MILAN — These days, the ping of a new text message sends a shiver of anxiety down Paola Pedrini’s spine. A family doctor in the Italian city of Bergamo, Pedrini, 38, has started receiving near constant updates from medical colleagues — not about their patients, but about their own health.
One recent morning, she received three texts in quick succession, letting her know of fellow doctors who have ended up in intensive care after being infected with COVID-19. A fourth message notified her that a colleague, Mario Giovita, had died at the main hospital in Bergamo, one of the epicenters of the coronavirus outbreak.
As the weeks drag on, doctors and nurses are increasingly bearing the brunt of the country’s fight against the spread of the virus — and authorities are failing to provide the resources to protect them and their patients, said Pedrini, who heads the Italian Federation of General Practitioners.
“We are like soldiers on the front without weapons,” she said in an interview over the phone. “If a normal person risks infecting two other people, we, family doctors for example, risk infecting 10, if not more. We see many patients, especially the elderly. It is too risky.”
Since the start of the outbreak, at least 2,300 health care workers have been infected by COVID-19, ending up in beds in their own hospitals. In Bergamo alone, some 110 doctors have fallen ill. In the wider region of Lombardy, one of the most severely affected regions, for every 100 infected people, 12 are health care workers.
Pedrini said she ended up having to buy her own protective equipment at an exorbitant price.
“We have a big problem with the protection of health workers,” said Filippo Anelli, the president of the doctors union in Italy, who said there was a shortage of personal protective gear — including masks, gloves and overalls — in the region’s hospitals. In the clinics in surrounding areas, there is often none available at all, he said.
“On the one hand, there are bureaucratic problems,” said Anelli, citing the difficulty of finding suppliers and getting equipment across borders, where they have been blocked by customs.
He also blames a lack of foresight by the authorities, saying they should have prepared in early January, when the virus was causing similar supply issues in China. “The institutions weren’t ready to face an emergency of this type. It was a superficial mistake.”
A man works in a new coronavirus hospital in Italy | Antonio Masiello/Getty Images
Pedrini, the family doctor, said she ended up having to buy her own protective equipment at an exorbitant price. Meanwhile, the doctors’ union of Lombardy has launched a fundraiser and called on citizens to pitch in to buy protective gear and distribute them throughout the region.
Not a ‘hero’
Beyond protecting their bodies, many doctors are also struggling to ward off the heavy toll it has taken on their personal lives.
Many are being subjected to grueling shifts in hospitals that were already understaffed before the epidemic.
“In Lombardy, these women and men are working shifts that sometimes last between 24 and 36 hours,” said Anelli. “They have great passion, but it is not enough. We cannot afford sick, tired and unprotected doctors and nurses. Without their lucidity, we risk even more.”
Because people are only tested after they display symptoms of the disease, many doctors and nurses may not know when they are infected until it is too late, contributing to the spread of the virus, he added.
Luca, a nurse from Lombardy who asked to remain anonymous, became a father a few months ago and has not seen his daughter or wife for three weeks. He lives with a colleague.
A medical worker tends to a patient at the a coronavirus intensive care unit in Lombardy, Italy | Piero Cruciatti/AFP via Getty Images
“I miss them, but I don’t want them to get sick because of me,” he said. Because of shortages, he added, some staff have had to use surgical masks that are “not suitable for preventing infection.”
Over the past week, videos of Italians celebrating the work of medical workers with long rounds of applause have gone viral on social media. But while Luca appreciates the recognition, he said doctors urgently need more tangible support.
“We are happy to have the support of the citizens, but we don’t want to be considered heroes,” he said. “We just want to do our job safely and to be able to embrace who we love again.”
The health workers’ union of Lombardy has vented its frustration with a hashtag — #eroiunaminchia, which loosely translates as #notaf**kinghero). In a statement published earlier this week, it said health workers feel abandoned by a system that has already exploited them beyond their limits.
It also lashed out against the fact that medical staff aren’t systemically tested for the virus, saying: “What makes us even more upset is the fact that in the major soccer league, if one player tests positive, they test the whole team and their staff. What about us?”
Emotional toll
The isolation requirements for infected patients are also thrusting doctors into the difficult position of having to provide emotional support to patients who aren’t allowed to see family or friends.
Looking a patient with COVID-19 in the eye and trying to calm their fears of dying by suffocation alone in bed is incredibly difficult, several doctors who asked to remain anonymous said.
Several hospitals have opened help desks to provide psychological support to frontline doctors and nurses.
In a recent interview with the newspaper Il Giornale, Francesca Cortellaro, head of the emergency room of the San Carlo Borromeo hospital in Milan, told the story of an older woman who wanted to see her granddaughter at all costs.
“I pulled out my phone and made a video call. They said their goodbyes and shortly after, the woman passed away. Now I have a long list of video calls. I call it ‘the farewell list.’”
Several hospitals have opened help desks to provide psychological support to frontline doctors and nurses wrestling with the emotional toll of their work, as well as extreme fatigue and the fear of making mistakes or becoming infected.
The national government — engaged in a blame game with the local regions, which are in charge of health policy — has also made moves to step up its support for doctors.
It launched a series of measures to encourage the production of protective equipment in Italy and signed a new bill, known as “Cura Italia,” that will fast-track the process for medical students to get their degrees, bypassing the need for a state exam.
The new measure is expected to create 10,000 new doctors and help swell the ranks. In Lombardy, hospitals are bringing in doctors and health care workers from China and the United States, according to Giulio Gallera, the welfare councilor for Lombardy.
A medical worker tends to patients inside a coronavirus intensive care unit | Piero Cruciatti/AFP via Getty Images
Guido Marinoni, the president of the Bergamo Medical Association, said he hopes the rest of the world is paying attention and can learn from what Italy got right and what it didn’t.
“We have done an extraordinary job with the increase in ICU beds. But we also made serious mistakes: We should have closed down everything as soon as there was the outbreak at the first breeding ground in Codogno, on February 21, and we should have monitored and helped family doctors more to protect themselves and the population from the virus.”
Italy should also have systematically tested everyone at the start of the outbreak, he said.
“Today doctors have to be tested, citizens should just stay home and respect the rules. If we had done it 15 days ago, we wouldn’t be at this point.”
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