4 ★ FINANCIAL TIMES Friday27 March 2020
C O R O N AV I R U S
M I L E S J O H N S O N A N D DAV I D E G H I G L I O N E
ROME
F E D E R I C A C O C C O— LONDON
As Italy’s doctors and medical staff
striveto save the lives of Covid-
patients, they are also fighting another
battle: oavoidinfectingthemselves.t
“Things are very bad, I’m desperate,”
said an intensive-care doctor in Brescia,
Lombardy, Italy’sworst-hit region. At
her hospital, where staff areusing snor-
kellingmasksboughtfromleisuregoods
chain Decathlon to hook up patients to
oxygen, protection equipment for doc-
torsandnurseshasrunout.
“I think we all have it here but they
won’t test us, even if we display symp-
toms, which allows the spread to con-
tinue,” the doctor old the FTt. “They are
not testing the medical staff because we
are understaffed and they can’t quaran-
tine us. If things go on this way, this will
never end because we will continue to
spreadthediseaseandtogetsick.”
Italy’s medical system, one of the bet-
ter-resourced in Europe, isstretched to
breaking point. More than 7,500 people
have died.So far 5,211 medical workers
in Italy have had the virus, equivalent to
8 per cent of all diagnosed cases in the
country at the start of this week. Of
those,33 have died, according to the
Istituto Superiore di Sanità, the science
armofthehealthservice.
“The first thing to do is to protect
healthcare workers, to make sure they
arenottheonesspreadingthevirus.Our
doctors have been sent to war
unarmed,”saidFilippoAnelli,president
of Italy’s national doctors’ association.
“The dead do not make a noise. Yet the
names of our dead friends, our col-
leagues, put here in black and white,
makeadeafeningnoise.”
The latest doctor to diewas Vincenza
Amato, head of public health for Ber-
gamo, the city in Lombardy with the
highestnumberofcases.
A group of doctors from the Papa Gio-
vanni XXIII hospital in the city wrote a
jointarticleintheNEJM edicaljournalm
last week saying their hospital was
“highlycontaminated”.
“We are learning that hospitals might
be the main Covid-19 carriers, as they
are rapidly populated by infected
patients, facilitating transmission to
uninfectedpatients,”theysaid.
“Health workers are asymptomatic
carriers or sick without surveillance;
some might die, including young peo-
ple... Older patients are not being
resuscitated and die alone without
appropriate palliative care, while the
familyisnotifiedoverthephone.”
Giorgio Gori, mayor of Bergamo,
admittedhealthcare workers had
become sick “during the first phase
when they were initially exposed to the
virus because of the lack of protective
equipment”. But uthorities “acteda
quickly and now the situation is under
control”.
Mr Gori believes that, for all the
deaths in hospitals, many more people
are succumbing to the virus at home
withoutmedical treatment.Official
death statistics for the city, he said, were
far higher than previous years and
higher than the official numbers
countedashavingdiedfromthevirus.
“Theratioisfourtoone,”hesaid.“For
eachpersonwhoisdeceasedwithadiag-
nosis of coronavirus, there are three
others for whom this is not ascertained
butwhodieofpneumonia.”
Bergamo’s hospital doctors are calling
for more patients to be treated at home
and for separate buildings inside hospi-
tals to be established for the infected,
meaning the risk of hospital contamina-
tion is reduced and help can be given
more quickly and efficiently. “We need
dedicated Covid-19 hospital pavilions
and operators, separated from virus-
freeareas.”
Theproblem is nationwide. Antonio
Magi, president of Rome’s doctors’ asso-ciation, said84 doctors in the Italian
capital had been infected, accounting
forabout13percentofthetotalnumber
ofcasesthere.
“Weareflexibleandweareallmaking
big sacrifices,” said Francesca Rapetti,
an anaesthetistin an intensive-care unit
at San Martino hospital in Genoa.
“Unfortunatelywearealsoquitescared:
we cannot work calmly.” Lack of protec-
tiveequipmentaddstothestress.
Italy has rushed to recruit more doc-
tors, urging retired professionals to
returntothefrontlineandlettingmedi-
cal students graduate early. Yet some
are torn between the desire to help and
the risks. Gianpiero D’Antonio, a 25-
year-old doctor from Potenza in south-
ern Italy, has already been offered sev-
eral jobs in Covid-19 departments in
hospitalsacrossthecountry.
“The risk of getting sick is very high,”
he said. “For me it would be a great
opportunity to start working in such a
challenging situation but, before taking
any job, I have to think about it three
times.”Hospitals. ransmission riskT
Italy medics’
fight for life
gets personal
With 33 health workers dying,
fear of sickness hampers push
to recruit additional doctors
‘I think we
all have ithere but
they won’ttest us,
even if wedisplay
symptoms’Brescia doctorDA N I E L D O M B E Y —MADRIDA surge ofcoronavirus ases in Catalo-c
nia has increased tension between the
region and the Spanish government,
which is being pressed toshut down
almost the entireeconomy.
As of yesterday there were about 11,
confirmed cases in Catalonia,with
1,000 peoplein intensive care and 670
dead. The figures mark a drastic deteri-
oration since March 16, the day after the
lockdown, when there were fewer than
1,000 cases in Catalonia, only 33 people
inintensivecareandjust12deaths.
Theworstaffectedpartoftheregionis
around the town of Igualada, an hour’s
drive from Barcelona. Catalan authori-
ties say the death rate thereis the equiv-
alent of 63.1 per 100,000 inhabitants.
The rate inMadrid, the worst-hit region
in Spain in absolute terms, is 27.9, and in
Lombardy, northern Italy, until now the
centreoftheoutbreakinEurope,41.6.
The regional authority on Wednesday
tightened restrictions in and around
Igualada, banning people from leaving
homeforanythingbutessentialwork.
But the central government said yes-
terday the ban lacked force under the
state of alert it invoked to deal with the
emergency, and which largely suspends
thedevolvedsystemofgovernment.
Pedro Sánchez, the prime minister,
said the lockdown measures were suffi-
cientandheldouthopethespreadofthe
virus would soon peak. “The Spanish
government continues to follow World
Health Organization recommendations
at all times and.. .has adopted the
most drastic measures in Europe and
thestrictestintheworld,”hisofficesaid.
The clash is just the latest between Mr
Sánchez’s government and the Catalan
administration, which at one point
called for the region to be sealed off to
fight the virus. This week it demanded
that Madrid “ban all movement outside
[the home] — on foot, in private vehi-
cles, or by any means of public, private,
collectiveorindividualtransport”.
Under the state of alert, people are
allowed to travel to work in areas such
as construction,although almost all
shops other than grocers and pharma-
cistshavebeenclosed.Spain
Catalonia and
Madrid clash
over control
measures
The World Health Organization has
said it has “started to see some
encouraging signs” in Europe, where
the pandemic has claimed nearly
12,000 lives.
The international body said that the
continent had reported more than
220,000 cases and 11,987 deaths
associated with Covid-19. That is six
out of every 10 cases and seven out of
every 10 deaths.
“While the situation remains very
serious, we are starting to see some
encouraging signs,” said Hans Kluge,
WHO regional director for Europe.
He pointed to a slightly lower rate of
increase in cases in Italy, which has the
highest number of cases in Europe.
As many countries go through a
period of lockdown, Dr Kluge said:
“Soon we will be able to determine
the degree to which the measures put
in place in many countries are having
an impact.”
Philip GeorgiadisEurope
WHO takes
heart from
slower rate
of cases
in ItalyDesperate: the intensive care unit in a Brescia hospital. Some staff use snorkel masks for protection —Claudio Furlan/LaPresse/APMARCH 27 2020 Section:World Time: 26/3/2020- 18:16 User:john.conlon Page Name:WORLD3 USA, Part,Page,Edition:USA, 4, 1