VO, Italy (AP) – Italy delivered the first shocking confirmation of coronavirus infections transmitted locally outside Asia a year ago on Sunday, with consecutive disclosures of cases more than 150 kilometers (almost 100 miles) away in northern parents.
First, a 38-year-old man in Codogno, an industrial city in the Lombardy region, tested positive for COVID-19, sending panicked residents to pick up their children from school, stock up on groceries at supermarkets and look in vain for surgical masks at pharmacies.
On the night of February 21, a 77-year-old retired carpenter from Vo, a wine town in the Veneto region, died – at the time, the first known fatality in a case of the virus transmitted locally in the West, setting off alarms everywhere.
In the days and weeks that followed, densely populated Lombardy would become the epicenter of Italy’s outbreak, and by the end of March, countries around the world would be under confinement to slow the spread of the virus that has claimed 2.4 million lives . But Vo, as one of the first cities in the West to be isolated, has a unique history, providing some of the first scientific insights into the deadly virus.
Adriano Trevisan’s death caused shock waves in the city west of Venice. Trevisan, known in Vo and a frequent visitor to a card game at a local bar, had been hospitalized for two weeks with circulatory problems related to a heart problem that could not be resolved with medication, according to his doctor, Dr. Carlo Petruzzi . There was no reason to suspect the coronavirus – since the retiree had no contact with China, until then a key element in the diagnosis.
After being warned of death, Mayor Giuliano Martini, who is also the city’s chief pharmacist, ordered schools and non-essential businesses to close and forbade residents to leave the city, even to work. He asked groups of local volunteers to help ensure that supplies of food and pharmaceuticals entering the city were transported to the shelves. The three family doctors in the city were quarantined because of suspected contact, and the nearest hospital, a 30-minute drive away, was closed.
“It was like a war movie,” said Martini. “We were completely alone.”
Surrounded by vineyards and agricultural fields, the city of 3,270 inhabitants nestled in Monte Venda has long lived a bucolic isolation. But three days after Trevisan’s death, his isolation was guaranteed by government decree: Rome sent soldiers to seal the city’s 12 access roads. Blockades were also made around 10 cities near Milan, where the other initial case of local transmission was confirmed.
“There was a sense of bewilderment, I would say,” said Dr. Luca Rossetto, one of the practitioners in Vo. “Even I, with a longstanding specialization in preventive hygiene, should have the right mindset. But there was an absolute disorientation. “
Rossetto reviewed his recent cases and realized that he had seen seven people in the previous days with symptoms similar to pneumonia. A week later, the 69-year-old doctor himself was hospitalized with the virus, a mild case from which he recovered.
Meanwhile, the governor of Veneto, Luca Zaia, instinctively ordered the blanket test for all residents of Vo, in order to understand the origin of the outbreak. The fact that he managed to make this call is due to the vision of the virologist at the University of Padua Andrea Crisanti, who ordered the necessary tools after the virus appeared in China. Many places around the world have struggled to institute testing so quickly.
Crisanti acknowledged that there would be value in testing the entire city immediately after contagion was confirmed and, again, after two weeks. And his work offered an initial insight into how the virus spread – clarity that Crisanti said was never properly translated into action.
The results of the first round of smear tests, available on February 27, showed that almost 3% of the population had been infected. This indicated that the virus had been circulating in the city since the end of January, according to Crisanti.
“With this data, we should have closed Veneto and Lombardy, immediately,” said Crisanti. But decision makers, he said, “did not realize the extent of the problem”.
The question of whether further restrictions on the movement should have been instituted earlier has been hotly debated in Italy, with many politicians noting that such decisions were extremely difficult, given that the measures have a high economic and social cost and infringe on freedoms. There is even a criminal investigation into whether authorities have waited too long to close two cities in Lombardy.
Turning the Vo off proved to be extremely effective in interrupting the transmission. When Crisanti conducted the second round of tests on March 7, no new cases were detected.
Crisanti said the findings – published by Nature magazine in June, but immediately known to Italian authorities – made it clear that isolation and mass testing are the best way to contain the virus before vaccines.
Although Crisanti managed to persuade the Veneto region to increase testing, it was not until March 9 – 17 days after the virus was detected simultaneously in two Italian regions, with cases multiplying and a mass exodus going south. – that then- Prime Minister Giuseppe Conte ordered the entire country to a nearly total blockade that would last seven weeks.
In late May, as cases began to decline in Italy, more than 232,684 people were infected, mainly in the north, and 33,415 died.
Scientists still don’t know how the virus got to Vo.
Although hit at the same time, Veneto fared much better than Lombardy, which has become the epicenter of both waves in Italy. It has half the population and its industry is more widespread, but experts also give credit to its health care system, which allows close contact between family doctors, district administrators and hospital staff and which depends less on private facilities. Another key element in his fight against the virus was the test system created by Crisanti.
Crisanti urged the government in Rome in August to expand its nasal swab testing capacity in the hope of keeping transmission low after a successful block. Although the government did this, Crisanti is disappointed to have relied heavily on rapid tests – as many other places have done and as some experts have recommended – rather than strategically deploying more reliable nasal swabs to isolate outbreaks.
In October, Italy was battling a resurgence that proved even more deadly than the peak of spring, with the death toll now nearly 95,000. New groups of one variant found for the first time in Britain have led to blockades located across the country, forcing the cancellation of one of the virus’s anniversary celebrations this weekend in Lombardy.
If the arrival of the virus last February caught the country off guard, the long-term resurgence of autumn was “crazy,” said Crisanti.
Vo also suffered a resurgence that is only now diminishing. The death toll in the city’s pandemic has doubled to 6.
Boasting an unusually high number of restaurants per capita in 45 locations, Vo is now an echo of his former self. Marriages, baptisms and first communions that attracted residents of nearby towns to the hillside town were limited by restrictions. The closure of restaurants also forced the Vo wine cooperative to reduce production in 2020. The local dance hall was never reopened.
Things could have been different, Martini believes.
“The virus in Vo came and died in Vo,” said the mayor about the first cases a year ago. Failure to repeat the model: “Ruinous,” he said.