The human faces of the COVID-19 outbreak: Who saves our heroes?

What follows are some remarkable testimonies collected from our members working in the frontlines of the health sector in Italy. No words can be added to better describe the challenges they are facing and the way they put their duty to protect others higher than their personal well-being. Please read them through and be empathic to the difficulties they are facing.

These testimonies underline the systemic problems our European societies had to deal with sooner than later, why today they are in such jeopardy and what has been missing: investment in the workforce, reallocation of funding for public social services, fair and good working conditions for the most important professions in society.

CESI publishes these testimonies in hope that once the crisis is over all these issues can be addressed and that a new societal order will be established with fair and safe working conditions for everyone as the building block of such a construction!

A nurse from FANO, Ancona, shares with us: “Today you call us heroes but the PPE (personal protective equipment), which we should have to work safely, in many realities is scarce and you work with what is there, even if not suitable: an example is the FFP2 / FFP3 masks, replaced in almost every activity surgical masks (which, I want to clarify, are not PPE but medical devices, a big difference!) and, moreover, even those now almost impossible to find and replaced with improvised “masks” with materials probably good at most for dusting at home.

(…) Do not take me as venal because, and I think this applies to all my colleagues, we are not interested in receiving anything more on this specific occasion. What we would like is a contract that always reflects our work and our professionalism! Every day we carry out advanced resuscitation manoeuvres together with our medical colleagues, we are trained to know how to use infusion pumps, defibrillators, monitors, machinery for invasive and non-invasive lung ventilation, yet we do not have a critical area allowance. Every day we are exposed to people potentially affected by diseases, due to the most varied viral or bacterial microorganisms (MTC, HIV, HCV, HBV, meningitis, pneumonia, and a myriad of other pathogens that would be too long to list) who expose us to the risk of developing diseases such as tuberculosis, hepatitis, AIDS, meningitis, and so on up to this COVID-19, yet we do not have an infectious disease allowance. Every day, when we carry out triage activities, to assign, with an evaluation that lasts just over a minute, a priority code to the hundreds of people who access our emergency room daily, we expose ourselves to the risk of errors that could also have consequences serious for patients. Yet we do not have a specific allowance for this delicate activity.

Today you call us heroes but every day, until just over two weeks ago, we were the workers most at risk of aggression than any other category of workers. “

Lorenzo Grazioli, Anesthesiologist, tells us: “My day starts at 7.30 am, at 9 am I reconnaissance all Intensive Therapies, which are now all Covid. We have reached 80 beds. Every day I take stock of how many intubated people are and then I manage the clinic. My day ends around 8 and 9 evening. The patient case history is a broad case study, here there are many infected patients and we have a huge number in Intensive Care. I collaborate more with Intensive Care Nurses and Perfusionists as regards the management of extracorporeal support. I feel very tired, I work with a madman, but none of us draws back “, to the Grazioli citizens he sends a piece of advice:” People must stay at home so as to block the infection, we are already at the limit: if we exceed this limit it is really a big problem”.

Nicola, 26 years old, resuscitation nurse in a COVID-19 sector, testifies: “I am afraid to return home to infect parents and grandparents”. In just a few days, its operating unit was transformed into COVID-19 Resuscitation. He works on three shifts, as does the vast majority of colleagues. He explained that he is afraid, afraid to go home and harm his loved ones by infecting them. He hasn’t seen his grandparents for weeks for the same reason. Yet hie and his family are very close, they used to eat lunch or dinner together. Now it is no longer possible, he lives locked up in his bedroom. He undresses in the garage, washes himself in a bathroom near the house, he no longer has the life as before. He works and returns home, goes home to work, is often frowning, nervous, inclined to cry. “I can’t take it anymore, it’s been a month since I have ceased to live and I am busy, this is the height, to save the life of my patients in Resuscitation – Nicola explains – it’s always more difficult, it seems we live in a film. For six hours locked in a suit, without eating, without drinking. I try to do my best, I try to pay attention to details and not to make the slightest mistake. I go home and go straight to my room. I miss the hugs of my parents and my sister, I miss the smile of my grandmother and of my grandfather. I miss my dog, I miss the life I used to have, I miss my hooks, I miss arguing with colleagues, my head nurse. I miss going to the bar, I miss cycling, I miss going running and playing soccer. “

Alessandra Ziniti goes straight to the heart of the problem of our health systems: “Until yesterday, politicians and economists taught us that, due to urgent public debt reduction needs, departments, hospitals had to be closed, hiring blocked when, despite these draconian treatments, the debt increased dramatically. After decades of villainous health policy based exclusively on cuts, only now, do some politicians realize that there are no beds, no machinery, no health personnel?

Now, by virtue of those unfortunate choices, Italy has 3.4 beds/ 1000 inhabitants, well below the threshold for adequate assistance. You blocked the competitions for specialist doctors, nurses, when you realized that the Doctor is no longer a coveted profession for various reasons (inadequate remuneration for commitment, responsibilities and professional risks; inadequate social protection, even before legal of health workers, etc.), that many of us prefer to work abroad and that the competitions to fill vacant positions in the emergency rooms are deserted, now what do you do? Now run to the shelters, trying to modify the employment contract, after for decades you have favoured the culture of precariousness and the intensive exploitation of the healthcare profession (doctors, nurses, socio-health workers, laboratory technicians, pharmacists, biologists) and you treated and humiliated us like many serfs, to whom everything can be imposed (exhausting shifts, missed rest, unused holidays). You have sown the wind and now you reap a storm.

We trust that citizens will finally understand who to blame for this dramatic situation and that the national health system has ruled only and exclusively thanks to the self-denial of health personnel. To the Italian citizens who today join the thanks of the politicians, we want to remind you that we are always the same ones who are attacked in the various Italian emergency rooms. (…) We are always the same ones who are killed at night in front of the entrance to an outpatient clinic or raped during a shift on medical guard, in a remote inland country. To all of you, politicians and citizens, I ask: why and above all for what do you thank us?

Maybe because none of you would be willing to do what we do, by free choice, every day? Do you thank us because today you are afraid, afraid of getting sick and not being treated, afraid of dying without assistance, fear of not finding a bed in an intensive care unit, of not finding an anesthesiologist, a pulmonologist, an internist who will heal you from Coronavirus? Once the spotlight has gone out and the curtain has fallen for this unfortunate epidemic spotlight, what we would like is only a minimum of respect for us health professionals and for our profession; not false thanks or ritual solidarity, but only respect and understanding. Understand and respect us, this would be enough to make us understand that you understand.”