In recent months we had written that the lockdown had been more harmful than ineffective (v.articolo), but also that the coronavirus was already circulating in China at the time of the Basketball World Cup, of which a group played in Wuhan, the Women's Tennis Open and the Military Games, both held in the capital of Hubei between September and October 2019 (v.articolo). We had, more recently, talked about coronavirus knowledge well before December 31st (v.articolo).
The second part of the interview with prof. Bassetti brings significant confirmations to our investigations, but also enriches our knowledge as only an infectious disease specialist can do.
Professor, when did you first hear about COVID-19 or this new coronavirus?
Look, I was on vacation in the mountains around 20 December Indeed, perhaps a few days earlier: around the middle of December there had been the first reports in international magazines.
Since when did it circulate in your opinion?
It is very difficult to establish it. At first, I really believed in the Chinese, today I have to change my mind: they told us a lot of bales!
I believe that Chinese cases reasonably date back to around September-October 2019. Just at that time there was a series of major sporting events, including the Military Games. It is probable, in my opinion, that the beginning of the circulation of the virus can be traced back to that time, when many people went there (to Wuhan, ed.) and they have probably been infected.
The cases of RSAs, cruise ships, now also slaughterhouses. Why did the virus circulate in these environments so significantly? For management errors?
The slaughterhouses, as well as a Chinese market, are nothing but places where there is probably low attention to hygiene. If you go to look at what happens in a slaughterhouse, however much one tries to maintain adequate insulation measures and so on, I don't think you can use gloves, masks, etc. that much. So I imagine that in the Slaughterhouse as in the market there is a great closeness between people so even an infected person is enough for the virus to pass to others easily.
I repeat what I have said many times: we are in a phase in which we must beware of these outbreaks. However, one thing is an internal outbreak in an RSA that affects fragile people who can die quickly, another is an outbreak in a market or in a slaughterhouse. They have different pathological meanings.
Warning: we must always explain what "having an outbreak" means: for example, in China I do not know that there are people in intensive care who are dying. We are talking about asymptomatics: we must also see what value you can give to all this because today the WHO is in some way saying that asymptomatics are perhaps not as "transmitters" as we have thought in the last four months. So having a hundred people with a positive swab does not mean immediately having an outbreak: having an outbreak means having a hundred people going to the hospital with COVID or going to their doctor with symptoms compatible with COVID. We need to clarify this concept because otherwise we risk confusing things.
Which of all the measures taken in these months of lockdown have been really effective? I am thinking mainly of the closure of kindergartens if it made sense.
The most effective were those that strengthened the hospital network. These were the only ones that really made it possible to manage the problem: increase places in intensive care, hire doctors, nurses, health workers and in general strengthen paths, ambulances, buy fans, strengthen virology laboratories where to swab etc. . We were very good at this, I have to applaud.
As for the rest, we have closed schools but we have not closed the elderly at home. Where do you think we were the kids who didn't go to school? With grandparents! While people were back to work, where were the kids? If we want to argue that children are a problem, why are they the ones who carried the virus, where don't we put them? At home with grandparents ???
Children are not a problem, if they were, we would have made a mess! We said that at that time we had every intention of putting the children at home away from their grandparents, but the only measure taken was the closure of the schools, in a society like ours which is based on the extended family, with the grandfather, the uncle and maybe a parent.
The lockdown, specifically ...
In my opinion, many things done, as well as the lockdown, were excessive. We could have probably achieved the same results without devastating the economy of our country if we had said: "let's put on the mask!", "let's keep the physical distance!" or "we keep all the elderly at home and let immunized people out once a week!". All this we could have done by safeguarding the productive part of the country.
We are the last country to reopen in terms of ability to react. We are doing it too slowly: with the excuse of smart working, there is now a slice of people who have not done anything for months. This, I say even if I am not a politician, we cannot afford it!
Nobody has ever asked me as an epidemiologist what I think: therefore, those who have made certain choices will take responsibility for them.
The debate on Lockdown is not a debate that Bassetti does with her, it is a debate that is all over the world. What are the benefits? What are the risks? If you look at the world nobody has done like us. Germany did not like us. Spain did not like us. We are not talking about Switzerland where they have been very good at managing very large outbreaks. They have not closed the hotels, they have never closed the people in the house.
If you look at the law of the state, there is talk of "multiple places in intensive care" but nobody has dealt with one fundamental thing: "infectious diseases". With us, the last law made in Italy on infectious diseases is the 135 law of 1990 called "AIDS law": since then the departments have been built with a conception of 30 years ago which, evidently, is no longer suitable. Today they upgraded us on the fly while a Marshall plan should be made for investment in infectious diseases. Attention, not only in the wards but also in the staff, in the infectious disease culture in the area. You do this only with a law that provides for substantial investments: until you do this, you will always find yourself making makeshift interventions.
We need to make a long-term investment not in the short term: we have to think about investing in the next pandemic, ten years from now, not only for the second wave in the autumn. If not, maybe in just two years, we find ourselves without a pandemic plan, without places, without infectious disease specialists, etc.
A specific question for the defense sector: how can we manage large ships, barracks, so that the system is not blocked, so to speak?
In my opinion, we can apply solutions very similar to those that we use today in hospitals and that are also available outside. I mean that all the people who get on a ship could be tested to see if they have COVID and, therefore, somehow prevent the virus from entering.
It is clear that even a flu epidemic is not pleasant on a ship. The military should be vaccinated against the flu. Until there is a vaccine for COVID, they will have to do their part to prevent, to prevent the middle of the sea from having 15-20% of the positive crew. The only safe method is screening, that is to do the rapid serological test at the same time as the swab. Stuff from a few euros ...
There is no vaccine for other coronaviruses. Will this be the first?
This will be the first but all this will be possible because there is all previous work. There are people today who are surprised when you say that there will be a vaccine and there hasn't been one for the other coronaviruses before. There was no case for the Sars virus because it disappeared but all the work done did not go to waste but was recovered for the COVID.
Much of what we will soon have is not only related to this new coronavirus. It will be the result of all the previous work.
Images: Online Defense / web / US Navy