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Why did Covid-19 cause such devastating losses? Dispatches from Italy 04: The death reckoning of Bergamo

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Dispatches from Italy 04: Why did Covid-19 exact such a devastating toll on Italy? The death reckoning of Bergamo

The novel coronavirus set out from Wuhan five months ago, but the lack of transparent information left doctors around the world groping in a fog for this unpredictable virus. China underreported cases, covered up the outbreak, and threatened and intimidated the doctors and scientists who raised the alarm. By contrast, Italy, the first country in the Western world to suffer a severe outbreak, was not afraid to air its dirty laundry in public, as doctors, experts, mayors and regional governors faced journalists' tough questions head-on.

"Go back and tell your countries this information, fight for your countries, get prepared, and don't let the tragedy that happened in Italy repeat itself elsewhere." Carlo Palermo, president of the Italian Association of Medical Managers (ANAAO), held back his grief as he uttered these words of blood and tears. He hoped Italy's devastating sacrifice could offer the world some lessons and save more lives.

Many people were unable to be at the bedside of family members infected with Covid-19 when they died (photo / Cheng Chieh-yi)

The death of Bergamo

When the new campus of the hospital named after Pope John XXIII was completed in 2012, Bergamo never imagined that this advanced hospital would become a symbol of the battle against death.

Bergamo is the hometown of Pope John XXIII. The hospital named after him has more than 4,000 employees. Beyond routine internal medicine and surgery, its pediatric organ transplant technology is second to none in Europe, and it has even performed heart surgery on fetuses still in the womb. It has 80 intensive care beds, and together with the beds at nine surrounding public hospitals, it should have been enough to care for the health of more than a million residents. Yet the novel coronavirus (Covid-19) outbreak crashed over Bergamo's medical system like a tsunami breaching a levee.

The feint to relieve the siege failed, and the virus raced toward the industrial and commercial heartland

Since the outbreak erupted in Italy at the end of February, Bergamo province has accumulated tens of thousands of cases, with more than 2,000 deaths. The largest facility, Pope John XXIII Hospital, took in the most patients. One doctor said that at the worst point, he had to issue more than 20 death certificates a day.

After "Patient One" was confirmed on February 20, Italy discovered that the novel coronavirus, commonly known as Wuhan pneumonia, had been smoldering for some time in the Po Valley in the north. It quickly ordered a lockdown starting February 23 of the small towns around Codogno, where the outbreak had erupted, confining more than 50,000 people to their homes in the hope of stopping the virus from spreading to the more densely populated and more heavily industrialized Milan, Bergamo and Brescia to the north.

The strategy of relieving the siege by attacking elsewhere did not work. Bergamo province's administrative level is like a "county" in Taiwan, with 243 municipalities under it, including the provincial capital of Bergamo. Its total population is 1.1 million, and the province covers 2,700 sq km, stretching from the edge of the Po Valley to the valleys of the Alpine foothills. It became the hardest-hit area in Italy. Starting March 3, the number of confirmed cases in Bergamo province jumped to first place nationwide, overtaking Lodi and Cremona, the main cities near Codogno, and then kept climbing.

For ordinary people, breathing happens without a thought, but now tens of thousands of people in Bergamo find even drawing a single breath difficult. Medical staff were run ragged, and funeral homes worked day and night. "We were not prepared. It wasn't just the city government; the regional government and the central government were all unprepared." Bergamo Mayor Giorgio Gori, in an interview with reporters, admitted to having underestimated the outbreak and failing to deploy epidemic prevention measures in advance.

Starting March 3, the number of confirmed cases in Bergamo province jumped to first place nationwide (photo / Cheng Chieh-yi)

The health minister's ignorance: banning flights from China while dragging in Taiwan

After two Chinese tourists from Hubei were confirmed infected with the novel coronavirus in Rome, Italy declared a national state of emergency on February 1. It looked like a major epidemic prevention move, but it was just a feint.

Health Minister Roberto Speranza not only lacked a background in medicine and public health, he also had no grasp of geopolitics. When he banned direct flights from China, he also grounded flights from Taiwan. The planes sat on the tarmac, but the virus kept invading through the open EU borders.

After Wuhan reported a mysterious pneumonia at the end of December last year and confirmed it was a novel coronavirus similar to SARS, Italy's Ministry of Health issued a warning. The Lombardia region, home to industrial and commercial hubs such as Bergamo and Milan, held a series of meetings. Doctors clearly pointed out that the number of intensive care beds was insufficient, but the central and local governments delayed in assigning hospitals to prepare for battle, and did not begin stockpiling medical equipment such as masks, face shields, protective suits and ventilators.

After the outbreak exploded in Codogno, doctors at Pope John XXIII Hospital wrote to the Lombardia government, asking it to free up several hospitals specifically to treat novel coronavirus patients, but still no one paid any attention.

They wouldn't let Bergamo stop, but the virus ran faster

The virus overran neighboring cities, and 20 people in Bergamo were confirmed infected, so residents began to go out less. But Mayor Gori still was not alert to the outbreak. Instead, he was more worried about business activity grinding to a halt. On February 26, he was still posting on Facebook, sharing a photo of himself and his wife eating pizza at a restaurant: "I believe the virus will not bring Bergamo to a standstill. We who love this city must give it courage and vitality." Two days later, videos shot by the Bergamo industrial association, titled "Bergamo Never Stops" and "Bergamo on the Run," were still circulating online, urging residents to keep safe social distance but not give up normal life.

As the outbreak spread, the mayor still said the virus would not bring Bergamo to a standstill (photo / Cheng Chieh-yi)

But the virus ran faster. Mario Rizzi, head of the infectious diseases department at Pope John XXIII Hospital, seemed to let out a cry of anguish: "The infection is spreading rapidly, we don't have enough beds, and the intensive care unit is almost full." The doctors' cries were drowned out by the bustle of cafes and restaurants and the roar of factories. The virus kept racing on. By the time politicians understood how serious the situation was, and shops were willing to close and businesses were willing to shut down, the tiger was already out of the cage and could not be stopped.

When Gori was enjoying pizza at the restaurant, some people had already noticed that cases were soaring in Nembro and Alzano Lombardo in the Val Seriana, and demanded that they be designated red alert zones just like Codogno and other towns. But industrial activity was thriving there, and neither the central nor the local government wanted to bear the responsibility for damaging business opportunities. In the end, when the nationwide lockdown came, the virus could no longer be stopped. "Declaring a red zone now is meaningless. It's like closing the barn door after the cow has already run away." Giulio Gallera, head of the Lombardia region's health and welfare department, did not even have the will to mend the fold after the sheep were lost.

Watching the people around them fall ill and be hospitalized, shops in Nembro and Alzano Lombardo surrendered to the virus and closed their doors on their own, sacrificing revenue in the hope of reducing gatherings and curbing transmission. But the rising death toll day after day still pierced the hearts of the people of Bergamo like a sword.

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