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The first diagnosis
Annalisa Malara, a 38-year-old anesthetist from the Codogno hospital in the northern region of Lombardy, was horrified when she saw the image of Mattia Maestri’s lungs, a healthy and fit person of the same age, while undergoing a CT scan. on the morning of February 20.
“The picture was monstrous: in less than 48 hours, her pneumonia had transformed from something small to something devastating,” he said. “But the idea that this patient could be infected with such severity really surprised me: he was young, healthy, and athletic. However, this is also what helped make the diagnosis since the case was so surprising. “
Malara was looking at the lungs of “Patient 1” from Italy, the first confirmed case of domestic transmission of the virus in a country where it would kill almost 29,000 people. Until that day, Malara said, the coronavirus seemed so remote that it only occurred in China and other Asian countries while the rest of the world watched from a distance.
“Yes, we had guidelines and we talked about it, but nobody could have imagined that it would extend so far in Italy,” he said.
The test at the time was only for those who had returned from China, and Malara had to double the guidelines to order a Covid-19 swab for Maestri. When the result returned, it caused both the closure of the hospital’s emergency wing and a government order to quarantine the entire city south of Milan, marking Europe’s first coronavirus blockade.
Maestri had had typical coronavirus symptoms (fever, cough, and shortness of breath) for approximately 10 days before visiting the hospital for the first time. An initial radiograph showed that there was mild pneumonia in his right lung. They gave him antibiotics and asked if he wanted to stay in the hospital, but he declined. His symptoms worsened and a few hours later he returned and was admitted immediately and given oxygen therapy. Malara was called by her colleagues for advice during Maestri’s CT scan.
Another detail that prompted the test came up during a conversation with Maestri’s wife, who was eight months pregnant. Maestri had told doctors several times that his last trip abroad was to New York in September, but his wife recalled that a few weeks earlier he was dining with a colleague who had just returned from China. The colleague had no symptoms at the time and was negative for the virus.
The diagnosis caught Italy off guard, despite the country’s first cases being detected in late January, when two Chinese tourists tested positive in Rome. During the interim period, life had continued mainly as usual. There were occasional reports that an Italian “possibly” has the virus, only to have it turn out to be a false alarm.
Two days after Codogno was quarantined, nine other Lombardy cities were blocked, along with one in the Veneto region, where Italy’s first coronavirus death occurred.
Massimo Galli, director of infectious diseases at Milan’s Luigi Sacco hospital, said in the week after the diagnosis that the virus may have been circulating in quarantined areas in northern Italy for weeks before it was detected by the Malara test. .
Maestri recovered, as did his wife and the two Chinese visitors. Malara has spoken to Maestri on the phone and said she is doing well. He became a father a few weeks ago. But tragically, before being released from the hospital, his father died of Covid-19 in his hometown of Castiglione d’Adda.
Outbreak horror revealed
On March 3, Costantino Pesatori, the mayor of Castiglione d’Adda, one of the 10 quarantined cities, posted a video seeking help. Until that time, most people in Italy were still very confused about the largely unknown threat, at the time primarily known in the West through reports from China. The virus was killing people and beginning to overwhelm hospitals, but the early deaths seemed to reflect a similar pattern: older people with underlying health problems.
While the leaders of some towns and cities encouraged citizens to fight fear, going to bars, restaurants and shops, Pesatori knew better.
“I knew immediately how serious it was because from the day the epidemic was discovered in Codogno, people in my city were dying, “he said. “If you consider that two or three people die per day in a city of 4,600, this is not normal.”
Pesatori’s plea revealed details of the virus’s devastating impact, which until then had been mostly under radar. Eighteen people died in the city in less than fifteen days, including a 55-year-old man with no known underlying diseases. With three of the city’s five doctors quarantined and two in the hospital, there was no one to care for those who were sick at home.
“The situation was really worrying,” said Pesatori. “I understood that this was something new and difficult to deal with, but many mayors lacked support and, because people in other places did not understand how serious things were, they felt they were free to continue as always.”
Two military doctors were dispatched to the city on March 11, two days after the Lombardy quarantine, a move that led thousands of people to flee south. It was also the day that Italy became the first country to enforce a national blockade. At that time, 827 people in Italy had died and more than 12,000 were infected. It was a movement that many believed could never be ordered in a democracy without the means to compel its citizens, but within weeks it was repeated across the continent and around the world as the number of deaths increased.
While Pesatori was struggling to help his citizens, his family was beaten: his mother, who died on March 25, is among the 76 deaths in the city.
“I learned through all of this that you have to keep your value,” he said. “Despite my pain, I had to look forward, for our future generation, but also to ensure that health is protected.”
Although people are still in the hospital, both the emergency and contagion rates have decreased. “But the virus is still circulating, so we cannot completely let our guard down,” said Pesatori.
While the focus was on Codogno during the first two weeks of his confirmed outbreak, a more discreet drama played out in Bergamo, a province north of Milan. The first coronavirus case was detected in a hospital in Alzano Lombardo on February 23, but Bergamo only closed in with the rest of the Lombardy region on March 8. It quickly became the most affected province in Italy.
No more beds in Bergamo
“There are no more beds here.” These were the last words Ettore Consonni, 61, a retired warehouse worker, heard before falling into a coma at a Bergamo hospital.
Consonni was admitted on March 4, shortly after returning from the Dominican Republic, where he and his wife celebrated their 40th wedding anniversary.
Back in Italy, he began to develop symptoms of Covid-19 fever and shortness of breath. A test confirmed the worst.
At that stage of the outbreak, well-resourced hospitals in Lombardy and in the second worst affected region of Emilia-Romagna were struggling to cope, with intensive care beds declining as the infection spread.
In an attempt to manage the emergency, sick people were placed in operating rooms or hospital corridors, while others were flown by military aircraft to southern Italy.
When Consonni woke up after 23 days in a coma, he was in Sicily.
“I thought it was a joke,” he said. “I fell asleep in Bergamo, my city in the extreme north, and woke up in Palermo, in the deep south. I heard accents among the medical staff, but thought it was just the many Sicilian healthcare professionals working in Bergamo. Then they took me to the window and I saw it wasn’t a joke. “
Consonni shared a room at the Benfratelli hospital with other patients from the north. “The doctors told me that I almost died,” he said. “So I’m glad I don’t remember anything from those days.”
Finally released from intensive care, in early April he was breathing normally. A second test came back negative and on April 21, Consonni left the hospital to applause.
“I’m going to have Sicily tattooed on my skin because they gave me a second life here.”
Consonni came home with more applause from family and neighbors, despite noticing a peculiar expression on their faces. “I knew that something really bad had happened. My wife sat me down and told me that my brother had died of Covid-19. “
Consonni realized that while fighting for her life, life in Bergamo had fallen to a broken heart. Doctors compared the situation to war, and one doctor claimed that saving a life was decided by age and health conditions.
The sirens never stopped, the church bells rang for each of the dead. Coffins piled in churches and, with cemeteries full, some were brought in military trucks for burial in neighboring regions. The corpses of those who had died at home were kept in sealed rooms for days as funeral homes struggled to survive.
Death at home: the story of a daughter
“He died in my mother’s arms when she was on the phone, trying to get help,” said Asia Marchesi, 24. “Watching him fight for breath was like watching someone drown.”
Her father, Siro, is one of many who died at home, a silent figure that, as with deaths in nursing homes, has not been recorded in official statistics.
The 64-year-old man is believed to have contracted Covid-19 on February 22, when he visited the emergency unit of a hospital in the city of Bergamo for a foot infection.
“He had to take an antibiotic for that, but it was nothing serious, after a week he was better,” said his daughter.
He then traveled to the family’s second home in Liguria, but returned to Bergamo on March 6 after he began to feel unwell.
“From the moment he got sick the nightmare started.” Asia Marchesi made frantic calls to the helpline numbers and while waiting for an answer, she could hear her father’s breathing getting worse. His GP saw him and prescribed an antibiotic. Despite having all the symptoms and being immunosuppressed, a coronavirus test was not performed.
He died on March 13 and kept his body at home for a day and a half, covered with a sheet, while the family waited for a doctor to certify death. As with many other deaths in the home or in residential care, a post mortem test for Covid-19 was not performed.
Asia Marchesi struggled not to cry as she described her father. “Until the last moment, all he said was, ‘Asia, stop calling the doctors, I don’t want to bother you.'”
She added: “There is a consolation that we were with him in the end, as many people die alone in the hospital, but he died of such a terrible death. We feel abandoned. “
With forbidden funerals and physical estrangement in place, she, her mother, and two siblings living nearby were unable to be physically comforted by relatives and friends, amplifying her pain. “We couldn’t even … get a hug.”
Marchesi joined NOI Denunceremo (We will report), a Facebook group for relatives of victims seeking justice.
“People have unfairly lost loved ones,” he said. “Even if these are tough economic times, I don’t want financial compensation, as it won’t bring my father back.” What I want is for whoever made a mistake to take responsibility. “
Only ambulances in Milan
In normal times, Milan is the center of business and fashion in Italy. The Lombardy capital began emptying out shortly after the outbreak in Codogno began, but was not quarantined until March 9.
The only vehicles on the streets normally obstructed during the shutdown have been ambulances, especially at night, when Matteo Derai, 33, joins the hundreds of volunteers who answer the calls. Eighty percent of calls during the spike were to suspected Covid-19s.
“Nobody forces me to do this, but especially at this time we must be brave,” he said. “Only when my shift ends do I realize that I haven’t slept in 24 hours.”
His partner, Fosca, is a nurse on maternity leave who cares for her newborn son, Tommaso. When Derai returns home, after transferring suspected Covid-19 patients to hospitals, she lives in fear of bringing the virus to her family.
“About eight out of 10 patients I have seen were suspected cases of Covid-19,” said Derai, who works during the day for a watch company. “And you often have no idea what to expect when you get home. When I did my job before the outbreak, I was full of adrenaline. Now I’m scared.
“If before the outbreak, I tried to emotionally support people as well, now, when you’re so concerned about your own safety, you let this human connection slip away.”
It has been common for first responders to bring to the family hospitals of patients who have already received treatment or died of Covid-19. “We brought in patients who had already lost loved ones to the virus,” he said. “And they are well aware that they too will have to face the same type of odyssey.”
One, Derai said, was a woman who had lost her husband. “She told us that what surprised her the most was the silence without him and that she could be heading towards the same destination.”
He doesn’t know if the dozens of patients he brought to the hospital lived or died. Their duty ends when they are admitted.
“At first, I was curious to know if the mothers, fathers, husbands, and grandmothers I had met and talked to on the way to the hospital had recovered from Covid-19.
“Then when I saw the number of deaths increase day by day, I stopped wondering and preferred to live in the hope that everyone would survive alive. Even if I knew it was probably not true. “
The uncertain future
After nearly two months under lockdown, the longest yet of any European country, Italy will slowly begin to ease the restrictions on May 4. But as the health emergency diminishes, the next big challenge will be the economic one.
The prognosis is bleak. Experts predict a crisis not seen in decades. While industry across the country will resume from Monday, most retailers won’t reopen until May 18, while bars and restaurants, the backbone of the economy in so many Italian cities, will remain closed. Until the 1st of June. Many small businesses may never reopen.
Soemia Ira, 38, a street artist who previously made a living in Catania, Sicily, has not worked since the closing began and has no idea what the future holds for her.
Their livelihood depends on a vibrant street culture. “I live for meetings,” he said. “With no people around me, my job is done. I am at risk of extinction.
“I dedicated the last six years of my life to being a street artist, but Covid-19 can take it all away from him.”
The government has allocated € 3.3bn (£ 2.9bn) for small business workers, but this may not be enough. The first sign of economic turmoil came in late March, when reports emerged of social unrest in Italy’s poorest south and of people robbing supermarkets after they ran out of food and money.
Red Cross volunteers are now delivering food to those in need, but the mob has also been exploiting the situation by distributing food packages to the poorest districts in southern Italy.
Thousands in the coming months are at risk of unemployment. And with summer on the way, the pandemic will have a devastating impact on tourism, a crucial contributor to Italy’s economy, risking the closure of hotels, bars, restaurants and tourist services.
A few days after the closing, people from all over Italy sang and played music from their balconies as they gathered to say: “Andrà tutto bene ”(Everything will be fine). But lives have changed in recent months, and a different saying is gathering momentum: “No,” Ira said. “Not everything will be fine.”
