Reportage. In Turin, the situation is chaotic and inefficient. Lines of responsibility are unclear, and parents are frantic. The rising contagion highlights the limits of the public health system.

Pediatric hotspots in Northern Italy are pushing health care to the brink

There are long waits, queues on the streets, in the cold, even in the rain. Portions of sidewalk are transformed into improvised parking lots, with cars slipping through where they can. In the cars—together with their dads, or, even worse, their grandparents—are very small children with fevers. The mothers are outside, standing in line. The situation at pediatric hotspots in Turin is on the edge of collapse. But they’re telling us that everywhere else is even worse.

The human column in front of us is exhausted, worried and angry about the management of the situation, which many have called totally inadequate. Those who arrived last simply queue up and wait. No directions, no signs. But there are children here, many with symptoms.

Sitting on the sidewalk, an Arabic woman looks at us, with eyes that are somewhat vacant. She holds her baby wrapped in a blanket, just a few months old, and she tells us he has a fever. A little further on, on another corner of the sidewalk, another woman is nursing her baby.

“I left my son there in the car with his grandfather. I have been here for three hours now,” a lady tells us. A father has come back for the second time, because a few days earlier it was pouring and everyone got wet: the son already had a cough and a cold. Another mother is also on her second attempt, on the same day: she is coming from another school hotspot, where the wait was endless. But there’s not much difference. “Next time I’m going to a private clinic,” she shouts, furious. “Fifty to 100 euros and that’s it.”

Everyone could have chosen the fast lane of the private clinics. The decades-long exsanguination of the public health care system, with thoughtless privatizations, textbook corporatization and boundless austerity, has been carefully set up to push us all to this condition. But being here today is also a political and social choice.

The swab tent closes at 3:00 p.m. One hour before, they announce that only the first ten will be able to enter, and the others can go home. There is a small uprising: moms and dads are not going to take it. Many had to ask for leave from work or take vacation days. A dialogue takes place where the responsibility is passed back and forth and remains unclear. This goes on for half an hour; then, finally, reassurance comes: “We’ll take everyone until 3 p.m. What they told you was an error.”

A miscommunication? Perhaps. And the chaos of the queues should also be resolved. Perhaps. The Commissioner of the Azienda Ospedaliera Universitaria Città della Salute e della Scienza of Turin, Giovanni La Valle, assures us that urgent measures have been taken.

At the pediatric hotspot at the Regina Margherita Hospital, the take-in procedure should be doubled in capacity, thus reducing the wait times. On Sunday, an indoor area was supposed to be set up for families, “where people can be properly spaced out.” Operation “Families in the Heat”—La Valle’s name for it—should make a clear difference for the situation. “We are only supporting the ASLs (Local Health Authorities), they are the ones who are managing everything.”

The ASLs are a sore point. Some teachers and parents tell us that the ASL sometimes fails to communicate to the school that the children have tested positive. For instance, a family learned that their child was infected from the pediatrician, but now, six days later, the local health authority has not yet officially notified the pediatrician, nor has it alerted the school. The classmates don’t know anything. If the ASL does not issue a notice, the class cannot be quarantined.

Some schools close down when only one COVID case has been found. Others are never contacted, no matter how many. It also happened that a child returned to class after quarantine but then was called in for a second swab. There are school managers who are “informally” letting families decide whether or not to send their children to class. There are pediatricians who impose isolation before the call from the ASL, which sometimes does not arrive at all. And there are others who, on the contrary, say that children can do everything they usually did. In many cases, the contact persons of reference of the Local Health Authority are unavailable. The Piedmont system is struggling.

The Regional Crisis Unit and the Inter-authority Department of Emergency-Infectious Diseases (DIRMEI) are working these days to rewrite the rules on swabs. The goal is to increase laboratory productivity and avoid unnecessary tests. On the contact tracing front, the Turin Local Health Authority will be strengthened with 61 additional units at the SISP and 40 at the call center. However, the unions have a simple message: “Don’t abandon the schools.”

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