ROME (AP) – An author of a retracted World Health Organization report on Italy’s response to the coronavirus warned his bosses in May that people could die and the UN agency could suffer ‘catastrophic’ reputational damage if it allowed political concerns suppress the document, said emails seen by The Associated Press.
The comprehensive report examined how the Italian government and health system responded after the country became the epicenter of the European outbreak in late February – providing real-time data and case studies of what was and was not intended to help other countries prepare for the virus spread.
The agency removed it a day after it was posted on its website, prompting the official who coordinated the work to appeal directly to WHO chief Tedros Adhanom Ghebreyesus on May 28 and warn that the report’s disappearance has added credibility. of the WHO. He warned that further attempts at censorship would jeopardize the agency’s independence and relations with the donor countries that funded the research.
The handling of the report could trigger a “scandal of enormous magnitude – at a delicate time for the UN health service with the forthcoming COVID-19 investigation,” wrote Francesco Zambon, WHO’s chief field coordinator for Italy and its regions during the pandemic.
WHO did not immediately respond to a request sent late Friday for comment on Zambon’s email to headquarters.
The report, written by Zambon and a team of WHO health experts and consultants, was posted May 13 after it received the necessary approvals within the UN system, according to internal WHO documents seen by AP. The agency later said it was withdrawn due to “factual inaccuracies” that it had not detailed and denied that it had received any pressure from the Italian government to remove it.
Despite criticism that the removal of the report denied countries data that could have helped them avoid Italy’s fate, WHO said on Monday that it has offered another “mechanism” to assess pandemic responses. But that wasn’t rolled out until two months after the report was drawn.
Concerns over the missing report have grown in recent weeks, sparking criticism of WHO leadership over the global response to the pandemic, leading the agency to agree to an independent investigation into its performance.
The UN agency hates open criticism of top donor countries, even if their policies could undermine public health.
For example, during the early stages of the January outbreak, WHO officials were privately frustrated by the lack of information is shared by China, but publicly praised the country for its transparency. When the pandemic got underway in Europe, WHO scientists internally questioned Britain’s policies – as when it suggested it pursue “herd immunity” – but publicly emphasized their support.
The missing report has highlighted preparedness in Italy, where Europe’s deadliest outbreak occurred. In the hard-hit province of Bergamo, prosecutors seized it as part of their investigation into what went wrong.
Paradoxically, the report is not even particularly critical of the Italian government and officials are credited for their efforts, and at one point praised how they used data to counteract “sensational expressions of disagreement in talk shows” that sparked fear.
The text noted that the Italian Ministry of Health had not updated its pandemic influenza preparedness plan since 2006. The 2006 plan was only “reconfirmed” in 2016-2017 without being updated and was “more theoretical than practical”.
“Unprepared for such a flood of critically ill patients, the hospitals’ initial response was improvised, chaotic and creative,” the report said. “It took a while before formal guidance became available.”
The state-run RAI TV investigative report “Report” program has released emails showing that a top WHO official, Raniero Guerra, who worked as a liaison with the Italian government during the pandemic, told Zambon to “correct” that the plan for Italy was “updated” in 2016, even though the 2016 version was identical to the 2006 version.
Guerra was in charge of prevention at the Italian Ministry of Health from 2014 to 2017, when the plan should have been revised. He himself wrote to the then health minister that the plan needed to be updated, according to a copy of his 2017 memo seen by AP.
The WHO has said the Italian government has “at no time” asked it to remove the report, but now says it does not endorse it. “The decision to remove the document from the website was taken by the WHO regional office for Europe due to factual inaccuracies,” the WHO said.
Guerra told the Financial Times he did not get involved. He added that the 2006 preparedness plan actually did not need to be updated as no significant strains of flu had been identified since then and that the preparedness plan was irrelevant to the current pandemic as it was only intended to treat flu.
Deputy Health Minister Pierpaolo Sileri begged to disagree. “That plan was from 2006 and needed to be updated,” Sileri told Corriere della Sera newspaper. Guerra did not immediately respond to questions from AP, saying he was traveling.
The emails AP has seen suggest WHO officials were concerned that the report had upset Italians, as it offered a rare insight into the UN agency’s decision-making, which is not subject to requests for freedom from information.
In an email sent to Zambon on May 13, Guerra noted that Italy had just made a voluntary donation of EUR 10 million ($ 12.3 million) to the WHO and that negotiations between WHO and Italy to finance the office of Venice were about to begin.
“There are already signs of institutional unrest on the Italian side and unnecessary resentment against the WHO,” Guerra wrote to Zambon on May 14, the day the report was torn.
A day later, the head of WHO Europe, Dr. Hans Kluge, told Zambon that the “main issue” at stake in the controversy was his relationship with Italian Health Minister Roberto Speranza, who he said was “very disappointed”. through the report.
The Italian government, he said, feels that “they are under constant attack by the press and every word can be misinterpreted. They felt stepped in by a friend. ”
Kluge said he would make a proposal to Speranza to involve Italian health officials in a review of the report. “Fortunately we need MoH (Ministry of Health) and sign for Venice,” he said, referring to the funding for the office.
The ministry has informed RAI that it does not regard the report as a civil servant.
Meanwhile, Zambon warned Tedros and Kluge that lives around the world were being endangered by withholding Italy’s ‘lessons learned’.
“A large team of experts literally worked days and nights with one motivation: to make sure that what happened in Italy is not repeated in those countries that fall behind in the epidemic curve in time,” Zambon wrote to Kluge on May 27. “The report contains important messages, extrapolated from facts about what worked (many things) and the blind spots of the system.”
A day later, in a message to the WHO chief, Zambon warned of a “risk of catastrophic harm in terms of independence and transparency if a ‘censored’ version of the aforementioned publication is changed,” as well as “compromised” relations with the government of Kuwait, one of the WHO’s largest donors, had funded the research with a grant of $ 80 million.
___
AP Medical Writer Maria Cheng in Toronto and writer Jamey Keaten in Geneva contributed.
___
Follow AP’s pandemic coverage: http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak.