The COVID-19 pandemic response and its impact on post-corona health emergency and disaster risk management in Italy

Abstract

BackgroundThe COVID-19 pandemic has profoundly impacted societies, influencing countries' Health Emergency and Disaster Risk Management (H-EDRM) systems. By taking Italy as a case study, this research aimed to investigate the response to the COVID-19 pandemic, focusing on the changes made to the existing H-EDRM system, with an emphasis on human resources, health service delivery, and logistics and the forward-looking strategies for the next health emergencies and disasters.MethodsWe performed a retrospective observational case study using qualitative methodology. Data was collected via semi-structured interviews and analyzed considering the World Health Organization (WHO) H-EDRM framework. Multiple interviewees were selected to obtain a holistic perspective on the Italian response to COVID-19. Stakeholders from five different sectors (policy-making, hospital, primary care, third sector, lay community) from three of the most impacted Italian regions (Piemonte, Lombardia, and Veneto) were interviewed, for a total of 15 respondents.ResultsResults on human resources revolved around the following main themes: personnel, training, occupational health, and multidisciplinary work; results on health service delivery encompassed the following main themes: public health, hospital, and primary care systems; results on logistics dealt with the following themes: infrastructures, supplies, transports, and communication channels. Lessons learned stressed on the importance of considering pragmatic disaster preparedness strategies and the need for cultural and structural reforms. Stakeholders mentioned several implications for the post-pandemic H-EDRM system in Italy.ConclusionsFindings highlight that the interconnection of sectors is key in overcoming pandemic-related challenges and for future disaster preparedness. The implications for the Italian H-EDRM system can inform advancements in disaster management in Italy and beyond.

Exploring Italian healthcare facilities response to COVID-19 pandemic: Lessons learned from the Italian Response to COVID-19 initiative

“…Strengthening primary and community care services might contribute to reducing the surge of avoidable hospitalizations for Ambulatory Care Sensitive conditions (ACSCs) that persist in the long term after disasters, as it was shown in a recent literature review ( 29 ). Furthermore, the respondents considered adequate training of HCWs as fundamental to guarantee safety and protection and to face the impact of the pandemic, reflecting findings reported in previous studies ( 30 ). Concerning HCWs' wellbeing, a relevant challenge identified in this study was the significant psychological stress to which the staff was exposed during the first pandemic wave.…”

“…This is mainly attributable to the increased workload together with the shortage of adequate PPE and the absence of an evidence-based treatment ( 24 , 25 ). The lack of adequate training ( 30 , 31 ), the fear of contagion ( 32 ) and the management of quickly deteriorating patients ( 32 – 34 ) are additional factors mentioned in the literature.…”

“…The effective management of the challenges that the COVID-19 pandemic posed to the Italian health system required multisectoral and multidisciplinary collaboration to be solved. Recent findings shown that the interconnection of different sectors (e.g., PHC, hospital and third sector) with a decentralized distribution of services to primary and community care was key for overcoming challenges posed by the COVID-19 pandemic ( 30 ). Within the context of multisectoral collaboration, strong relationships between healthcare facilities and the third sector represented an irreplaceable strategy to face the pandemic disaster during the first wave.…”

The Fallout of Catastrophic Technogenic Emissions of Toxic Gases Can Negatively Affect Covid-19 Clinical Course

“…Эти данные особенно поражают, если сравнить общий уровень смертности с показателем за предыдущие 5 лет. Подобный необъяснимо высокий уровень смертности в условиях столь грамотно организованной системы здравоохранения, как в Ломбардии, признанной одной из лучших, если не самой лучшей в стране [2], безусловно, требует убедительного объяснения. Существует предположение о потенциальной негативной роли загрязнения воздуха микроскопическими взвешенными частицами (PM-10), наблюдаемого в Ломбардии [3] и некоторых соседних регионах, также серьезно затронутых пандемией COVID-19.…”

“…This situation is particularly troubling if the general mortality rate is compared with the one that prevailed in the previous five years. This inexplicably high mortality rate in the context of a very well-developed health care system such as the one in Lombardy – largely recognized as one of the best, if not the best, in the country [ 2 ] – certainly calls for a satisfactory explanation. Some experts have directed their attention at the potential negative role of PM-10, which are overrepresented in Lombardy [ 3 ] and some neighboring regions also significantly affected by the Covid-19 pandemic.…”