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I am online minute of meetings in Coronavirus of the Scientific technical committee of the government. About a hundred documents have been published on the website of the Department of Civil Protection, starting with those relating to the first meetings in January and February. In practice, a chronicle of the dramatic and difficult decisions that were made at the beginning of the epidemic, including the mistakes made (but this can only be said in hindsight).
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Some examples: on February 24, when the wave of contagion has already risen first in Codogno, then in other areas of Lombardy, Emilia and Veneto, the CTS understands that many more resuscitation places will be needed than are available in the country. But there is another conviction: if those numbers were, in fact, doubled, made public, there would be panic. For this reason, the minutes of February 24 said: the plan of organization of the Italian response to the epidemic: “must be completed, the part related to the preparation of resuscitation is still under discussion, a subject that will be submitted to the experts of the sector” ; The CTS reflects on whether the document should be circulated and explains: “There is consensus in recommending the utmost caution in the dissemination of the document to prevent the figures from reaching the press.” Even that day, the scientists observed: “It is noted that the quality of the data coming from the periphery is insufficient to define a precise epidemiological profile of the epidemic; therefore, the CTS recommends dispatching epidemiologists to areas with confirmed cases for detailed analysis.
And following international guidelines, a choice is reiterated that will later turn out wrong: tampons should only be made for those with specific symptoms. “In the absence of symptoms, the test is not justified because it does not provide a clinical indication of the case. The notifications of positivity not associated with symptoms determine an overestimation of the phenomenon in the country, causing the data to be not homogeneous with those published by the WHO ”. Also that day, accepting a request from the Regions because the hospitals ran the risk of running out of doctors and nurses, it is said that the health personnel who came into contact with positive patients could not quarantine, if they had used the Dpi (devices protection such as gloves and masks).
The next day, at Aeroporti di Roma, who would also like to measure the fever of departing passengers, the CTS responds that it is not necessary.
The minutes of March 1 stipulate the new rules of behavior “while the emergency lasts”: stop shaking hands, kissing and hugging “in interpersonal relationships.” In the most affected areas, it is also recommended to plan a “shift schedule, also hiring operators who carry out activities in other areas of the country.” The situation was still evolving and the recommendation is to strengthen surveillance in Regions with “cases attributable to known transmission chains” and “promptly adopt new containment measures.” At the request of the Liguria and Marche Regions, the CTS responded that “containment measures can also be applied to the provincial area, where there are local transmission outbreaks.” The Lombard situation had also led experts to request an increase in “places at the national level” and “in the shortest possible time, in accredited public and private structures.” The experts considered it necessary to activate a model of interregional cooperation coordinated at the national level. But also a regional increase of “50% of beds in intensive care. And 100% of the beds in the pulmonology and infectious diseases wards, isolated and equipped with the necessary equipment for ventilatory support. According to the experts, it was also necessary “to redeploy the health personnel assigned to assistance, providing a rapid training course of training in respiratory support for nurses and doctors, to be dedicated to the sub-intensive areas.” At the same meeting, a group of anesthesiologists and resuscitators is invited to be formed, to make it available to the territorial emergency system 112/118. Finally, the CTS considered it necessary to “redefine the triage routes of emergency rooms with areas dedicated to the temporary stoppage of suspicious patients”, identify “Covid devices”, define “a protocol for the execution of swabs”, increase laboratories, “define a security and surveillance protocol for healthcare personnel.”
On March 2, the CTS analyzes the data on infections in the municipalities of Alzano Lombardo and Nembro. Lombard councilor Gallera and the region’s director general, Caiazzo, are contacted, confirming a large increase in cases. Therefore, the Committee proposes «Adopt the appropriate restrictive measures already adopted in the municipalities of the red zone also in these two municipalities, in order to limit the spread of the infection in the contiguous areas.».
However, on the 4th of the month, the discussion is about school closings. The Health Minister asked for an opinion on the advisability of “closing schools of all levels throughout the country.” And the Committee registers that “the closure options must be proportional to the spread of the viral infection” and that “currently there are no data that irrefutably address the usefulness of closing schools regardless of the local epidemiological situation. Some predictive models indicate that the closure of schools could guarantee a limited reduction in the spread of the viral infection. There is consensus among professionals that it is estimated that a possible closure of schools will only be effective if it is of long duration. “” These technical considerations -is specified- they are only part of the evaluations with which to formulate decision-making options on the subject. “On March 5, the next day,” the CTS reiterates that the text prepared yesterday, referring to the suspension of teaching activity , does not in any way contradict the suspension decision adopted by the Council of Ministers “.
On March 6, the alarm was raised about the shortage of health personnel and the fact that many doctors are in quarantine or have been infected. Therefore, the CTS establishes that operators who have found themselves in contagious situations but who have a negative swab (which must be repeated every 5 days) can work, always with protection devices. The same is true for healthcare workers who, while reporting mild flu symptoms, have negative swabs and a temperature that does not exceed 37.5 degrees.
The next day, an assessment of the situation within the red areas is carried out and a differentiation between red and yellow areas is requested. “In the red areas there was a slight decrease in the increase of cases – says the report – which in turn corresponds to an increase in the incidence in areas that were not previously included in the red areas themselves.” A real alarm, which then led the Committee to call for the closure of all Lombardy, after having acquired updated data on the spread of the Coronavirus from the Istituto Superiore di Sanità. “The Scientific Technical Committee reiterates the need to take all the necessary actions to stop the spread of the virus”, writes the CTS that later asks to apply “more rigorous measures” than those foreseen throughout the national territory in Lombardy and in 11 provinces of Emilia Romagna, Marche, Veneto and Piedmont.
In the minutes of March 10, immediately after the start of the confinement, the CTS values ”the measures taken are consistent with the epidemiological situation.” The Committee also highlights the need for a legal norm that “protects the work of the members of the CTS in the exercise of their functions, in the conditions of extreme urgency and technical-scientific uncertainty in which the members are obliged to work.”
The next day the alarm is due to the delay with which the provisions given by the committee are applied. March 11 is also the day of the discussion about masks: it seems impossible to supply the entire population, so the line is to privilege social distancing and leave protection devices for the fragile categories, for health workers and for those who are. risk of contagion. Furthermore, the Committee stresses, the use of the devices by the entire population could generate a “false sense of security” that would lead to ignoring the other basic hygiene rules.
At the meeting on March 18, it was stressed that “the use of drugs of unproven efficacy must be managed within the framework of routes of approved protocols or clinical trials coordinated by Aifa. The CTS reiterates that any deviation from this path will occur under the direct responsibility of the doctor who prescribes these therapies and the hospital that provides the treatment.
While the possible scenarios for Phase 2 are on the table already on March 30. The CTS considers it necessary to extend the blockade throughout the entire Easter period. There would have been – the newspaper reads – “a first period with the continuation of the containment measures in force until April 3; a later period for the provision of a gradual relaxation, albeit guided by epidemiological evidence, of containment measures for a progressive return to normality ”. The following day the CTS agrees to extend the regulation at least until April 18, but at the same time it considers it necessary to consider the need to allow all subjects of developmental age to carry out motor and recreational activities in the open air: «too long», is written in the minutes.
Last updated: 17:36
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