Fewer deaths in Veneto offer clues to fight coronavirus

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When Lombardy and Veneto recorded the first local cases of coronavirus transmission in Italy in late February, the two regions quickly erected roadblocks, establishing the first lock in Europe and a precedent for the rest of the continent.

Since then, the fortunes of the two wealthy neighbors, who have some of the best-endowed healthcare systems in Europe, have tragically diverged.

Struck by an invisible human catastrophe in Europe outside of the war, with military trucks carrying corpses from the city of Bergamo, Lombardy has a death rate of 17%.

But the Veneto represents a little more than 5%. Although virologists warn that the percentage of mortality is closely linked to the level of tests, they also attribute the deviation to other factors, such as the reluctance of Veneto to hospitalization compared to its neighbor.

“The Veneto has a very low mortality compared to the rest of Italy,” said Professor Andrea Crisanti, a virologist from the University of Padua, responsible for a mass testing program across the Veneto. “It shows that our approach has worked well so far.”

On Wednesday, Lombardy, which has 10 million inhabitants, represents 7,593, or 57.7%, of the total number of deaths declared by the virus in Italy, or 13,155. Meanwhile, Veneto, which has 4, 9 million inhabitants, recorded 499 official deaths out of 9,625 diagnosed cases.

Higher levels of screening and screening in Veneto are the most frequently cited explanation for why the region has managed to control its epidemic more effectively than its neighbors.

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Luca Zaia, Governor of Veneto, was the first regional official in Italy to design an extensive test program involving swabs at the wheel in cars and tests in medical centers.

They acted in direct contradiction to the guidelines of the World Health Organization, which only advise to test the sick. On the advice of scientists in the region, Veneto has carried out 112,746 tests to date, the second highest in Italy after 121,449 in Lombardy, despite half its population.

Yet experts say tests are not the only reason for the decline in the death rate.

Venetian doctors also cite the region’s expertise in infectious diseases, which they recall from its pioneering history of viruses arriving in its port from the east. The word quarantine derives from quarantena, the Venetian word for “forty days”, or the amount of time that ships arriving from plague-ravaged destinations have been isolated.

For Giorgio Palù, one of Europe’s leading virologists and scientific advisor to the Governor of Veneto, a critical factor has been the number of patients diagnosed in hospital.

Professor Palù said that the hospitalization rate in Lombardy, which means that the number of diagnosed patients who are treated for clinical treatment at the start of the epidemic was around 65%.

This compares to 20% in Veneto, where the majority were asked to stay at home, unless urgent care was needed.

“There were different instructions given to the sick by the different regional health authorities,” he said. “Yes, there have been more tests in Veneto, but people have been kept at home and have not been hospitalized. The more patients you admit to the hospital, the more cases you receive. You create the epidemic like in the beginning, nobody was in the business of sampling doctors or nurses, [so] you take the infection home. “

His observation comes after more than 60 Italian doctors and health workers have died, the majority of them in Lombardy. A group of doctors from Papa Giovanni XXIII Hospital in Bergamo last month warned that hospitals have become the primary source of transmission of Covid 19 infections and urged more patients to be treated at home.

Doctors and nurses on the front line in the fight against coronaviruses in Rome, Bergamo and Brescia

Doctors and nurses on the front line in the fight against coronaviruses in Rome, Bergamo and Brescia © Domenico Stinellis / Antonio Calanni / Luca Bruno / AP

“We learn that hospitals may be the primary carriers for Covid-19,” they wrote in the New England Journal of Medicine. “They are quickly populated with infected patients, which facilitates transmission to uninfected patients.”

The Veneto region has an extensive network of small health centers, which have been used to diagnose and treat patients so that they are kept away from large hospitals, said Professor Palù.

The fact that Lombardy has a higher proportion of private hospitals than Veneto has also contributed to more Covid-19 patients ending up in hospitals, he argued. The Lombard administration is also under political pressure, he added.

“In Lombardy, there were too many admissions on the primary side, where triage was done. At first, the Italian Prime Minister criticized the hospitals in Lombardy, and it seems that they reacted by wanting to show that they were treating people, without telling them to stay at home. “

The Lombard authorities also said that Rome should have done more. “I put my mask on television, and they insulted me and told me that I had undermined Italy’s credibility,” said Governor of Lombardy Attilio Fontana this week. “Maybe I should have been harder to oppose the [central] government. At the end of last month, Lombardy set up teams of doctors to monitor patients discharged from the hospital at home.

At the moment, the mood is bleak in both regions.

“Have we made mistakes? Of course, we did, “said Giulio Gallera, head of welfare for Lombardy last week. “We have always done our best to provide the many people who have come to our hospitals with the care they need. . . we did our best. “

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