August 21, 2020 | Friday

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Giuseppe Ruocco – an Italian medical professional shares his advice for Kosovo in the COVID – 19 fight 

We interviewed Giuseppe Ruocco, Secretary General – Chief Medical Officer for the Italian Ministry of Health, and a member of the Scientific and Technical Committee’s advisory body for Civil Protection – one of several entities playing a crucial role in the management of Italy’s COVID-19 pandemic. As Italy was one of the first few countries to face the pandemic’s ‘first wave,’ we asked Giuseppe Ruocco to shed some light on the country’s ongoing COVID-19 situation, and his advice for Kosovo.

What is Italy’s current situation with regards to the COVID-19 pandemic? How is the country reacting?

The situation in Italy has much improved in comparison to what we had experienced in the spring, although it still cannot be said that the virus no longer circulates within our country. Nevertheless, we have had a number of smaller outbreaks, which, until now, have been successfully contained and not led to the pandemic’s further expansion. The virus is still present, it is still being transmitted, and over recent weeks, its presence in Italy has also been fuelled by the arrival of people from abroad who are either sick, or who carry the virus with them from countries that are currently experiencing the worst phases of the so-called ‘first wave.’ It is for this reason that further precautionary measures have been taken with regards to arrivals from a number of countries. It could be said that the Italian population’s reaction at the moment is biphasic. On the one hand, we have matured, we are cognizant as to which habits to adopt (such as interpersonal distancing, the use of masks when social distancing is not possible, frequent and thorough hand washing), and we are all aware of these rules by now. On the other hand, the desire to resume ‘normalcy,’ and the reduced number of cases, emboldens people into doing things that they would not ordinarily do given this critical moment, such as approaching other individuals without donning masks in certain evening-time situations – including convivial locations where there is an increased desire to resume normal social life. In such situations, we must somehow resist the impulse and curb our desires.

What are some of the strategies that are proving most useful in containing the epidemic (taking into account governance and communication)?

With regards to governance, what is certainly proving to be very useful is our fully operational monitoring system, which provides us with a weekly dashboard made up of a series of indicators that gives us a general picture of the epidemic, relevant numbers, and system responsiveness. However, this system was not fully operational from the very beginning, as it required the commitment of regions, local health authorities, the central government, and scientific bodies. Furthermore, the system helps people and other relevant entities along the operational chain feel that there is an institution in charge, thus motivating them to do their part, while assisting in the prompt identification of potential viral comebacks, which certainly cannot be ruled out, given that this type of viral pandemic has, in the past, shown ‘waves’ of return – even if at lower peaks. As such, this is our first effective tool. The second tool at our disposal is to resist indiscriminate and somewhat hasty reopenings. We had initiated reopening the country in various stages beginning on 4 May; however, there are still a number of activities that are not allowed – particularly mass gatherings such as those seen in sporting events. We also delayed the reopening of schools, given that the pandemic’s impacts have yet to be clearly identified. Assuredly, measures that prevent unconditional reopenings come with a number of pros and cons – nevertheless, they remain the second strategic factor. The third strategic factor was to invest in a series of state-funded enhancements which are slowly gaining traction, entailing the ability to better implement contact tracing with regards to infections, the improved monitoring of home patients, as well as the surveillance of individuals who are meant to stay at home. The war on Covid-19 is also fought outside hospitals.

What message or advice would you give Kosovar institutions/public entities, and to the country’s medical and paramedical staff, given the growing number of COVID-19 cases there?

Although they currently face a bad situation, there is still a silver lining – they have at their disposal the collective experiences of countries that have already undergone the pandemic’s worst moments. I can vouch that the rigid application of the measures I mentioned earlier do indeed work, and, although they may not definitively resolve the problem, they do serve a ‘double positive’ function. Firstly, these measures reduce the speed of viral spread, which subsequently results in a decrease of serious cases, and a reduction of the pandemic’s impact on the health system – thus buying Kosovo time to face this emergency. Secondly, this must be accompanied by large diagnostic capabilities, like swabs, luckily now quicker and more-standardised laboratory tests are available. Kosovo certainly has several advantages at their disposal – they can use them in the best way, the important thing is they to do not hesitate to adopt severe measures should they be necessary. It is crucial that the above-mentioned measures be combined with accurate communication initiatives. In my opinion, it is of the utmost importance that a clear chain of communication is continuously maintained when handling such emergencies. This entails knowing the individual who is dispensing the information, their reasons for doing so, and ensuring that they consistently convey such communication with maximum transparency, without obscuring information, and that they readily admit to not knowing all the answers. This is especially true when the situation is still being studied, as the provision of a false sense of security is dangerous, and resulting failures may cause individuals to lose confidence in the authorities who are handling the pandemic. Consequently, transparency, intellectual honesty, clarity of communication, and the timeliness of communication, are, I believe, crucial elements in dealing with all types of emergencies.

What advice would you give the Kosovar population, and what can they do to help improve the situation while protecting themselves?

I would advise Kosovars to follow the indications being given by their health authorities. Do not underestimate symptoms, because even if someone is displaying mild symptoms of COVID-19 (as is often the case), this does not guarantee that those they infect will also experience mild symptoms. Subsequently, individuals have a double responsibility both to themselves, and to their community – unconscious behaviour such as walking around when one is feeling unwell is, for example, not a good idea. To this end, everyone can, and must, contribute to the solution of the pandemic by adopting suitable precautionary measures. This should be coupled with the preventive measures mentioned earlier: interpersonal distancing, the use of a face mask in closed venues or when social distancing is not possible, as well as frequent and thorough hand washing. I would like to emphasise to individuals who are potentially ill: do not attempt to bypass lockdowns as that would certainly not be a smart move, instead, respect the elderly or chronically-ill individuals who, as we have all seen, are most vulnerable to the virus.

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