A virus that has morphed into a pandemic is bringing the world economy to its knees. Covid-19 is a phenomenon of epic proportions spreading at unprecedented speed; it is highly adept at evolving and has a powerful capacity for penetration, especially among the most vulnerable segments of the population. Experience thus far has shown that it is possible to fight back against a pandemic where an efficient healthcare system is in place, which explains the serious difficulties the United Kingdom is having, as is the United States, where Bill Gates has been contributing financially to public health for years as well as funding a study that actually predicted the pandemic risk. Clearly, that has not been enough.
It could be said that Italy is at the halfway mark, with a national healthcare service that has managed to hold up, but not entirely. There is no denying the extraordinary selflessness of all healthcare personnel, but serious errors have been made, especially the mistake of placing the burden of fighting the virus on hospital care and neglecting the strategic role of family medicine.
Furthermore, two strategic factors have failed to be effective: governance and investments. The former having been overly fragmented as a result of conflicts between central government policies and those of the regional administrations that manage healthcare – obviously a new balance needs to be struck.
Moreover, former cutbacks in national healthcare services were too radical and the results are being felt now in the form of shortages in medical personnel, especially medical specialists and nurses. The question is not only one of investing more resources in healthcare but also in research, as well as of having the foresight to provide new doctors and healthcare personnel with the proper training.
Many public and private research centers and some major industries have been responding to a call for cooperation in the massive effort to discover a treatment and a vaccine; the timeframe is surely not going to be brief but it may at least be shortened if such an approach prevails. There are those who envisage a vaccine within the year, but more is expected from the development of virus therapies, which evokes memories of HIV/AIDS, for example: a vaccine has never been found but the disease can now be kept under control thanks to the discovery of effective treatments.
Another failure in Italy during the Covid-19 emergency lies undoubtedly in the shortages of essential medical supplies such as facemasks, ventilators and testing reagents. This is explained by the fact that Italy’s manufacture of these kinds of healthcare supplies has been delocalized, and mainly to Asia. By contrast, the pharmaceutical industry is a high tech sector with a strong presence in Italy, and collaboration between AIFA and Farmindustria has ensured that there is no lack of medicinal supplies.
Also pointed out was the need to properly restore the relationship between institutions, research facilities and the pharmaceutical industry. Some recent effective undertakings have included the formation of a single ethical committee under direction of the Spallanzani Hospital in Rome, whose initial result has been the approval of 18 experiments; it has also been possible to improve transparency in relations between the AIFA and the business community. An idea for strengthening interinstitutional relations that comes from The United States, and could also be applicable in Italy, is the creation of a national military-like reserve corps, and making a substantial number of well-trained doctors available to the civil defense department for immediate response in the case of a pandemic.
This is not the only solution that could be borrowed from the defense sector. Viewed as an investment rather than an expense, healthcare should be considered a sector of national interest just as the defense industry is: a protected industry with a controlled technological production line that calls for suppliers to be selected in accordance with strict criteria. Thus, the idea of opting for low cost (i.e. low quality) is to be ruled out – in essence, we cannot depend on Asia.
The defense against this pandemic, and eventual future ones, must be built on an international network with shared rules and standards. Indeed, current collaboration seems not much more than a façade, with every country reporting only what it wants to and not always what is useful to waging a common battle. Networks need to be developed ahead of and not during a crisis.
Health and the economy must go hand in hand and not come into bitter conflict as sometimes seems to happen. What’s more, there is no denying that once the health emergency has passed the economy will undergo a difficult recession much like those terrible days of 1929. Heavy too will be negative social effects such as unemployment, increased poverty, unrest and violence, which is why we have to be prepared to deal at public and private levels with all the psychological consequences of life in quarantine and economic disaster.
The post Covid-19 era will see a surge in new and old mental health problems, and there will be obvious changes in private and public behavior. Of course, the virus has devastating destructive energy but it can also offer an opportunity to foster correct public health behaviors – such as improved hygiene – and greater confidence in science and the value of skill – two weapons that humanity has in its arsenal and that we are going to need to vanquish this pandemic.