Reportage. The government's plan to move Italy's coronavirus response to the next phase was met with protest by general practitioners in Lombardy. 'Phase 2 risks becoming another Phase 1.'

In Lombardy, doctors revolt against ‘Phase 2’ plan they say politicizes healthcare

“In Lombardy, Phase 2 risks becoming another Phase 1,” reads the alarm raised by the general practitioners of Lombardy, criticizing the plan voted on Monday afternoon by the majority supporting the Fontana administration. “We must point out the absolute inconsistency of the contents of the document on Phase 2,” says Paola Pedrini, the secretary for Lombardy of the Italian Federation of General Practitioners (FIMMG).

According to the doctors, Attilio Fontana and Giulio Gallera’s proposal is a retread of what has been done during the past 60 days, failing to address the critical issues that have emerged. The Federation is contending that the plan voted by the center-right majority could even result in doctors being silenced, by tying them to political authorities more than before.

“The critical issues that we have signaled so far are not being dealt with,” says Paola Pedrini, such as “the strengthening of prevention and hygiene services to allow adequate care of positive or suspected COVID patients, adequate isolation and an epidemiological investigation to identify close contacts during the 14 days prior to the onset of symptoms.”

As the secretary of FIMMG Lombardy points out, these measures were not implemented in Phase 1, so “if these problems are not addressed, Phase 2 risks becoming another Phase 1.”

Then, there is the political issue, connected to the autonomy of family doctors. “We risk being subjected to politics even more, because in the beginning of the document one can read the intention to make family doctors and pediatricians dependent on the regional system; however, we are independent professionals who have an agreement with the National Health Service,” Pedrini explains. Hopefully, that may prove to be an editing error, but it is increasing confusion among this professional category nonetheless.

A strategy of deliberate chaos seems to be Attilio Fontana’s preferred mode of communication since Matteo Salvini and his spokesman Matteo Pandini arrived in the region. There are thundering announcements that confuse the citizens, followed by targeted attacks on political opponents and an ostentatious self-satisfaction regarding everything that has been done, at levels that are perhaps excessive. “I would do it all again,” Fontana said yesterday referring to the past 60 days of the COVID crisis. “Fontana must continue to be the institutional Fontana, and not Salvini’s muppet,” said Deputy Minister of Economic Development Stefano Buffagni from the M5S. The members of the regional council from the opposition are asking to be involved in Phase 2 as well.

“Everyone’s contribution is needed,” said the representatives of the PD, M5S and the civic lists. “Not involving us means not being willing to listen to the input of thousands of citizens. Until now, they have done everything on their own, with catastrophic results; it’s time they let us get involved, for the good of Lombardy.”

Meanwhile, Attilio Fontana has welcomed the positive opinions coming from ANCI Lombardy and the construction companies on the Phase 2 plan. In order to start it safely, it would be useful to know what the real number of people sick with COVID is, and where they got infected during this month of lockdown. According to an estimate made by Radio Popolare, thanks to monitoring data between GPs and the health authorities on the sick people at home and in live-in facilities, the number of people infected with COVID in the province of Milan is at least twice as high as the one in the official reports from the Region: 32,000, compared to the official 16,000.

In the meantime, serological tests should start today in four provinces: Bergamo, Brescia, Lodi and Cremona. This operation is also starting with a fair a bit of confusion. In the evening, Health Councilor Gallera spoke of 14 sampling centers where the tests will be carried out, five from tomorrow, the others operational from Friday, but the final dispositions with the operational plans for the execution of the tests have yet to be completed, and the delivery of the kits with the reagents is also running late.

According to what was announced by Councilor Gallera, the first ones to be tested will be the citizens still in quarantine, the symptomatic ones, the people without symptoms for 14-21 days reported by general practitioners to the health authorities and those who have had contact with symptomatic cases identified by the health authorities but have not been swabbed. However, the list circulated on Wednesday evening by the Councilor fails to include doctors and nurses, as had been announced some days ago.

In addition, there is one other aspect that could expose medical personnel to further risks. A symptomatic person should stay at home, and going out to the laboratory for testing risks infecting other people on the way, on public transport or in the laboratory itself, if special protected transit routes are not provided. For this reason, final operational plans and guidelines must be provided before starting operations. This is a point on which Regional Councilors Elisabetta Strada and Marco Fumagalli have asked for clarification. It is not the most auspicious of beginnings for the much-touted Phase 2.

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