Veronica, as doctor in a hospital in Piedmont, you experience on your own skin the Covid 19 emergency. Which is your point of view about the current health situation and which scenarios do you assume will occur within a year?
Now the situation seems to me very dramatic. Hospitals are collapsing and, certainly for this reason, they are unable to guarantee the necessary care for everyone. Given the long-term consequences of the first wave my fear is that this situation will continue for several months.
I wouldn’t feel, however, to make any prediction, because of the uncertainty of the moment. In my opinion there are too many elements which make difficult to imagine how the near future will be like: the difficulties of the healthcare system both in terms of economic and human resources, the lack of knowledge about the mode of spread of this virus, the immune memory, the long-term effects of the infection and, at least, the possibility of the vaccine to contain the pandemic.
Do you think that the many hypotheses of virologists, epidemiologists and doctors in general should be filtered by a scientific committee before being brought to the public attention, in order to avoid misunderstandings and incomprehension? Let me explain better: never than now the medical science seems to be based on opinions rather than on facts. Don’t you think that scientists should take a stance basing only on real facts and on scientific evidence rather than on hypothesis?
In general yes, I believe that opinions should be based on real and solid facts. Unfortunately, there is not always such clear and well defined scientific evidence to refer to.
Until a year ago no one knew what the SARS COV-2 virus was. We got to know it in such a n abrupt and dramatic way that we had no time nor the possibility to analyze it methodically. Initially this lead to the necessity of “improvising”, to try many different courses of therapy, which were in fact against the unknown.
As a consequence the whole world has mobilized so that more or less valid scientific studies have been published from hospital centres from every State: usually the publication process is much longer and more articulated, but in this situation we needed to rush.
I believe that this is the main reason explaining so many different opinions: the virus is still “new” and is still under study, so it is more difficult to obtain more consolidated information.
Inoltre, al giorno d’oggi, c’è tanta voglia di dire la propria e molto poca di ascoltare gli altri: la mia sensazione è che non ci sia un confronto costruttivo nell’ambito scientifico, così come in tanti altri campi.
Moreover, nowadays people desire to have its say and does not want so much to listen to the others: I feel that there is no constructive dialogue both in the scientific as in many other field. I think however that it would be better if there were a filter or, better, that experts from all over the world would meet to develop a clear message. The constant flux of different information makes difficult to understand to whom to believe.
oday, in order to be considered reliable, it is enough to have a sufficient knowledge of the subject enriched by some quotations from studies from scientific journals.
The mechanism is much more complex and, moreover, not all the published studies are reliable: it is needed to know how to read them, understand the statistics, the sources, the type of journal and so on.
You recently posted on Facebook a post about your experiences as a doctor, a Covid-19 patient and the distressing experience as a relative of a Covid-19 patient. There have been numerous reactions, from those who supported you to who lashed out against you and against the medical profession as a whole. Could you comment on what you experienced with these reactions?
Sure. It was nice to read the words of many people who in some way supported me but, I cannot deny it, I felt frustrated and disheartened towards those who lashed out at me. This is not because I cannot accept criticism, on the contrary, I think it is always useful to question oneself, but because of the content and of the tone with which they have been exposed.
understand that people are dazed from this situation, we all are in a way or another, but denying the pandemic or affirming that we are exaggerating it seems crazy to me. There are constant comparisons with the flu, people argues that it also causes many deaths and that it is therefore comparable to Covid-19. If it were really so for many years every winter hospitals would have collapsed and this situation would have happened on several occasions.
What some people refuses to understand or to accept is that, just because themselves, their loved ones and acquaintances did not got sick or developed only a mild form of infection, that does not mean that everyone else is experiencing the same situation. Doctors are sounding an alarm not because of their delusion of protagonism or because they are excessively careful but because there are no means for properly treating such a large number of patients.
Anger is certainly a justified feeling, but not if it goes side to side to the presumption of being able to decide on the life of others. Today’s society lacks of empathy: it strucked me to see highlighted everywhere the fact that mostly elderly people are dying: considering that the point is not the mortality but the severity of the infection and the need for extensive therapies, it is in any case it very demeaning that a life counts less then another.
Below a reworked version of the post, apple of discord, which was interpreted from the readers in many different ways. To avoid any misunderstanding would you like to tell us the reason and feelings that pushed you to publish it?
“Dedicated to all those who have not used and do not use the mask.
Thank you, because I am locked home and depend on others for everything. Because I saw a loved one with pneumonia and I feared he needed to be hospitalized and that he would die.
I thank you because I cannot practice as a doctor where it would be needed, from where I hear saying “the situation is dramatic”, “we are back to March”. Wards are now collapsing, full with patients in a severe clinical condition.
Now, probably being endowed with civic sense and humanity is making people corrupted and mislead by the system. Maybe, if you had felt the fear, if you had walked through those departments, if you had touched first-hand the suffering of the others, if you had watched people consume themselves, you would change your mind.
The problem is not having a more deaths than other pathogens, but the severity of this infection, the lack of beds in hospitals, the long term consequences, at today still unknown. The much cited flu causes deaths and leads to the need of hospitalization, but the numbers, the severity and consequences does not have the same reach.
Does a mask really represent a form of limitation to the personal freedom? If it was the new trend of the year would not everyone rush and buy it? We should ask ourselves at length what freedom of choice really is.
I only ask you to seek within yourselves a bit of humanity and to wear a mask as small sign of altruism.”
I think that I partially already explained my reasons by answering to the previous question.
This post was definitely an outburst of fear and anger. I was afraid that my mother would be hospitalized and needed to be ventilated with a helmet and that, given to the saturation of the hospitals, it would have not been available for her, so I was afraid to lose her.
Anger because she, who almost keeps the mask for sleeping, strict and careful, has come into contact and has been infected by people without mask, who probably do not even believe that the virus exists.
Anger because wearing a mask is such an insignificant and, above all, altruistic gesture in everyday life. I believe that, if people had worn a mask as much as possible, we would not be at this point. Instead, the mask seems to be considered an imposition from a dictatorship, as if it were the first step towards the deprivation of liberty. Probably many people don’t seriously stop to think about what a dictatorship is and what freedoms individuals who live in states with such governments need to give up.
I think that this pandemic highlighted how much the society is disintegrated, how there is no concept of common good, but that only the interests of the individual prevails.
A hot topic concerns the resistance of the health care system from the infrastructural point of view rather than the issue of the health personnel. What do you think about this issue? What has been done and what is still missing?
The healthcare system has been in a critical situation for several years, also because the cuts have been greater than the investments. On a theoretical level we have a really good system since the payment of taxes would allow access to any kind of medical service.
Problem is that, by gradually removing resources, the public healthcare system has found itself in the situation to offer less and less with the consequent need to turn to the private system: if you have money you can cure yourself. It is inconceivable to me, because health should be a right for everyone.
However, I am not an expert on the subject and I cannot tell specifically which measures should be implemented in order to reverse the trend. Perhaps if a bigger share of the GDP wqs invested in the healthcare system, it would be a step forward.
Taking the reinforcement of the health system as an indispensable assumption, would this really be the solution to the problem or it would be like stopping a river that has already reached the valley? Wouldn’t it be better to create a dam upstream through prevention? Do we have other solutions besides wearing a mask?
Preventive medicine would be a great method in order to optimize the expenses of the healthcare system. Prevention results to be cheaper in the long term than treatment interventions, but, in order to realize them, a well-organized system is obviously necessary, especially at a territorial level.
A model that could explain better this concept is that of “Prevenzione Serena” (Serene Prevention), a screening program for breast, colorectal and cervical cancer offered from the Piedmont Region. Let’s take breast cancer as an example: for the health system the cost of an annual mammography is much lower than the tumor removal surgery, but in order to grant the female population access to this service, buildungs, tools and personnel are needed. Therefore, in the immediate future a big investment is required, the results of which will be seen only in time: if the system is already in a crisis it will probably not have the means for realizing it immediately.
However, there is no doubt that strengthening the local medicine would be a necessary and extremely effective intervention in a system like ours, which is becoming more and more hospital-centric but with hospitals which are not able to manage the amount of patients in charge.
For what concerns Covid-19 I believe that, other social distancing, wearing masks and washing hands and in general the measures indicated by the health authorities, there are at the moment no particularly effective means.
I recently read that, other than the flu, this virus spreads by overdispersion, which means that it creates outbreaks: one highly infective person is enough to infect a large number of other people. This effect is enhanced by a series of concomitant conditions: close environments, poorly ventilated rooms, prolonged contacts and overcrowded places.
For this reason, we all must adopt the precautions I enlisted before.
I personally find media information deficient from the point of view of people who has been seriously ill with Covid-19 or from doctors who, like you, are in a daily contact with these patients. Perhaps it is only now that some personalities in the world of information and entertainment have contracted the disease that the direct testimonies of seriously ill patients are gaining resonance. Do you think that hospital doctors and sick people should be better represented in terms of mass media information? After all, these are the two categories who experiences the discomforts of the disease. Do you think that the contribution of us all in our daily life could convince those who are skeptical of the existence of Covid-19? In this regard is there something that could be done and that has not yet been done?
I indeed also had the impression that the experiences of those who got Covid-19 where not so much “advertised” compared to the opinion of experts, hospital managers and other figures. I believe that if more place was given to those who have experienced the infection on their own skin or who works in direct contact with Covid-19 patients, the public would have more means for understanding what is going on now in the treatment centres.
There are people who argues that hospitals are not really collapsing and that this is all a fake. Maybe, if they were more exposed to the testimonies of those have been hospitalized or taken care of at home, or to the ones of health workers, they could maybe see the situation under another perspective.
Unfortunately, it is not easy to convice the skeptics, also because internet allows everyone, also the not competent people, to express his opinion and to gather a certain number of followers. Today people tend to question everything except from what they have decided to believe in, without ever thinking that they can be wrong. Yet, the fact that every person specializes in a particular field serves precisely to train competent individuals in a certain subject.
If for example I am shopping with a friend who is a seamstress and I would like to buy a shirt, but she says that the fabric is not worth anything, I don’t question it, I trust her because I know that she is more competent than me in that field. In the same way I don’t say to the electrician that he does not understand anything and that he is wrong, neither to the surveyor, nor to the bank consultant, nor the pilot, nor the butcher and so on. Everyone, even if competent in a field, can be proved wrong, and it is legitimate, in fact we can compare each other, but in the same way we can be wrong. I think we should trust others more and not to believe only what is convenient to us.
Perhaps we could take some steps to make people gain trust again in the scientific community, perhaps by being more communicative but with a less complicated, a simpler and humbler language, perhaps by using intermediaries who are more able convey a message. It is for sure not a simple task, but now necessary more than ever.
ERMANNO CAPIRONE
WriterFermo sostenitore del DIY, approccia alla scrittura per puro piacere convinto che la penna ferisca più della spada.
Lavora in piscina e produce musica sotto lo pseudonimo di Bob Rocket
