ROME – Remember the, uh, good days of cholera?
For many in Italy, the slow rollout of the coronavirus vaccinations has made people almost nostalgic 1973, as Naples faces an outbreak of a potentially devastating disease many believe has long been lost in industrialized nations.
The city was rescued after a mobilization effort that saw nearly 80 percent of the city’s population – about 900,000 people – vaccinated within five days. Only 24 people died in Italy, thanks in part to the US Navy, the Italian Communist Party, and a lack of vaccine skepticism.
Nearly five decades later, as stop-start vaccine rollouts in Italy continue, the reaction to the 1973 Napoli outbreak has been held by virologists and politicians as a model to follow.
“In Naples half a century ago we vaccinated one million people a week … why are we going so slowly in Italy?” said former Prime Minister Matteo Renzi, yang bring down the government in January due to differences in coronavirus recovery plans. He called the delay in vaccination an “unforgivable mistake.”
Since the first injection was given two months ago, Italy has managed only six doses per 100 people (in the UK, the figure is 27 per 100). At the current rate, the government’s target to vaccinate 70 percent of the population will be achieved in April – April 2024, that is.
The first cholera case in Naples was detected in August 1973, with an error attributed to shellfish illegally imported from Tunisia.
The authorities’ response has been to add chlorine to water supplies, ban the sale of seafood and clean city streets.
However, the European cholera epidemic 1911 – that’s inspired Thomas Mann “Death in Venice” and resulted in 6,000 deaths in Naples alone – still in living memory. To prevent a recurrence, Napoli are demanding a mass vaccination campaign.
“In Naples, the fear of cholera is ancestral, that word only creates mass panic,” Paolo Cirino Pomicino, then a member of the city council and later national minister, told POLITICO.
Within days, large lines formed outside dozens of immunization centers in public buildings, churches and theaters, with vaccinations being carried out 12 hours a day, Pomicino said. “There is no jumping queue,” he said. A very disorganized city suddenly becomes very orderly.
The US Navy’s 6th Fleet, stationed in Naples, played a valuable role, immunizing thousands of people who showed up at its base. Using syringes from a fast-acting pistol, first used in the Vietnam War, they were able to vaccinate 30,000 people in less than five hours, according to Francesco De Lorenzo, the former health minister. The then mayor of Naples, Gerardo De Michele, who was a doctor, helped vaccinate the people in the City Hall grounds.
The opposition Communist Party also made an important contribution, setting up vaccination centers in loyal neighborhoods.
The Communist Party “wants to demonstrate its technical and organizational skills, showing that communists are not baby eaters, they were created in the 50s and 60s, and are capable of ruling cities, if not countries,” said historian Luigi Mascilli Migliorini of Napoli L’Orientale. University.
Although the efficiency is impressive, there is a reason why it is difficult to replicate the campaign of the 1970s today.
The coronavirus has a much lower death rate than cholera, so fearlessness drives people to seek immunity and, while cholera is a known disease with existing vaccines, COVID-19 is a new disease. Italians are also more skeptical of vaccines today, with only six out of 10 say they’ll get the vaccine.
The Italian government blames pharmaceutical companies for distribution delays and the European Commission for drafting toothless contracts, but supply failures cannot fully explain the delays. In Italy, 80 percent of the doses of the Oxford / AstraZeneca vaccine that have arrived have not been used.
The lack of qualified personnel is a problem – and the syringes can no longer be used because of the risk of spreading diseases such as HIV or hepatitis. A typical vaccination in Italy now takes six minutes.
For some, the reorganization of the Italian health care system in 1993, when regions were given health responsibilities, led to a lack of coordination between central and local governments.
“There is no ability to control. They know a vaccine is coming, they can employ the 12,000 doctors they know will be needed, but now there is a shortage of personnel, “said De Lorenzo.
Some areas, including Veneto, even had looking to secure their own vaccine supply rather than relying on national stocks.
Better than expected
Napoli at first appear to have weathered the coronavirus crisis quite well.
A mix of densely populated cities, notorious for poor governance and with populations often characterized as skeptical of authority and overly friendly – and therefore reluctant to stay home – can be a recipe for disaster.
But in the first wave there was a higher than expected level of public compliance, perhaps thanks to the memory of the cholera crisis. The death rate in the Campania region of Naples in 2020 was the lowest in Italy at 1.3 percent, compared to 5.4 percent in Lombardy, according to a study by National Observatory of Health in Italian Territories.
Excess death – the number of deaths from all of the above and beyond forecast under ‘normal’ conditions – in Naples between January and October 2020 was less than 1 percent compared to 60 percent in the worst-affected area, Cremona in the north.
The city hospital of Cotugno, once the epicenter of a cholera epidemic, is becoming a global model for coronavirus best practice, without its medical staff members becoming infected.
The former director of the hospital, Franco Faella, who started his career at the forefront of the cholera crisis, is brought out of retirement when the pandemic begins, to train staff in safety procedures and set up field hospitals for COVID-19 patients.
But Napoli’s lockdown compliance has gradually diminished. Social distancing is a big question when about two in three workers are engaged in informal work, sometimes working as little as € 20 a day.
On Friday, after cases increased to 2,000 per day in Campania, regional president Vincenzo De Luca ordered schools to close.
With the focus shifting to vaccination, there are complaints that Campania has allocated less vaccine than any other major region.
De Luca promised to vaccinate 4 million out of Campania’s 5 million people in July, but he has already done it be warned on several occasions that it takes a “miracle” to complete this year’s vaccination campaign.
“We need to vaccinate 50,000 a day but currently we are receiving deliveries of only 50,000 vaccines a week,” De Luca said in a statement video statement.
The Neapolites wanted to point out that the last case of cholera was diagnosed on September 19, 1973, at a feast of the city’s beloved patron saint, San Gennaro, when bottles filled with the dried blood of 4th century martyrs were put on public display. in the city’s cathedral and devotees praying for its thawing, known as the “Miracle of San Gennaro.”
Although the blood failed to thaw that year, the saint’s liberation of the city from cholera was carried out. This September, the Napoli people will most likely be waiting for another miracle.
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