COVID-19 and Italian Healthcare Workers From the Initial Sacrifice to the mRNA Vaccine: Pandemic Chrono-History, Epidemiological Data, Ethical Dilemmas, and Future Challenges

Abstract

On March 11, 2020, the World Health Organization (WHO) declared the coronavirus disease 2019 (COVID-19) outbreak a pandemic. Simultaneously, in Italy, in which the first case had occurred on February 18, the rigid phase of the lockdown began. The country has attracted worldwide attention, becoming at the same time a field of study both concerning the spread of the pandemic and advanced assessments of the effectiveness of political, public health, and therapeutic measures. The protagonists of the Italian crisis were the healthcare workers (HCWs) who were exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) without having any perception of what they were facing, courageously contributing to the containment of the epidemic to be defined by the media as “heroes.” However, in the first phase of the pandemic (March–May 2020), the price that the Italian Public Health System had to pay both in terms of the number of positive virus cases and deaths among the HCWs was beyond and represented a peculiarity compared to what happened in other countries. In the current study, after a summary of the evolution of the pandemic in Italy, we offer an analysis of the statistical data concerning contagions and deaths among healthcare workers (physicians in particular). In conclusion, we describe the critical issues that still need to be resolved and the future challenges facing healthcare workers and the general population.

Clinical Activities, Contaminations of Surgeons and Cooperation with Health Authorities in 14 Orthopedic Departments in North Italy during the Most Acute Phase of Covid-19 Pandemic

“…No one had an instruction from the hospital either to avoid familiar contacts during the shifts in COVID units or to quarantine before coming back to “COVID-19-free” environments; this could be a further method to limit contamination in and out of hospital, as earlier described by Liang et al [ 7 ]. In comparison with other HCWs, orthopedic surgeons are involved in procedures with the formation of bioaerosols, especially in operating rooms (among others, suspensions of water vapor from bone drilling, bone saws, combustion products from electrocauterization, ventilation procedures related to anesthesiology), as such they are a group at risk for contamination with SARS-CoV-2, similar to dentists, maxillofacial, plastic and spine surgeons [ 9 ]. The role of bioaerosols in orthopedic operating rooms and SARS-CoV-2 has been analyzed by Sharma et al [ 53 ], concluding that the bioaerosol potential to transmit infectious diseases like COVID-19 is questionable.…”

“…Personal Protective Equipment (PPE) was a topic of great concern during the first wave. Firstly, there was scarce experience with COVID-19, secondly the availability of PPE forced a rationalization and often downgrading of the PPE, leading to uncertainty among the health care workers (HCWs) during a critical situation [ 9 ].…”

Dealing with COVID-19 Epidemic in Italy: Responses from Regional Organizational Models during the First Phase of the Epidemic

“…The COVID-19 pandemic dominated scientific literature in 2020. [ 38 ] Many researchers try to describe the current situation by focusing on specific topics: For example, the situation of healthcare workers [ 3 , 39 ] or the predictive modeling to help health policies [ 40 , 41 ]. In Italy, several scientific papers were published, focusing on the clinical, epidemiological, and public health management of the disease in a specific region [ 42 , 43 ].…”

“…In this scenario, the healthcare workers role has been pivotal. In fact, they were exposed to an unknown threat, and they were both a high-risk category and a potential source of the outbreak [ 3 , 4 ].…”

Look at the COVID-19 Pandemic with an Open Mind

“…Acute inflammation of the lung tissue remains the leading cause of severe illness and death. The concentration of such patients in the prescribed departments is an exorbitant psychological burden for their medical staff, who do not have ways to effectively suppress the pathological process (35)(36)(37)(38)(39).…”