Photo submitted – Former Little Falls High School exchange student Samuele Vaccari works on school work from his home in northern Italy.

by Dave Warner

When you listen to the news reports coming out of Italy, it’s hard to get a grip on what is happening there and how it relates to us here in Little Falls, but former Little Falls High School exchange student Samuele Vaccari knows what’s going on all too well, as he lives in the epicenter of the hardest-hit area in northern Italy.

He resides in an area that is in the middle of one of the ‘red zones’, which means one of the most dangerous areas in the country.

He said it all started when two older people got sick and died in the province of Padua, but they had pre-existing conditions, so there wasn’t that much concern. Then, they had another 38-year-old man get sick in Codogno, a province of Lodi, who had had no contact with the couple.

“He was a runner and in very good health, and he was considered the first patient who had the coronavirus,” he said.

He said that everyone wasn’t really worried about it because they felt it was something far away and only something that China had to worry about.

“People thought it would be impossible for it to get here and influence our lives, but it quickly spread. It started three weeks ago on a Friday and by Sunday, the government decided to close all the schools.”

Vaccari said that people continued to go to work and proceed as if life was normal. “Everyone just thought it was another flu,” he said.

After a week though, it was clear that it was much worse and the Italian government took much stronger measures.

He said, “Not everyone here pays taxes, so the government really has had to cut back on healthcare. For example, they had to leave some doctors home and they didn’t have enough money to get the correct medical supplies.”

But once they started testing everyone who went to the emergency room, it was clear how large the problem was getting.

Vaccari said that the other countries in Europe were much slower to react, and people couldn’t figure out why Italy was getting hit so hard. He said, “we have contact with Chinese people, but how was it possible that it’s spreading so quickly?”

It was coming in through all of the other countries that weren’t testing, and because Italy was testing so frequently, and nobody else was, it just made it look like Italy was the only place with the problem.

“Many others had it, but we were the only ones reporting the cases at that time because we were the only ones doing the testing,” he said.

Two weeks ago, the country decided to close everything, including most of the workplaces. “Since then, we’ve been in quarantine,” he stated.

“People can’t leave their houses. If you have to go get groceries, you can, but it’s really better to stay home.”

The hospitals are full, so he said some people are getting taken care of at home.

In fact, on Saturday, physicians at the epicenter of Italy’s Covid-19 outbreak issued a plea to the rest of the world, warning that medical practice during a pandemic may need to be turned on its head — with care delivered to many patients at home.

“Western health care systems have been built around the concept of patient-centered care,” physicians Mirco Nacoti, Luca Longhi, and their colleagues at Papa Giovanni XXIII Hospital in Bergamo urged. But a pandemic requires “community-centered care.”

The U.S. medical system is centralized, hospital-focused, and patient-centered, as in most western countries, “and the virus exploits this,” said Maurizo Cereda, co-director of the surgical ICU at Penn Medicine in a paper published on Saturday.

“We are far beyond the tipping point,” Nacoti and his colleagues write. With 70% of ICU beds reserved for critically ill Covid-19 patients, those beds are being allocated only to those “with a reasonable chance to survive,” as physicians try to make choices about who has a chance to live.

“Older patients are not being resuscitated and die alone without appropriate palliative care, while the family is notified over the phone, often by a well-intentioned, exhausted, and emotionally depleted physician with no prior contact,” they stated.

Major hospitals such as Bergamo’s “are themselves becoming sources of [coronavirus] infection,” Cereda said, with Covid-19 patients indirectly transmitting infections to non-Covid-19 patients.

“All my friends in Italy tell me the same thing,” Cereda said. “[Covid-19] patients started arriving and the rate of infection in other patients soared. That is one thing that probably led to the current disaster.”

Vaccari says that being quarantined for two weeks hasn’t been too bad for him because he’s in the country and can take walks, but for those people in the city, you have to stay in your own house. “It’s not like in the U.S. Most people have flats or apartments, and you can’t leave them. It’s really hard to keep everyone inside.”

He has talked to many of his friends back in Little Falls, and he says they don’t really care about this thing. “I’m not saying they’re wrong, because I was the same way three weeks ago. But now that I’ve been home for two weeks and I haven’t seen my friends or gone to school or been able to hang out with them, I really miss it.”

Vaccari says that it’s really stressful for everyone and at this point, the government has not told them when it might end. “It’s really hard to tell because the deaths have continued to climb from 350 per day, to now over 600.”

“It’s a really bad situation and I’m glad you took the time to interview me because I’m telling you that soon, it will be the same there. We’re not in this situation because our healthcare is bad, it’s because it’s fast-spreading and hard to contain,” he stated.

He said that people had been making jokes about it and didn’t really understand the situation. “My advice for my friends would be to keep calm, and please stay home and don’t pretend that you can see your friend and that is going to be ok and that you might not get it.”

“I know it’s hard, but just stay home, because here, it’s all messed up. I’ve never seen my hometown so empty,” he stated.

Right now, he’s taking classes six days a week online and at home.

Vaccari thinks there will be long-term changes to Italy’s culture. “There’s already an idea out there that we won’t go back to school until September. If I get a fever next year though and have to stay home, it won’t be a problem because they’ll have a webcam in the class so I can follow from home. I think that will be a good thing.”

He thinks that business and adults will also change, using a lot more video-conferencing instead of traveling. “I believe this is going to change everyone’s mind. There are going to be a lot of home workers where there weren’t before.”

In the end, he said, “I wish we could just go back to school. We were the first to close, but we’ll be the last to open. I’m in my 12th year and at the end, I’m supposed to have a big exam to go to college. If I don’t pass it, I have to repeat the year. I want to go back to school to get ready for this,” he said.

He had a final message for his young friends in Little Falls. “If you want your parents and grandparents to live, you’d better stay at home.”