Miracle a Padua? As the toll of the virus pandemic continues to worsen in the world, this Venetian province offers the first “glimmers of hope”, as the experts who are managing the emergency define them. In the last decade of February, when the epidemic began in the outbreaks of Codogno in Lombardy and Vo 'Euganeo in Veneto, this part of the northeast seemed doomed to disaster: Padua was the second most affected province in Italy, after Lodi, in the number of infected, hospitalized and deceased. A month and a half later, the disease is not defeated, but at least here it is in a noticeable slowdown. The numbers go up every day, but the trend is clear: Veneto has one third of the victims of Emilia Romagna, half of Piedmont, one fifteenth of Lombardy. And within the region, Padua suffers much less than Verona, which has more than double the deceased. Objective data, which make this city a model to study. Starting with a possible miracle. The experimentation of a new therapy based on human generosity and solidarity: healed patients who donate their antibodies to treat seriously ill people.
“The experimentation has already started,” announces Giustina De Silvestro, the director of the transfusion medicine service, who is also a professor of immuno-hematology: “The first donor was one of our specialists, who was among the first infected and was cured. All the plasma collected among the volunteers must be subjected to the tests prepared by the scientists of our university, who have made the work more difficult: one must be certain that there are antibodies, but not the virus or other pathogens. We aim to make the first transfusions, effective and safe, next week, as collateral therapy for severe, but not very serious cases, which according to virologists could respond better “.
The doctor, born in the Belluno mountains, graduated in medicine with double specialization, has always worked in public health and since 2003 is the “blood queen” in Padua, where she leads a team of 70 technicians and researchers.
Only these transfusions in intensive and subintensive therapies, also started at the Pavia hospital after contacts with Padua, will be able to measure the effectiveness of the blood donations of the healed. But hope is great: “In recent years the same technique has been used against the viruses of Sars, Mers and Ebola”, explains the director. “My first therapy, as a young doctor, was just this: we used the plasma of the healed to prevent the leukemic children from getting sick with chicken pox.”
In Padua doctors, nurses, professors and researchers are used to working together in the same structures. “A strength of this city is the consolidated operational alliance between hospital and university, between medicine and science,” explains the rector, Rosario Rizzuto, of a university with over 2300 professors and two thousand researchers and doctoral students. The rector, who is a doctor, is responsible for the arrival in Padua of Professor Andrea Crisanti, a world-renowned virologist who extinguished the first Venetian outbreak by multiplying the swabs. “In China, antibodies and experimental drugs have given encouraging, but not conclusive results,” warns the scientist, “so the only way to reduce the infection is active surveillance: test all people at risk and isolate cases positive. ” In the first 40 days of emergency, more than 60 thousand tampons were performed in Padua alone: two thirds of the regional total, one eighth of all Italy, including Lombardy. In nearby Verona still at the end of March it was difficult to exceed 400 tampons a day, so two thirds of hospital employees remain out of control, almost all family doctors and even nurses and doctors of the many hospices killed by the virus. “We are at home with a fever and a cough, but they are not giving us a swab,” dozens of GPs report in the messages sent to the Espresso. Padua looks like another planet. “At the end of March, we exceeded four thousand tampons a day,” replies Dr. Daniele Donato, medical director of the large public hospital in the city, which has 1723 beds. «In the next few days we expect to exceed ten thousand, thanks to a new powerful machine with 7 thousand tests per day. It has already arrived: we took it to Holland, we are installing it “.
Another crucial point: the infections within hospitals, which also massacre in rich and efficient regions. 7,276 people work in the hospital in Padua: on March 30, only 18 were infected in the ward. “In total we have 95 positive operators”, points out the health director, but most of the cases are due to “external causes: relatives, friends or periods of work in other hospitals”. “Between February and March, the hospital tested 5,385 employees, 74 percent of the total, in the most risky cases with 3 or 4 swabs each.” The checks continue: only the staff who has no contact with patients are missing.
In the history of the emergency in Padua, then, a circular with an unbureaucratic date jumps to the eye: Sunday 23 February. Two days earlier, in Codogno, the first Italian case of Covid-19 emerged. A few hours later the alarm goes off in the small Venetian hospital of Schiavonia. The same evening, in Padua, emergency measures are being prepared, approved on Saturday morning after an emergency summit with the governor Luca Zaia. And so, already that Sunday, the health management puts on line the instructions that too many other hospitals still struggle to comply with, even for lack of means: different entrances and routes for “infected suspects”; obligation for all staff in contact with patients to wear “protective suits, gloves, visors, shoes and masks with a special filter”. The next day, the tents arrive in front of the hospital: eleven now, patients at risk are visited there, “on average 400-500 arrive per day”. So the emergency room remains free, for all other patients, without the danger of contagion.
But why in Padua there are plenty of tampons that are scarce in the rest of Italy? Dr. Donato replies that “our luck is Professor Crisanti, who solved the problem before the emergency”. The scientist smiles: «It was January 15th. Two weeks earlier, China had communicated the new epidemic. On the 7th the genome of the new virus had been published. So in Padua we went ahead: we immediately bought the chemicals to make the reagents for half a million swabs ». Purchased in bulk before the disaster. At reduced costs: 30 euros per test, all inclusive. Without having to depend on private suppliers. Or from foreign products now blocked at customs. “There remained the problem of machinery to speed up and multiply the analyzes, but now that too is solved: it is called prevention”, minimizes Crisanti. That to the request to foresee, at this point, the next phase of the Italian tragedy, he answers with concern: «If the number of deaths will not begin to drop significantly, it means that the infection has moved from the streets into the houses. I think it is urgent to plan capillary controls in families: if a positive is forced to live with others in confined spaces, he must be isolated, otherwise they will all get infected. I fear that political authorities will have to organize themselves to requisition large hotels and campsites to house thousands of people for quarantine. It would also be a sensible way to help the tourism industry. Think of Venice: with sustainable spending, empty hotels could be transformed into protected residences. If the data doesn't change, I don't see any alternatives ».