Dear Editor,
The recent paper of Gudi, et al ,1 has highlighted certain aspects of COVID-19. In particular, the attention for social and economic consequences of this emergency, usually underestimated, has been clearly and widely described.
The dramatic increasing number of people with COVID-19 is now dramatically increasing in Italy and, to date, it remains a severe urgent public health emergency.2 Hospital teams, local and national authorities are constantly working to face the dramatic consequences of COVID-19 outbreak and to fix specific issues about Emergency Department overcrowding, bed resources and available health care professionals, and the need for patient transfer to other specialized facilities. Recent literature, statistical data and rates of the disease morbidity and mortality suggest that the viral spread is still expected to grow and many new cases would occur, possibly in the hundreds of thousands of people; the preparedness of public health systems will be challenged worldwide.1 As the outbreak of COVID-19 progresses, epidemiological data are needed to guide situational awareness and intervention strategies. Current goals are to ensure that adequate personal protective equipment (PPE) will be available, not only to health personnel but also to the whole population at risk of contagion, to minimize the risk of further infections and deaths; and to understand more clearly how this novel coronavirus can be controlled by drugs and an effective vaccine. However, this is not only a health issue, but it also gives rise to a lot of socio-economic consequences, widely modifying our lifestyles and policy, with long-term consequences; at the end of this period the whole world will probably be very different.3
The world needs to rethink the social and health funding, and other related policies.4 In Italy, for example, during the last decade, we lost a large amount of health funding, hospitals, and health professionals to respect the need to control public spending and to meet the EU directives. At this time, this led to a reduction in the number of hospital beds, intensive care units (ICUs), clinical laboratories, and health professionals. Moreover, it would affect doctors and nurses, with the reported dramatic effects on the current possibility of continuing to cure patients in the central and northern regions,2 and the risk of being able to warrant adequate cures only to a few people in southern regions.
Hopefully, the extraordinary economic interventions adopted to support the Italian National Health Service (SSN, Servizio Sanitario Nazionale ) to counteract COVID-19 crisis will have to become largely ordinary after the emergency if a new, future situation of health crisis is to be tackled with greater serenity and appropriate tools. Lessons from ancient history report the importance of reconsidering the whole lifestyle of people after severe crisis, usually related to infectious diseases (ie , plague epidemics, “Spanish” flu pandemics, AIDS, etc ), to create new health models and to implement health-related policies.5 School system, national and international economy, and personal relationships are currently changing considerably; and any government must consider these in the next future.1
Conflicts of Interest:
None declared.
Financial Support:
None.
Cite this article as: Santacroce L, Bottalico L, Charitos IA. The impact of COVID-19 on Italy: a lesson for the future. Int J Occup Environ Med 2020;11:151-152. doi: 10.34172/ijoem.2020.1984
References
- 1.Gudi SK, Tiwari KK. Preparedness and lessons learned from the novel coronavirus disease. Int J Occup Environ Med. 2020;11:108–12. doi: 10.34172/ijoem.2020.1977. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Grasselli G, Pesenti A, Cecconi M. Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: early experience and forecast during an emergency response. JAMA. 2020 doi: 10.1001/jama.2020.4031[Epubaheadofprint]. [DOI] [PubMed] [Google Scholar]
- 3. Leichfield G. We're not going back to normal. MIT Tech Rev March 17, 2020. Available from www.technologyreview.com/s/615370/coronavirus-pandemic-social-distancing-18-months/ (Accessed March 28, 2020).
- 4.Emanuel EJ, Persad G, Upshur R. et al. Fair allocation of scarce medical resources in the time of Covid-19. N Engl J Med. 2020 doi: 10.1056/NEJMsb2005114[Epubaheadofprint]. [DOI] [PubMed] [Google Scholar]
- 5.Bottalico L, Charitos IA, Kolveris N. et al. Philosophy and Hippocratic ethic in ancient Greek society: evolution of hospital-sanctuaries. Open Access Maced J Med Sci. 2019;7:3353–7. doi: 10.3889/oamjms.2019.474. [DOI] [PMC free article] [PubMed] [Google Scholar]