A nation in despair and danger, knocked to its knees by a virus.
An enemy that must be defeated, and which has two insidious and terrifying qualities: invisibility and contagiousness.
This is the general picture of the situation in Italy; we talked about this with Professor Silvio Angelo Garattini, a scientist and pharmacologist, president and founder of the IRCCS Pharmacological Research Institute Mario Negri.
Professor Garattini, where was the coronavirus born?
“From what reliable virologists have said, it probably comes from a bat or some other animal, and then mutates until it is able to spread to humans. Living in a globalized world, he spread everywhere the next step; the trail would indicate Italy, and more specifically, “patient 1” turned out to be a person from Codogno, and the virus arrived there from Germany. However, it is highly likely that there were many other sources of infection.
However, I believe that there is no basis for the hypothesis that it was created in the laboratory. “
And why is Italy suffering so much in this situation?
“Look, there are plenty of factors to consider. Let’s just think about how people live, our habits and our mentality: compared to countries such as China, Japan and South Korea, we are used to expressing interpersonal relationships through physical contact, from a banal handshake to frequent kisses and hugs. A trivial example: at the Atalanta-Valencia match there were 25,000 fans from Bergamo who hugged and kissed, enjoying every goal scored; it could have been a huge infection detonator.
Add to this the fact that at the beginning the crisis situation was somewhat underestimated by everyone and therefore no emergency plan was launched and you will understand that in the case of this type of virus, highly contagious and often asymptomatic, not much is enough to lead to an explosion of infection .
Let’s say there was some ambiguity; maybe the approach and behavior as adopted during the African swine fever epidemic would be appropriate, but of course it’s easy to talk about today.”
How to understand numbers related to the outbreak of an epidemic?
“It depends on how we want to analyze it and what we want to see: they can say a lot and nothing at the same time. To prepare the correct statistics, we should first perform tests to check for the presence of the virus in everyone, take into account those in whom the test result turns out to be positive, and then calculate the various percentages that interest us (e.g. mortality). One of the data that I think is important is related to the number of admissions to the hospital: there are many asymptomatic people or those who recover without major problems (about 80%), but it is important to understand how many people needed hospitalization so that we could estimate the severity of the virus.
The reference points that we have at our disposal for the purposes of statistical calculations are the cruise ship “Diamond Princess” – data collected by the mayor (who is a physicist) of the town of Nembro and data from the Institute of International Politics: these are cases of closed circuits, which allow us to more accurately calculate what we want to analyze and which result in mortality of around 1%. “
Do you think you can create a vaccine? If so, will it give us the right immunity or will it be like flu cases?
“The vaccine will be ready, hopefully, by the end of the year. We are working on a vaccine that will provide us with immunity, but it is too early to be so sure. We must be able to understand the properties with which the virus mutates; if we can’t create one that gives immunity, we’ll create one in the style of an influenza vaccine, that is, one that can contain a hard core of information about a virus that needs to be fought.
Therefore, at present, we cannot predict whether or not second waves of infection will come, precisely because we must first understand how the virus behaves. However, it will probably mutate a bit and come back every year, just like the flu; if that were the case, we would have to vaccinate significantly more, especially those at risk. “
While we are waiting for the vaccine, our health service is collapsing. What is your assessment of this aspect?
“First of all, it must be said that, fortunately, there is public healthcare. I also believe that everything that was possible was done; what the hospitals in Lombardy, and more specifically in Bergamo did, would hardly have done the best hospitals around the world.
The real problem is that the medical staff were unprepared and therefore many employees were not properly equipped with everything necessary to deal with the viral infection.
Even today, there are opinions about not only not enough respirators but also masks.”
From the perspective of your experience and prestigious functions that you perform, what can you suggest?
“I hope that when this bad time is over, we will not forget everything, avoiding talking about it, but we will take the opportunity to prepare ourselves and introduce the appropriate procedures, really without any discussion.
From my point of view, I would like to highlight in particular three elements that need to be improved.
The first is the lack of a relationship between regionalization and hospitals: our mentality is hospital-oriented, while I personally think that regionalization should just be a big filter. We noticed that GPs didn’t play a big role because they couldn’t do it.
The second concerns reserves, if we want to call them that: we have a lot of weapons, armored ships, planes that are available if needed; I see no reason why it should not be the same for medical equipment. We do it for military reasons, but no longer for health?
The third concerns what we have talked about earlier. Today, everyone is asking researchers and scientists to act as soon as possible, to tell us what to do, etc., but in Italy we have limited the research to a minimum, to the extent that we are at the bottom in terms of: investment, number of scientists, restrictions on animal studies, which we need, no matter how bad they are, because some studies cannot be done on humans.
As we said, it is a globalized world: we travel, our goods travel, even bacteria and viruses travel. Let us hope that this will never happen again, but we must be prepared for such threats.”