Where are we with the Bergamo Covid investigation (and the three decisive points of the secret plan) – Corriere.it

on investigations for the management of the Covid epidemic, Joseph Remuzzi
director of the Mario Negri pharmacological research institute, reiterates al Courier what he had already said: Rather than placing the blame on this or that for managing dramatic moments that anyone would have had trouble dealing with lucidity, let us not forget that in the last thirty years it has been tried in all ways a dismantle the National Health Service. The so-called “Lombard model” was based on the logic of the market, free choice and competition: the complete opposite of what is needed in healthcare, where the market just doesn’t work. They noticed it in England (“our health system is sick but it can still be treated” writes the Lancet) and even in the United States. That logic has also contaminated public hospitals: if you pay you are assisted immediately, otherwise you wait for months or even years.

Yet, they continue to hold the court inquiries to shift the responsibility to this or that. In Bergamo, Milena Gabanelli and Simona Ravizza explain, the National Health Plan could be crucial in response to a possible pandemic emergency from Covid-19, which the then Minister of Health, Roberto Speranza, had recommended remain confidential.

The contents of the Plan – write Gabanelli and Ravizza – play a decisive role in assessing whether whoever has to decide at that moment has the knowledge and tools to do so. In early February 2020, before patient 1 was identified, Stephen Merlerthe mathematician of the Bruno Kessler Foundation (Fbk), one of the world’s leading experts in epidemiological models – who had already begun to study the spread of Covid in China before Christmas 2019 – had pointed out to the drafters of the Plan, that given the high transmissibility of the virus (R0 = 2.6, from Chinese data), even by implementing interventions that greatly reduce transmissibility but do not completely eliminate the disease, the impact on the health system could be devastating.

Based on scenery designed by Merler and to the real data of the last days of February 2020, the Bergamo prosecutor concludes: The contagion increased exponentially day by day, so it would not have been difficult to hypothesize right away what the trend of the epidemic could be in the days immediately following.

The second that already at 18 on 29.2.2020, i.e. 9 days after first positive of Codognothe limit of 1,000 positives that the Plan envisaged had been exceeded, in the worst and most serious case scenario, 38 days after the first case, meaning that the infections were now out of control.

The third is that the Plan envisaged the occupation of 60 beds in intensive care on 38 days, while in reality after 8 days the number of beds occupied in intensive care was already 64. It follows that the worst scenario hypothesized by the Plan was far from the harsh and serious reality, with the obvious consequence that since those days the CTS should have proposed, and the ministry adopted, much more incisive restrictive measures.

Meanwhile, however, in Rome, the Court of Ministers has filed the complaint of the victims’ families and of the grassroots union representatives who had asked to investigate the leaders of the Conte 2 executive (Giuseppe Conte, Roberto Speranza, Luciana Lamorgese, Lorenzo Guerini, Luigi Di Maio, Roberto Gualtieri and Alfonso Bonafede) for the spread of Covid-19. The reasons for the filing seem to clash with the prosecutorial system of Bergamo:

The archiving decree contains some passages in particular that seem to mark the fate of the Bergamo investigation, where it had been contested the crime of culpable epidemic (Article 438 of the Criminal Code). For this to happen, write the judges the conduct must consist in the voluntary or culpable propagation of pathogenic germs.. In the case under examination there is no doubt that the Prime Minister, the Ministers and the scientific consultants do not have possession of the virus nor have they spread it. A concept that can be applied not only to ministers but also to the other suspects by the prosecutor of Bergamo.

For the court of Rome the accusation of manslaughter is also unfounded: It should know the genesis of the infection of the individual victims and establish, beyond. any reasonable doubt, that containment measures that have not been adopted by the Government, or arranged late, would have avoided contagion and lethal outcome. But gScientific instruments are unable to ascertain such circumstances

Ultimately therefore, there were no great alternatives to the lockdown in the terms in which it started at the beginning of March 2020 : In a situation of uncertainty such as the one described above, it was not required of the government bodies to adopt outright measures capable of preventing any spread of infections that did not take into account the need to reconcile different interests and in particular the protection of health and the maintenance of the socio-economic fabric of the community. (…) it is reasonable to believe that an early lockdown would not have had the effect of avoiding the epidemic which cannot therefore be considered caused by government representatives.

Meanwhile, also the name of the two former health ministers Beatrice Lorenzin and Giulia Grillo (Renzi and Conte 1 governments) ended up in the register of suspects of the Bergamo prosecutor’s office for failure to update the Pandemic Plan. Also in this case the documents were sent to Rome but the only crime of refusal of official acts (article 328) punished with imprisonment from six months to two years (or one fine of 1032 euros) but which only in rare cases leads to a definitive sentence.

While waiting for the judicial outcomes, perhaps it is appropriate to meditate on Remuzzi’s gloomy forecast in the event of a new pandemic (We could even find ourselves in a worse situation. We have fewer doctors, fewer nurses, who are increasingly tired and less motivated) and on his suggestions about things to do: It would be enough to implement the National Recovery and Resilience Plan (Pnrr), which in mission 6 says in detail everything that should be done: “proximity networks, structures and telemedicine for health care territorial”, with community homes in which multidisciplinary teams and integrated home assistance operate (“home as the first place of care”). Even more important to prevent the drama from repeating itself: we cannot afford any more deaths after all that has happened. And then we need to put our hand to public health: it must really be for everyone, from Turin to Trapani, and work.

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