Ancient and new pandemy. Nothing new under the sun: Cov-2 management, nothing new since Caterina Sforza

Dear Editor in Chief,

I would like to share with you and our collegues an interesting experience from many centuries ago, but really very modern indeed.

XV Century, North of Italy, at the end of a very hot summer, not far from the Adriatic sea, 50 miles south of Bologna, close to Ravenna, the former Capital of the Eastern Roman Empire.

On August 29th 1499, a young lady, Miss Faustina Riario was reported as the first victim of a new pestilence arrived into the city of Forlì, in Romagna. Faustina, daughter of the Cardinal of Saint George, was a VIP of the place, and described by Andrea Bernardi in his Cronicle [1] (the media of period) as the “patient Zero” of a new incoming bubonic plague.

In september Caterina Sforza, Countess of Forlì, a true “ironlady” who was ruling the city of Forlì at that times (Forlì is the same city were G.B Morgagni, “his Anatomic Majesty”, father of the modern Pathology, was born in 1682, two centuries after the event), in order to fight the impending plague, devised some really interesting end new solutions:

• •complete city lockdown, defining totally separated cold and hot areas inside the city, and stopping any movements in and out the walls; the stationed garrison was committed to check any city gate for possible intrusion or escape. As in the recent Italian lockdown for the Italian Government, Caterina had to put at risk in a very significant way her popularity for the citizens of Forlì;
• •she recruited medical doctors from all over and provided them very high fees for their activity of assistance;
• •most of the patients were moved away from the families and their home and assisted outside the walls of the city, in the countryside lazarets, not in the city hospitals (mostly nearby the churches). Some centuries later this idea proved to be the key for controlling the spread of the Covid-19 infection;
• •an efficient system of patients and cadaver transportation was organized, based on the “professional” role of the so called “Monatti”;
• •last but not least food and “drugs” were provided for free to all the people living inside the walls of the city or in the lazarets.

This amazing policy was very effective in controlling the spread of the plague, which disappeared after few months and couldn’t kill more than 176 habitants of Forlì. That's incredible if we put into account that nobody at that time was aware of the real mechanism of the infection, and if we consider that the most powerful drug was the prayer…

Disclosure of interest

The author declares that he has no competing interest.