April 23, 2021

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When the coronavirus came for me

6 min read
Getting ill made the gaps in Italy's health care system painfully clear.

MILAN — The first thing I think, when I find out the result of my COVID swab, is that I wish I had a diary or a calendar of some kind. It’s a strange and ridiculous thought, but I feel as though I need a physical marker of this day: the day the coronavirus found its way into my home.

It is February 24, and I have tested positive for COVID-19. After a year of dodging the virus, I am now a data point — one of the many cases announced by Italy’s health ministry on the news every evening at 6 p.m.

I have severe pain in my lower back and legs. If my father, who is 72, did not have a fever and had not tested positive for COVID-19 as well, I never would have thought these symptoms were related to the virus. My nose doesn’t run, I don’t have a fever or feel tired. But my mother, who lives with my father, is also starting to have the same pains. My brother has a cough. (Incredibly, my two little girls are negative.)

In the news, I read that the far more contagious British coronavirus variant is running rampage across Italy. Perhaps this is the strain that has infected my family. Too many overlapping thoughts invade my mind. Where did we get infected? How could this happen, after we were so careful? What will happen to us?

I alternate between moments of confidence and hope and moments of real fear. The countless stories I’ve heard and written as a journalist over the past few months aren’t reassuring, and thinking about my elderly parents at home alone takes my breath away.

The process that follows my positive result is one I know well: quarantine, monitor symptoms and if the situation worsens, call the hospital. But I am seriously unprepared for the ordeal my family and I are about to go through over the next three weeks.

The first wave of infections last year exposed one of the key weaknesses in the health care system in Italy — and particularly in the region of Lombardy, where I live. The local network of general practitioners who provide preventative care is weak. Instead, the system is entirely focused on hospitals, which are quickly overrun with COVID-19 patients.

In most cases, local GPs are overburdened with patients and paperwork, their role relegated to writing prescriptions and sending the sick to specialists. Few come to visit patients at home anymore and those who do are considered heroes.

But individual acts of heroism isn’t enough to save most people — only a functioning, well-funded structure can do that. Last year, 337 doctors died of COVID-19. Many of them were general practitioners whom the state and the regions did not protect, sending them to the front lines of the pandemic without adequate PPE.

I knew about this problem, and had reported on it. What I didn’t realize was that, 12 months and more than 100,000 deaths into the pandemic, nothing much had changed. Even as we face the likely prospect of a third wave, there is still no adequate system in place, nothing to do when you fall ill with COVID-19 but call your GP and hope for the best.

Our doctor prescribes paracetamol for me and the COVID-19 treatment — antibiotics, heparin, cortisone — for my parents. He tells us to monitor our symptoms. And at first, everything seems to be fine. But within two days things change.

My father’s fever starts to rise and his oxygen levels drop. The doctor tells us to monitor his oxygen saturation levels and says he will have to go to the hospital if it falls below a certain level. My siblings and I all feel invested with a huge responsibility, but since we can’t visit him and have no way of knowing if he has pneumonia or whether he is having trouble breathing, we feel unprepared.

My mother is the one who measures his saturation levels, using an oximeter she bought on Amazon. My father spends most of the day in bed and has lost his appetite. He has no pre-existing conditions, and yet the virus is destroying him. He has never gone through anything remotely like this before.

We try to stay lucid and rational, but we are overwhelmed with fear. What if the oximeter isn’t working properly? What if it isn’t reliable? What if we are underestimating the severity of his symptoms? What if he dies?

“See if he finds it hard to breathe while lying down,” the doctor tells us when we call again. But how do you recognize a troubled chest?

Meanwhile, my pains are getting worse, and I’m home alone with the girls. I would like to rest but I can’t. There are distance learning classes to oversee, lunch to cook and thousands of requests to field from two bored little kids. I struggle to get anything done, and I have a headache. When I got sick my husband was on a work trip, so he stayed away to avoid getting infected too. 

I call my parents every two hours. Now my mother has a fever too. The days pass waiting for the general practitioner to call. When my father seems to be getting worse, we call and text again but don’t get a response. When we finally get through to him, he sounds put out. He reminds us that he is very busy, that he has countless other patients like my father. That’s certainly true. But what else can we do?

I feel immensely lonely, like my family has been abandoned. There are times when I find it hard to hold back the tears, and my daughters, scared to see me like this, ask: “Is grandpa dying?”

My father’s saturation levels sometimes come extremely close to the limit that would warrant a call for an ambulance. It is hell, and we pray for his levels to go back up. I video call my father to try to help my mother figure out whether his breathing can be considered labored — but it is almost impossible to tell through the phone.

Desperate, I get in touch with a doctor I once interviewed for a story, who has been working in the COVID-wing of one of the largest hospitals in Milan. I feel guilty for disturbing him and encroaching on his time. But he answers, listens and gives me advice. His attention and interest in our family’s situation moves me.

He starts to check in every day, one of the many heroes helping to fill the gap in care for families like ours. He tells me I have to either take my dad to the emergency room or ask our general practitioner to call the special continuity care units (teams of doctors known as USCA, who make up the shortfall in regional out-of-hospital care) to come to our house and do an ultrasound of his lungs. 

My father is on the brink. He has had a fever for 13 days. He can hardly eat anymore and has lost a lot of weight. When I ask our doctor to call on the USCA service, he does it — but accuses us of not trusting his judgment. We are stunned.

When the USCA team arrives, they have no doubts: My father needs to go the hospital, immediately. My mother calls the ambulance. The neighbors look out from their balconies to wave to my father, who comes out with a mask and smiles.

I am home alone and cry, fearing that what I have heard happen again and again will also happen to my father. I know I may never see him again.

In hospital, he is treated for his bilateral pneumonia and receives oxygen. He recovers within a week. Doctors tell him he’s lucky he got sick now and not in three weeks when the wards will be full again. My mother, meanwhile, has a strong cough and a persistent fever, but for now she’s still at home.

I have tested negative again, and am officially COVID-free. But my life won’t change much: Italy is preparing for another lockdown and infection numbers are climbing at an alarming pace again in Lombardy.

Watching countries like the United States, Britain and Israel vaccinate their population efficiently and quickly, I can’t help but feel despondent. Why can’t Italy do the same? When will this end? And perhaps most of all, why is it that we can’t take better care of our sick, leaving them to make agonizing decisions by themselves?

Source: POLITICO https://www.politico.eu/article/coronavirus-milan-italy-lombardy-hospitals-health-services/?utm_source=RSS_Feed&utm_medium=RSS&utm_campaign=RSS_Syndication

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