VO, Italy (AP) – Italy delivered the first shocking confirmation of locally transmitted coronavirus infections outside of Asia on Sunday, with back-to-back revelations of cases more than 150 kilometers (nearly 100 miles) apart in the north of the country. country.
First, a 38-year-old man in Codogno, an industrial town in the Lombardy region, tested positive for COVID-19, forcing panicky residents to pick up their children from school, stock up on supplies at supermarkets, and in vain for surgical masks at pharmacies.
By the evening of February 21, a 77-year-old retired roofer from Vo, a wine town in the Veneto region, had died – at the time the first known fatal accident from a locally transmitted case of the virus in the West, which set alarm bells everywhere.
In the days and weeks that followed, densely populated Lombardy would become the epicenter of Italy’s outbreak, and by the end of March countries around the world would be shut down to slow the spread of the virus that has now claimed 2.4 million lives. But Vo, as one of the first cities in the West to be isolated, has a unique story and offers some of the first scientific insights into the deadly virus.
Adriano Trevisan’s death caused shock waves through the city west of Venice. Trevisan, known in the Vo area and a regular at a card game at a local bar, had been hospitalized for two weeks due to circulatory problems linked to a heart condition that, according to his physician, Dr. Carlo Petruzzi, could not be resolved with drugs. . There was no reason to suspect the coronavirus – as the retiree had not been in contact with China, a key element in diagnosis until then.
After being notified of the death, Mayor Giuliano Martini, who also serves as the town’s chief pharmacist, ordered the closure of schools and non-essential businesses and forbade residents to leave the town, even to to work. He asked local volunteer groups to ensure that food and pharmaceutical supplies entering the city were brought to the shelves. The town’s three GPs were quarantined for suspected contact, and the nearest hospital, a 30-minute drive away, was closed.
“It was like a war movie,” said Martini. “We were all alone.”
Surrounded by vineyards and farmland, the town of 3,270 people, nestled against Monte Venda, has long enjoyed rural isolation. But three days after Trevisan’s death, isolation was secured by a government decree: Rome sent soldiers to seal the city’s 12 entrances. Blockades were also set up around the 10 cities near Milan, where the other early case of local transmission was confirmed.
“There was a sense of bewilderment, I would call it,” said Dr. Luca Rossetto, one of the practitioners in Vo. “Even myself, with an old specialization in preventive hygiene, should have the right mindset. But there was an absolute disorientation. “
Rossetto reviewed his recent cases and realized he’d seen seven people with pneumonia-like symptoms in the past few days. A week later, the 69-year-old doctor was himself hospitalized with the virus, a minor case from which he recovered.
Veneto government, Luca Zaia, meanwhile, instinctively ordered general tests for all residents of Vo, with the aim of understanding the origins of the outbreak. The fact that he was even able to make such a call is thanks to the foresight of the virologist Andrea Crisanti of the University of Padua, who ordered the necessary tools after the virus emerged in China. Many places around the world struggled to set up tests so quickly.
Crisanti realized it would make sense to test the entire city immediately after the contamination was confirmed and then again after two weeks. And his work provided early insight into how the virus spread – clarity that Crisanti says was never properly put into action.
The results of the first round of nasal swabs, available February 27, showed that nearly 3% of the population was infected. That indicated that the virus had been circulating in the city since the end of January, according to Crisanti.
“With that data, we should have shut both Veneto and Lombardy immediately,” Crisanti said. But decision-makers, he said, “failed to see the magnitude of the problem.”
The question of whether more movement restrictions should have been put in place earlier has been hotly debated in Italy, with many politicians noting that such decisions were extremely difficult, given that the measures entail high economic and social costs and encroach on freedoms. There is even a criminal investigation into whether officials have waited too long to shut down two cities in Lombardy.
Turning off Vo proved remarkably effective in stopping the broadcast. When Crisanti ran the second round of testing on March 7, no new cases were discovered.
Crisanti said the findings – published in June by the journal Nature but immediately known to Italian officials – made it clear that isolation and mass testing were the best way to control the virus before vaccines.
Although Crisanti did manage to convince the Veneto region to step up testing, it wasn’t until March 9-17 that the virus was detected simultaneously in two Italian regions, with cases multiplying and a massive exodus to the south – that was then Prime Minister Giuseppe Conte ordered the whole country to an almost total lockdown that would last seven weeks.
By the end of May, when cases began to decline in Italy, more than 232,684 people had been infected, mostly in the north, and 33,415 had died.
Scientists still don’t know how the virus got into Vo.
Although hit at the same time, Veneto fared much better than Lombardy, which became the epicenter of both peaks in Italy. It has half the population and the industry is more dispersed, but experts have also yielded to the health system, which allows for close contact between GPs, district administrators and hospital officials and relies less on private facilities. Another important element in the fight against viruses was the Crisanti test system.
Crisanti urged the government in Rome in August to expand its nasal swab testing capacity in hopes of keeping transmission low after a successful lockdown. While the government has done so, Crisanti is disappointed to have relied heavily on rapid testing – as many other places have and as some experts have recommended – rather than strategically deploying more reliable nasal swabs to isolate outbreaks.
In October, Italy fought a resurgence that proved even deadlier than the spring peak, with a toll now reaching nearly 95,000. New clusters of a variant first found in Britain have led to local lockdowns across the country, canceling one of the virus anniversary commemorations in Lombardy this weekend.
If the arrival of the virus took the country by surprise last February, the long-awaited autumn resurgence was “madness,” Crisanti said.
Vo also suffered from a revival that is only now diminishing. The city’s pandemic death toll has doubled to 6.
With an unusually high number of restaurants per capita at 45 eateries, Vo is now an echo of his former self. The weddings, baptisms, and first communions that drew residents of nearby towns to the hilltop town were limited by restrictions. Restaurant closures also forced the Vo wine cooperative to cut production by 2020. The local dance hall has never reopened.
It could be different, Martini thinks.
“The virus in Vo has arrived in Vo and died in Vo,” the mayor said a year ago of the first cases. Failure to repeat the model: “Ruinous,” he said.