcoming the spike in coronavirus infections.


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