On February 21, 2020, Italy’s “patient one” tested positive for COVID-19 at a hospital in Codogno, a town in Lombardy – and that was the day the lives of millions of people across the world changed beyond imagination.
The team at the small hospital soon realised this was not an isolated case. The virus had long spread outside the city of Wuhan, China, which had been under a strict lockdown for more than a month.
It took another 20 days for Italy to announce a blanket lockdown, on March 9, closing all commercial activities and confining citizens to their homes.
The lives Europeans had taken for granted in peacetime changed almost overnight: Access to healthcare, free movement and seeing friends and family were no longer a given.
A year later, more than 88,000 people have died after contracting the virus in Italy, the second-highest death toll in Europe after the United Kingdom.
Inequality and poverty are rising as the economy, which had never fully recovered from a 2008 crisis, weakens.
“By the time it came to face the pandemic, the national health system had been severely weakened by a decade of funding cuts,” said Nino Cartabellotta, a leading Italian public health expert, professor and president of Gruppo Italiano per la Medicina Basata sulle Evidenze (GIMBE – Italy’s Group for Evidence-based Medicine).
Between 2010 and 2019, Italy’s public health sector faced cuts and lost revenue amounting to 37 billion euros ($45bn). Doctors of pension age were not replaced, resulting in a shortage of specialists such as anaesthesiologists, and weak local care networks that led to hospitals becoming overwhelmed.
“The virus has always travelled faster than politics and bureaucracy,” Cartabellotta told Al Jazeera.
Al Jazeera spoke to four people whose lives were overturned by the events of the last year:
- Annalisa Malara, the doctor who discovered the first case
- Stefania Principale, a young woman looking for answers to the death of her 41-year-old husband
- Antonella Cicale, an overwhelmed family doctor in Naples
- Lorenzo Stocchi, a healthy young man dealing with the aftermath of the infection
The images I saw showed a very serious interstitial pneumonia, with the aspect typical of viral pneumonia. On top of that, I had seen his chest x-ray from 36 hours earlier. What I was looking at was a very rapid progression. He looked strange, he had bad conjunctivitis and bloodshot eyes, something we later saw in many other patients. He said he had some difficulty breathing, but his condition appeared considerably worse from his exams. He was surprised when I told him he required hospitalisation in the ICU.
It was clear the case was not a common one. When his wife arrived, she told me that two or three weeks earlier her husband had been at a dinner with a colleague that has recently returned from China. Alarm bells began ringing at that point.
But the link was in fact very feeble. That colleague had been in an area 800 kilometres (497 miles) from Wuhan.
At first, we hoped this was an isolated incident, but that night we realised that wasn’t the case. We hospitalised three more patients that weren’t linked to the first. A colleague of mine in intensive care had had a fever for a few days. He came to A&E for the swab and tested positive.
The first weeks were a shock. We were completely overwhelmed by the number of patients that were coming to A&E, with peaks of more than 100 people a day.
The most difficult part was realising the virus could hit anyone – young, old, healthy or ill. Particularly at the beginning, we had to cure those patients without really knowing what this virus was capable of.
We had to close the hospital to family members and sometimes had to announce by phone that their loved ones had passed away. It was very difficult.
Just before we reached the plateau in the first wave, we were in such a state of uncertainty that we thought it was possible we were at the start of a complete catastrophe. Before then, we truly feared the virus could be unstoppable, or at least uncontrollable.We were living a quiet life with our two children, Andrea and Chiara, who are eight and four.
March 8 came, it was a Sunday. My husband had a fever, we called the family doctor who couldn’t visit him but prescribed some medication. His temperature kept rising and he developed a cough. The doctor said COVID tests could only be done in hospitals. She suggested an x-ray. That showed the start of bilateral pneumonia.