In Naples, Italy’s third-biggest city and the heart of the mezzogiorno, the country’s south, ambulances carrying COVID-19 patients queued up outside overflowing hospitals. Images of an elderly man who died in a hospital bathroom and was reportedly left on the floor for over half an hour also prompted outrage.
Authorities have been caught flat-footed by the resurgent virus sweeping through Europe. Already 15 Italian regions — as well as one smaller administrative area — are either in the medium-high or high-risk categories which involve some kind of lockdown, with the country exceeding 1 million cases since the start of the pandemic.
That is piling political pressure on the government, with cracks in the ruling coalition widening over ministers’ handling of the crisis.
A series of gaffes involving the Calabria region, also in the south, haven’t helped. This region, the poorest in Italy, is now under the strictest level of lockdown, with its dilapidated health infrastructure at risk of complete collapse. In a trainwreck interview, Calabria’s Acting Health Commissioner Saverio Cotticelli struggled to answer the reporter’s questions before admitting that he didn’t know he was responsible for drafting the region’s COVID-19 plan.
Following the interview, Cotticelli — who was given control of the region’s health service after it had been put under national supervision due to financial mismanagement — resigned. He also bizarrely suggested that his poor performance may have been due to him being drugged. A new controversy immediately erupted when a video of his replacement surfaced showing him saying, in colorful terms, that face masks are useless for stopping the virus. The new appointee defended himself, saying that the video was from when the World Health Organization was warning against the use of face masks, but has since been shown the door. His replacement almost immediately pulled out before being confirmed, leaving the region without a health commissioner after going through three in little over a week.
On the brink
Meanwhile, infections have surged throughout the country, putting to rest any illusions of the unique efficacy of the Italian model. The government — like several others across Europe — passed incremental measures through October with little success, before unveiling a larger package of restrictions on the night of November 3.
The new measures — dubbed a “lockdown light” on the model of the one implemented in Germany by Undersecretary for Health Sandra Zampa — are a balancing act: aiming to bend the viral curve while minimizing collateral damage to the economy. Prime Minister Giuseppe Conte argued that a nationwide lockdown would have a “double negative effect.”
The idea is to assess areas of the country by their risk level — taking into account both epidemiological data as well as hospital capacity and readiness.
Given recent street protests, the government is under pressure to keep the economic impact to a minimum and to avoid the stringent spring lockdown when the country was one of the worst-hit in Europe. Protesters emptied into piazzas across the country, demonstrating against the impact of measures such as curfews and mandatory shop closures.
The right-wing opposition has lined up behind some of their demands. Giorgia Meloni, of the right-wing Brothers of Italy party, said that while she denounced any violence, she defended the demonstrators. “Shopkeepers, restaurant owners, workers of every stripe showed up to defend their sacred right to live and work with dignity,” she said.
Antonio Tajani, a former president of the European Parliament and vice president of Berlusconi’s center-right Forza Italia party, said the country had found itself unprepared despite the fact that the return of the virus had been “pre-announced.” He recommended that the government tap into European Stability Mechanism funds — something that it has been loath to do — in order to shore up the health system ahead of any eventual third wave.
Others though are criticizing the government for its piecemeal regional approach to lockdown. “The problem is that currently, we have a picture of contagion that is 10 to 15 days old,” said Giovanni Leoni, vice president of Italy’s Order of Doctors, which represents the profession, referring to the time lag between when an infection occurs and its detection. “We keep trying to chase a virus that continues to spread,” he added.
One concerning feature of the second wave is that the south is hit as hard as the north of the country, which bore the brunt the first time around. Leoni noted that poorer southern regions have fewer intensive care beds per capita and that although the government has made efforts to improve capacity, staffing hasn’t kept up. That has led to more ICU beds per doctor, straining the system further.
There has been political friendly fire too. Former Prime Minister Matteo Renzi, whose Italia Viva party is part of the governing coalition, has also said that shutting down restaurants and theaters was a mistake and that a country-wide lockdown was preferable to “half measures,” according to La Repubblica.
And the Governor of the Campania region Vincenzo De Luca — a member of the ruling Democratic Party — has repeatedly clashed with ministers. In one Facebook broadcast, he accused the government of “wasting two precious months, during which we had a dramatic increase in cases, as well as deaths.”
“With the exception of three or four ministers, this is not a government,” said De Luca. “In these conditions, better to send the government home.”
Nino Cartabellotta, president of the GIMBE Foundation, an NGO dedicated to championing evidence-based health care, said the government’s shifting rules have created uncertainty and anxiety for citizens while failing to get on top of the outbreak.
“The steady drip of [measures to restrict the spread of the virus] on a weekly basis shows that politicians are constantly chasing after the day’s case numbers,” he explained. “They ignore, or don’t want to believe that the virus is always two weeks ahead and that bureaucratic delays then add one more week.”
He said ministers need a medium- to long-term strategy that is based on science, not politics: “Data and scientific evidence seem to play less and less in a role in decision-making.”
Otherwise, the consequences will be dire, he warned. “Only a total lockdown will be able to avoid a total collapse of the hospital system.”
This article is part of POLITICO’s premium policy service: Pro Health Care. From drug pricing, EMA, vaccines, pharma and more, our specialized journalists keep you on top of the topics driving the health care policy agenda. Email [email protected] for a complimentary trial.
View original post