Coronavirus in Italy: the people who managed to contain the spread of the virus with an experiment unique in the world

Italy has the highest number of people affected by Covid-19 in the world, with almost 60,000 cases and more than 5,000 deaths.

Italy has the highest number of people affected by Covid-19 in the world, with almost 60,000 cases and more than 5,000 deaths. Vo 'Euganeo was, until a month ago, a beautiful town like many in the Veneto region of northern Italy.
Italy has the highest number of people affected by Covid-19 in the world, with almost 60,000 cases and more than 5,000 deaths.


Vo 'Euganeo was, until a month ago, a beautiful town like many in the Veneto region of northern Italy.

Embedded on the slopes of some volcanic hills, a half-hour drive from the city of Padua, Vo was famous for its prosecco wine, its natural park, and the nearby hot springs.
Few would have imagined that this idyllic setting would become in a few weeks one of the first epicenters of the covid-19 epidemic in Italy.
And even fewer are those who could even think that Vo 'Euganeo would be the scene of a "unique scientific experiment”.

The town of Vo 'Euganeo is located on the slopes of the Euganean Hills and about 65 kilometers from Venice.

At the beginning of February Adriano and Renato, two residents of this town of about 3,300 inhabitants, were hospitalized in the area for pneumonia.
In the absence of symptoms to indicate this, the doctors ruled out the idea of ​​conducting the test to detect the coronavirus, as the protocols provided.
However, after two weeks of ineffective cures, a doctor from that hospital decided to skip the planned rules and carried out a co -19 exam on the two neighbors.
The answer? Positive.
The two men were immediately transferred to the Infectious Diseases Department of the Padua hospital and underwent the treatment planned for these cases.
But there was a mystery: how could they have been infected?
The first death
Authorities found that neither Adriano nor Renato, 77 and 83 years old, respectively, had traveled to China and had not contacted people with symptoms either.
Until then, those were the main known causes of human-to-human transmission of the virus.
All that was known was that, shortly before their illness developed, the two men had spent many hours together playing cards in one of the town's bars.
The region in which Venice is, Veneto, is one of the most affected in Italy by the spread of the coronavirus and has forced the authorities to close many tourist sites.
Unexpectedly, on February 19 Adriano's clinical picture worsened and, after two days, on the 21st, the man died. It was the first recorded death in Italy from coronavirus.
That same night the mayor of Vo', Giuliano Martini, owner of one of the two pharmacies in the town, declared the quarantine.
It closed schools, bars, shops, and even bus stops. Banned church masses and Carnival parties. It forced the neighbors to stay home.
On February 23, the Italian government and regional authorities imposed a quarantine on Vo 'Euganeo and sent dozens of police and military personnel to block the town's accesses.
No one could enter or leave the town until further notice. Only trucks supplying supermarkets, bakeries and pharmacies would be allowed entry.
"It was like being at war," recalls Martini in a telephone conversation with BBC. "Being locked up and surrounded by your own armed forces is much worse than being in a prison."

The town of Vo 'Euganeo was cordoned off by police and military for 14 days due to an outbreak of Coronavirus.

However, the mystery remained to be solved: how had the virus reached this community?
Innovative experiment
To discover it, on February 23, the health workers installed an analysis center in the town school to carry out the test to detect the spread of coronavirus to all the residents who wanted it.
In the following six days, practically all the inhabitants voluntarily submitted to the test with a kit prepared by the School of Medicine of the University of Padua, directed by Professor Stefano Merigliano.
"This would not have happened without the spirit of collaboration of all the neighbors," the mayor proudly acknowledges.
In Italy, since the beginning of the epidemic, 4,824 health professionals have contracted the coronavirus, the equivalent of 9% of the total number of infected people, according to data from the European Institute of Higher Health (ISS).
Investigators detected the virus in 89 people, who authorities ordered immediate isolation in their homes for 14 days.
Something else caught their attention: between 50 and 60% of them showed few or no symptoms.
"That is something that had not happened in any of the epidemics of the last century," Professor Merigliano explains.
"Having this percentage of asymptomatic is extremely dangerous", adds Professor Andrea Crisanti, professor of Epidemiology and Virology at the Hospital of the University of Padua and Imperial College London, "because these people follow their usual lives and infect a very large number high of people. "
It was at this time that Merigliano and Crisanti proposed to the Veneto governor, Luca Zaia, an idea: to transform Vo 'Euganeo into "a unique experimental laboratory in the world”.
"Being locked up and surrounded by your own armed forces is much worse than being in a prison," says the mayor of Vo 'Euganeo regarding the quarantine that his people lived through.
"We had unique conditions to understand how this virus behaves", illustrates Merigliano. "There was a consistent sample of isolated people. We knew their health status and we could control their movements and who they related to. It was perfect! "
With the approval of the regional authorities, on March 6 -12 days after the first examinations and while in Italy the number of those infected reached 4,636 (with 197 fatalities) - a team from the University of Padua returned to control to all the inhabitants of Vo 'Euganeo.
The new cases that tested positive this time were eight, of which six were related to those infected from the first examination. Isolation was imposed on all of them.
"Before, there were only estimates," says Crisanti, "while we scientifically demonstrate two fundamental questions: that the incubation period for the virus is two weeks and that any strategy for containing this pandemic must take into account the high number of positives. asymptomatic."
Two professors from the University of Padua used the Vo 'Euganeo quarantine days to transform the town into "a unique experimental laboratory in the world".
To understand the approach of the experiment, Crisanti compares the case of Vo 'Euganeo with that of the Diamond Princess cruiser, which was detained for two weeks in a port in Japan when a case of coronavirus was detected on board.
"On board there were about 3,000 people including passengers and crew," says Crisanti, "a number similar to that of the population of Vo 'Euganeo. But they decided to carry out the examinations only on those who were presenting the symptoms."
"After two weeks of quarantine," Crisanti concludes, "about 542 positive cases were reported."

Reopening
On March 8, two weeks after the death of Mr. Adriano, the isolation of Vo 'Euganeo was lifted. Life in the town began to circulate normally and, as of March 14, there were no new cases of infection.
Until last Friday, March 20, when a new outbreak was detected in the town.
"It was to be expected," says Crisanti. "With what parameters is it decided to lift the quarantine?" Asks this epidemiologist. "If quarantine is based only on the decrease in the number of patients, you are also leaving out all asymptomatic, and that means that the epidemic may return."
"The Vo 'Euganeo experiment is not replicable in larger cities." Says Crisanti. "But it is possible to control the spread of the virus at the neighborhood level in the same way."
Crisanti acknowledges, however, that the Vo 'Euganeo experiment is not replicable in larger cities. But it ensures that it is possible to control the spread of the virus at the neighborhood level, quickly identifying where the outbreaks are generated and isolating the possible contagion.
Something similar to what, he says was what South Korea managed to do.
Meanwhile, the Veneto region has just launched a parallel campaign, also led by Professor Crisanti, to examine people from at-risk groups, such as health personnel, police forces, supermarket employees and bus drivers.
The goal, according to regional authorities, is to conduct 13,000 exams a day before the end of this week.
More than 4,000 people in Italy have died since Mr. Adriano died in the Padua hospital.
Last Friday, a month after his death, his family was finally able to celebrate his funeral.


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