The Hard Lessons Learned by the COVID-19 Epidemic in Italy: Rethinking the Role of the National Health Care Service?

Abstract

The dramatic events precipitated by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus pandemic have highlighted the limitations and contradictions of our country's current health care delivery model plagued by the closure of healthcare delivery structures, staff reductions, privatizations and inadequate funding which have been affecting the Italian National Health System during the past 10 years. The COVID-19 epidemic has a hefty bill: thousands of deaths -mainly elderly, hospitals overwhelmed, residential assistance structures reaching their limits, sick people left alone and uncared in homes, the disruption in life habits and an altered daily way of living never experienced before; all have contributed into making the ongoing tragedy even more painful. Herewith, we present and discuss the information and reflections from our experiences and postulate the rethinking of the established socio-health policies not only in Italy but also in other western countries which have failed to curtail the epidemic via conventional management approaches.

The Impact of the COVID-19 Pandemic on the Mental Health of Healthcare Workers in Italy: Analyzing the Role of Individual and Workplace-Level Factors in the Reopening Phase After Lockdown

“…Low trust in the workplace capacity to manage COVID-19 and having a reliable network of supportive colleagues at work were the factors with the strongest association. This is not a surprise considering that the financial cuts to the national health system left Italian health services with limited resources and personnel ( 8 ), and thus in a difficult position to face the pandemic effectively. This could also explain why the assignment to a new team and functions was associated with depressive symptoms in Italy but not, for instance, in a country such as Spain that, although close to Italy in terms of organization of services, did not experience the same lack of resources and personnel ( 36 – 38 ).…”

“…The pandemic has revealed the excessive optimism of these statements and has produced a shocking awareness in healthcare workers (HCWs) of the fragility and vulnerability of the Italian healthcare system ( 8 ). During the first months of the pandemic, a substantial number of health professionals found themselves without basic personal protective equipment, with scarce opportunities to get tested for the virus, and with the additional challenges of working in a system with considerable organizational deficiencies that soon went into crisis ( 9 – 13 ).…”

The perception of professionals and users of the quality of care and respect for human rights in four outpatient care facilities of an Italian hospital during the Covid-19 pandemic

“…27 Under the impact of the pandemic, HW became dramatically aware of the organizational weakness and of the scarcity of resources that afflicted the Italian healthcare system, 28 daily facing the scarcity of personal protective equipment and diagnostic tests. 15,29 However, the data from this study seem to highlight that there is a sort of mutual trust between users and HW in all care facilities that were evaluated by the research in May 2021. At least in the four facilities for outpatients (dermatology, oculists, pain therapy, and endocrinology) investigated, the perception of organizational well-being, job satisfaction (by HW), or satisfaction with the care received (by users) seems sufficiently high although not at excellent levels, even if the satisfaction of the users is even, and in some questions paradoxically, higher than that of the HW.…”

“…Under the impact of the pandemic, HW became dramatically aware of the organizational weakness and of the scarcity of resources that afflicted the Italian healthcare system, 28 daily facing the scarcity of personal protective equipment and diagnostic tests. 15 , 29 …”

Covid-19: Early Cases and Disease Spread

“…Travelers from and to China may have introduced the virus to several countries, notably France, Italy and the USA, either as tourists or for business. For example, the tight economic links between Lombardy and China might have contributed to the early Covid-19 epidemic in this region before the virus and associated disease spread to other parts of Italy [85,86]. The relationship between commercial trade and the SARS-CoV-2 spread was examined in Italy [87], European countries [88] and at a planetary level [89], showing that international trade should be considered as 'one of the main indicators of the COVID-19 spread' [89].…”