| Peer-Reviewed

Vulnerable Population in Covid-19 Outbreak: A Look at Italy

Received: 5 May 2020     Accepted: 27 May 2020     Published: 16 June 2020
Views:       Downloads:
Abstract

We examine the population groups most exposed to Covid-19 in the Italian social and health context. These groups include, firstly, elderly and disabled people with one or more pre-existing diseases and, secondly, health workers, especially doctors and nurses, who have paid a very high price in terms of contagion and death. If elderly people are infected with the virus and become ill with severe interstitial pneumonia, they are unlikely to be admitted to intensive care units and are destined to die in a short time. Therefore, in accordance with the principle of "equity" recommended by the World Health Organization, some resources should be devoted to protecting these elderly persons, so that they would not come into contact with the virus. Unfortunately, the measures taken by the Italian National Government and Regional Administrations have not been effective in protecting this elderly group, as is evident from the ongoing judicial disputes. Covid-19 health care professionals are the most exposed to the risk of contagion, which increases dramatically if there are no adequate personal protection equipment. And these protections were lacking, especially in the early stages of contagion. Meaningful demonstrations of a human solidarity have happened, which have crossed the boundaries of duty to the point of sacrifice of life.

Published in American Journal of Health Research (Volume 8, Issue 3)
DOI 10.11648/j.ajhr.20200803.14
Page(s) 42-48
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Covid-19 ItalianVulnerable Groups, Covid-19 Health Workers, Covid-19 Outbreak in Italy, Allocation of Intensive Care Resources

References
[1] Nacoti, M., Ciocca, A., Giupponi, A., Brambillasca, P., Lussana, F. and Pisano, M. (2020). At the Epicenter of the Covid-19 Pandemic and Humanitarian Crises in Italy: Changing Perspectives on Preparation and Mitigation. NEJM Catalyst, March 21, 2020. Website: https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0080.
[2] World Health Organization (WHO 2016). Guidance for managing ethical issues in infectious disease outbreaks. Website: https://apps.who.int/iris/handle/10665/250580.
[3] Fengyuan, D. (2020). How does China protect human rights amid Covid-19 outbreak. CGTN, March 3, 2020. Website: https://news.cgtn.com/news/2020-03-03/How-does-China-protect-human-rights-amid-COVID-19-outbreak--OvcwjUJjgs/index.html.
[4] Hunter, D. J. (2020). Covid-19 and the Stiff Upper Lip - The Pandemic Response in the United Kingdom. NEJM 2020; 382 (16): e31. Website: https://www.nejm.org/doi/full/10.1056/NEJMp2005755?af=R&rss=currentIssue.
[5] World Health Organization (WHO 2020). Clinical management of severe acute respiratory infection when COVID-19 is suspected. Interim guidance. March 13, 2020. Website: https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected.
[6] Parri, N., Lenge, M. and Buonsenso, D. (2020). Children with Covid-19 in Pediatric Emergency Departments in Italy. NEJM.org, May 1, 2020. Website: https://www.nejm.org/doi/full/10.1056/NEJMc2007617?query=RP
[7] Higher Institute of Health (ISS 2020). Characteristics of SARS-CoV-2 patients dying in Italy. Report based on available data on April 23th, 2020. Website: https://www.epicentro.iss.it/en/coronavirus/bollettino/Report-COVID-2019_23_april_2020.pdf.
[8] National Institute of Statistics (ISTAT 2020). Demographic Indices and Structure of the Italian Population from 2002 to 2019 (Indici demografici e Struttura della popolazione italiana dal 2002 al 2019). Website: https://www.tuttitalia.it/statistiche/indici-demografici-struttura-popolazione.
[9] National Institute of Statistics (ISTAT 2020). Demographic Indices (Indicatori demografici). Februar 11, 2020. Website: https://www.istat.it/it/archivio/238447.
[10] Worldometers (2020). China Population (Live). Website: https://www.worldometers.info/world-population/china-population.
[11] Ministry of Health (2020). Recommendations for the management of oncology and onco-haematology patients in emergency from Covid-19 (Raccomandazioni per la gestione dei pazienti oncologici e onco-ematologici in corso di emergenza da Covid-19). March 10, 2020. Website: http://www.trovanorme.salute.gov.it/norme/renderNormsanPdf?anno=2020&codLeg=73635&parte=1%20&serie=null.
[12] Ministy of Health (2020). Address Lines for the reshaping of the programmed activity differing during emergency from Covid-19 (Linee di indirizzo per la rimodulazione dell’attività programmata differibile in corso di emergenza da Covid-19). March 16, 2020. Website: http://www.salute.gov.it/imgs/C_17_pagineAree_5373_6_file.pdf.
[13] Coronavirus, SARS-Cov-2 and Covid-19 Facebook group for doctors only (2020). Covid-19, Appeal of 100 thousand doctors: strengthen the presence on the territory (Covid-19, Appello di 100 mila medici: rafforzare la presenza sul territorio). Panorama della Sanità, April 18, 2020. Website: https://www.panoramasanita.it/2020/04/18/covid-19-appello-di-100-mila-medici-rafforzare-la-presenza-sul-territorio/.
[14] Higher Institute of Health (ISS 2020). National Survey on COVID-19 contagion in residential and social health facilities (Survey nazionale sul contagio COVID-19 nelle strutture residenziali e sociosanitarie). Third Report. Update on 14 April 2020. Website: https://www.epicentro.iss.it/coronavirus/pdf/sars-cov-2-survey-rsa-rapporto-3.pdf.
[15] Higher Institute of Health (ISS 2020). COVID-19 epidemic National update 23 April 2020 (Epidemia COVID-19 Aggiornamento nazionale 23 aprile 2020). Website: ttps://www.epicentro.iss.it/coronavirus/bollettino/Bollettino-sorveglianza-integrata-COVID-19_23-aprile-2020.pdf
[16] Region of Lombardy - Giunta (2020). Resolution No. XI/2906 8 March 2020 (Annex 2). Website: https://www.regione.lombardia.it/wps/wcm/connect/5e0deec4-caca-409c-825b-25f781d8756c/DGR+2906+8+marzo+2020.pdf?MOD=AJPERES&CACHEID=ROOTWORKSPACE-5e0deec4-caca-409c-825b-25f781d8756c-n2.vCsc.
[17] Higher Institute of Health (ISS 2020). ISS Covid-19 Report No. 8/2020 (Rapporto ISS Covid-19 n. 8/2020 - Indicazioni ad interim per un appropriato sostegno delle persone nello spettro autistico nell’attuale scenario emergenziale SARS-CoV-2). Website: https://www.iss.it/documents/20126/0/Rapporto+ISS+COVID-19+n.+8+autismo+%282%29.pdf/c558b34e-1bc9-c868-0c75-0030f8299bca?t=1585757457709.
[18] Grasselli, G., Zangrillo, A. and Zanella A. (2020). Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA 2020; 323 (16): 1574-1581. Website: https://jamanetwork.com/journals/jama/fullarticle/2764365.
[19] Vergano, M., Bertolini, G., Giannini, A., Gristina, G., Livigni, S. and Mistraletti G. (2020). Clinical ethics recommendations for the allocation of intensive care treatments, in exceptional resource-limited circumstances. Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care – SIAARTI. March 6, 2020. Website: http://www.siaarti.it/SiteAssets/.
[20] Daugherty Biddison, E. L., Faden, R., Gwon, H. S., Mareiniss, D. P., Regenberg, A. C. and Schoch-Spana M. (2019). Too Many Patients…A Framework to Guide Statewide Allocation of Scarce Mechanical Ventilation During Disasters. Chest 2019; 155 (4): 848-854. Website: https://journal.chestnet.org/article/S0012-3692(18)32565-0/fulltext.
[21] Berlinger, N., Wynia, M., Powell, T., Micah Hester, D., Milliken, A. and Fabi, R. (2020). Ethical Framework for Health Care Institutions Responding to Novel Coronavirus SARS-CoV-2 (COVID-19). Guidelines for Institutional Ethics Services Responding to COVID-19. The Hastings Center, March 16, 2020. Website: https://www.thehastingscenter.org/wp-content/uploads/HastingsCenterCovidFramework2020.pdf.
[22] National Federation of Orders of Physicians Surgeons and Dentists (FNOMCeO 2020). List of the Physicians who fell during the Covid-19 epidemic (Elenco dei Medici caduti nel corso dell’epidemia di Covid-19). May 2, 2020. Website: https://portale.fnomceo.it/elenco-dei-medici-caduti-nel-corso-dellepidemia-di-covid-19/.
[23] AssoCareNews - Editorial Staff (2020). Coronavirus. Here are all the deceased Nurses for Covid-19 (Coronavirus. Ecco tutti gli Infermieri deceduti per Covid-19). May 2, 2020. Website: https://www.assocarenews.it/infermieri/coronavirus-ecco-tutti-gli-infermieri-deceduti-per-covid-19.
[24] Anelli, F., Nume, C. and Piscitelli, P. (2020). Italian doctors call for protecting healthcare workers and boosting community surveillance during covid-19 outbreak. BMJ 2020; 368: m1065. Website: https://doi.org/10.1136/bmj.m1065.
[25] Ministry of Health (2020). Covid-19 - Recommendations for health professionals (Covid-19 - Raccomandazioni per gli operatori sanitari). Last updated on 24 April 2020. Website: http://www.salute.gov.it/portale/nuovocoronavirus/dettaglioContenutiNuovoCoronavirus.jsp?lingua=italiano&id=5373&area=nuovoCoronavirus&menu=vuoto.
[26] Rosenbaum, L. (2020). Facing Covid-19 in Italy — Ethics, Logistics, and Therapeutics on the Epidemic’s Front Line. NEJM.org, March 18, 2020. Website: https://www.nejm.org/doi/full/10.1056/NEJMp2005492.
[27] Castelletti, S. (2020). A Shift on the Front Line. NEJM.org, April 9, 2020. Website: https://www.nejm.org/doi/pdf/10.1056/NEJMp2007028?articleTools=true.
[28] Nicoli, F. and Gasparetto, A. (2020). Italy in a Time of Emergency and Scarce Resources: The Need for Embedding Ethical Reflection in Social and Clinical Settings. The Journal of clinical ethics 2020; 31 (1): 92-94. Website: https://www.researchgate.net/publication/.
Cite This Article
  • APA Style

    Antonio Rimedio. (2020). Vulnerable Population in Covid-19 Outbreak: A Look at Italy. American Journal of Health Research, 8(3), 42-48. https://doi.org/10.11648/j.ajhr.20200803.14

    Copy | Download

    ACS Style

    Antonio Rimedio. Vulnerable Population in Covid-19 Outbreak: A Look at Italy. Am. J. Health Res. 2020, 8(3), 42-48. doi: 10.11648/j.ajhr.20200803.14

    Copy | Download

    AMA Style

    Antonio Rimedio. Vulnerable Population in Covid-19 Outbreak: A Look at Italy. Am J Health Res. 2020;8(3):42-48. doi: 10.11648/j.ajhr.20200803.14

    Copy | Download

  • @article{10.11648/j.ajhr.20200803.14,
      author = {Antonio Rimedio},
      title = {Vulnerable Population in Covid-19 Outbreak: A Look at Italy},
      journal = {American Journal of Health Research},
      volume = {8},
      number = {3},
      pages = {42-48},
      doi = {10.11648/j.ajhr.20200803.14},
      url = {https://doi.org/10.11648/j.ajhr.20200803.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajhr.20200803.14},
      abstract = {We examine the population groups most exposed to Covid-19 in the Italian social and health context. These groups include, firstly, elderly and disabled people with one or more pre-existing diseases and, secondly, health workers, especially doctors and nurses, who have paid a very high price in terms of contagion and death. If elderly people are infected with the virus and become ill with severe interstitial pneumonia, they are unlikely to be admitted to intensive care units and are destined to die in a short time. Therefore, in accordance with the principle of "equity" recommended by the World Health Organization, some resources should be devoted to protecting these elderly persons, so that they would not come into contact with the virus. Unfortunately, the measures taken by the Italian National Government and Regional Administrations have not been effective in protecting this elderly group, as is evident from the ongoing judicial disputes. Covid-19 health care professionals are the most exposed to the risk of contagion, which increases dramatically if there are no adequate personal protection equipment. And these protections were lacking, especially in the early stages of contagion. Meaningful demonstrations of a human solidarity have happened, which have crossed the boundaries of duty to the point of sacrifice of life.},
     year = {2020}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Vulnerable Population in Covid-19 Outbreak: A Look at Italy
    AU  - Antonio Rimedio
    Y1  - 2020/06/16
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ajhr.20200803.14
    DO  - 10.11648/j.ajhr.20200803.14
    T2  - American Journal of Health Research
    JF  - American Journal of Health Research
    JO  - American Journal of Health Research
    SP  - 42
    EP  - 48
    PB  - Science Publishing Group
    SN  - 2330-8796
    UR  - https://doi.org/10.11648/j.ajhr.20200803.14
    AB  - We examine the population groups most exposed to Covid-19 in the Italian social and health context. These groups include, firstly, elderly and disabled people with one or more pre-existing diseases and, secondly, health workers, especially doctors and nurses, who have paid a very high price in terms of contagion and death. If elderly people are infected with the virus and become ill with severe interstitial pneumonia, they are unlikely to be admitted to intensive care units and are destined to die in a short time. Therefore, in accordance with the principle of "equity" recommended by the World Health Organization, some resources should be devoted to protecting these elderly persons, so that they would not come into contact with the virus. Unfortunately, the measures taken by the Italian National Government and Regional Administrations have not been effective in protecting this elderly group, as is evident from the ongoing judicial disputes. Covid-19 health care professionals are the most exposed to the risk of contagion, which increases dramatically if there are no adequate personal protection equipment. And these protections were lacking, especially in the early stages of contagion. Meaningful demonstrations of a human solidarity have happened, which have crossed the boundaries of duty to the point of sacrifice of life.
    VL  - 8
    IS  - 3
    ER  - 

    Copy | Download

Author Information
  • Biotechnology and Life Sciences Department (Center for Clinical Ethics – CREC), Insubria University, Varese, Italy

  • Sections