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SARS-CoV-2 pandemic in Italy: ethical and organizational considerations

The current SARS-CoV-2 pandemic is still raging in Italy. The country is currently plagued by a huge burden of virusrelated cases and deaths. So far, the disease has highlighted a number of problems, some in common with other Countries and others peculiar to Italy which has suffered from a mortality...

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Autores principales: Nardini, Stefano, Sanguinetti, Claudio M., De Benedetto, Fernando, Baccarani, Claudio, Del Donno, Mario, Polverino, Mario, Annesi-Maesano, Isabella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: PAGEPress Publications, Pavia, Italy 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7256627/
https://www.ncbi.nlm.nih.gov/pubmed/32499910
http://dx.doi.org/10.4081/mrm.2020.672
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author Nardini, Stefano
Sanguinetti, Claudio M.
De Benedetto, Fernando
Baccarani, Claudio
Del Donno, Mario
Polverino, Mario
Annesi-Maesano, Isabella
author_facet Nardini, Stefano
Sanguinetti, Claudio M.
De Benedetto, Fernando
Baccarani, Claudio
Del Donno, Mario
Polverino, Mario
Annesi-Maesano, Isabella
author_sort Nardini, Stefano
collection PubMed
description The current SARS-CoV-2 pandemic is still raging in Italy. The country is currently plagued by a huge burden of virusrelated cases and deaths. So far, the disease has highlighted a number of problems, some in common with other Countries and others peculiar to Italy which has suffered from a mortality rate higher than that observed in China and in most Countries in the world. The causes must be sought not only in the average age of the population (one of the oldest in the world), but also in the inconsistencies of the regional health systems (into which the National Health System is divided) and their delayed response, at least in some areas. Ethical issues emerged from the beginning, ranging from restrictions on freedom of movements and restrictions on personal privacy due to the lockdown, further to the dilemma for healthcare professionals to select people for ICU hospitalization in a shortage of beds in Intensive Care Unit (ICU). Organizational problems also emerged, although an official 2007 document from the Ministry of Health had planned not only what measures had to be taken during an epidemic caused by respiratory viruses, but also what had to be done in the inter-epidemic period (including the establishment of DPIs stocks and ventilators), vast areas of Italy were totally unprepared to cope with the disease, as a line of that document was not implemented. Since organizational problems can worsen (and even cause) ethical dilemmas, every effort should be made in the near future to prepare the health system to respond to a similar emergency in a joint, coherent, and homogeneous way across the Country, as planned in the 2007 document. In this perspective, Pulmonary Units and specialists can play a fundamental role in coping with the disease not only in hospitals, as intermediate care units, but also at a territorial level in an integrated network with GPs.
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spelling pubmed-72566272020-06-03 SARS-CoV-2 pandemic in Italy: ethical and organizational considerations Nardini, Stefano Sanguinetti, Claudio M. De Benedetto, Fernando Baccarani, Claudio Del Donno, Mario Polverino, Mario Annesi-Maesano, Isabella Multidiscip Respir Med Review The current SARS-CoV-2 pandemic is still raging in Italy. The country is currently plagued by a huge burden of virusrelated cases and deaths. So far, the disease has highlighted a number of problems, some in common with other Countries and others peculiar to Italy which has suffered from a mortality rate higher than that observed in China and in most Countries in the world. The causes must be sought not only in the average age of the population (one of the oldest in the world), but also in the inconsistencies of the regional health systems (into which the National Health System is divided) and their delayed response, at least in some areas. Ethical issues emerged from the beginning, ranging from restrictions on freedom of movements and restrictions on personal privacy due to the lockdown, further to the dilemma for healthcare professionals to select people for ICU hospitalization in a shortage of beds in Intensive Care Unit (ICU). Organizational problems also emerged, although an official 2007 document from the Ministry of Health had planned not only what measures had to be taken during an epidemic caused by respiratory viruses, but also what had to be done in the inter-epidemic period (including the establishment of DPIs stocks and ventilators), vast areas of Italy were totally unprepared to cope with the disease, as a line of that document was not implemented. Since organizational problems can worsen (and even cause) ethical dilemmas, every effort should be made in the near future to prepare the health system to respond to a similar emergency in a joint, coherent, and homogeneous way across the Country, as planned in the 2007 document. In this perspective, Pulmonary Units and specialists can play a fundamental role in coping with the disease not only in hospitals, as intermediate care units, but also at a territorial level in an integrated network with GPs. PAGEPress Publications, Pavia, Italy 2020-05-25 /pmc/articles/PMC7256627/ /pubmed/32499910 http://dx.doi.org/10.4081/mrm.2020.672 Text en ©Copyright: the Author(s) http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License (by-nc 4.0) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Review
Nardini, Stefano
Sanguinetti, Claudio M.
De Benedetto, Fernando
Baccarani, Claudio
Del Donno, Mario
Polverino, Mario
Annesi-Maesano, Isabella
SARS-CoV-2 pandemic in Italy: ethical and organizational considerations
title SARS-CoV-2 pandemic in Italy: ethical and organizational considerations
title_full SARS-CoV-2 pandemic in Italy: ethical and organizational considerations
title_fullStr SARS-CoV-2 pandemic in Italy: ethical and organizational considerations
title_full_unstemmed SARS-CoV-2 pandemic in Italy: ethical and organizational considerations
title_short SARS-CoV-2 pandemic in Italy: ethical and organizational considerations
title_sort sars-cov-2 pandemic in italy: ethical and organizational considerations
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7256627/
https://www.ncbi.nlm.nih.gov/pubmed/32499910
http://dx.doi.org/10.4081/mrm.2020.672
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