We can console ourselves because Mario Draghi has put a piece of it, as many Italians of good faith think. Or we can rejoice because he has beaten a minister in confusion, as do the political opponents of Roberto Speranza. In both cases we are looking at the finger: vaccinations. The premier’s turnaround to the ban on administering the second dose of AstraZeneca under the age of 60 is a scientifically straight finger, because it puts medicine back in line with its evidence, preventing it from making heterologous immunization mandatory on which sufficient data is lacking. And it is a big finger, because it is swollen by the controversy, so much so as to hide the Moon behind it from view: the Italian health system. On whose fate has come the greatest and most serious eclipse of public consciousness.
If we had the courage to look behind the finger, we would discover that we are the country in Western Europe with the highest mortality for Covid and non-Covid. A monstrous record, which nobody talks about. In 2020 Italy counted 108,178 deaths more than the average of the previous five years. Three out of four are victims of the virus. The remainder, that is 27 thousand, took away a heart attack, or other cardiovascular diseases. They are the first. Because the others, the oncological and chronic deaths will come this year and in subsequent ones. And there will be many more.
These data alone tell the disaster of the National Health Service, despite the commitment of those who work there. They are contained in an article by Francesco Cognetti, president of the Confederation of oncologists, cardiologists and haematologists, published two days ago on the Giornianosanità.it website. In many regions, the so-called electoral interventions are still suspended: one hundred thousand operations for cancer have already been skipped. Cancer treatments are at stake, prevention has almost completely disappeared from the radar. Heart attack victims outside the hospital doubled. And who talks more about waiting lists? Sooner or later someone will have to deal with it. And then creepy delays will come out.
The latest vaccine ministry gaffe is the photograph of non-government in the midst of a storm. We are at the mercy of a scientific technical committee where bureaucrats abound and clinicians can be counted on the fingertips. He has a fragile relationship with hospitals and completely ignores territorial medicine. Its decisions should be opinions. But in the vacuum of political responsibility they become binding deliberations.
On the death of the 18-year-old, killed by a poorly managed thrombosis after an administration of AstraZeneca, the Cittiesse faced the enormous emotional impact of the country as if it were a political body, but without being one. And it went into confusion. Incidentally: a few days later a healthy fourteen-year-old died, killed by Covid. None of the media that tried the vaccine in the square seems to have noticed. But that’s another story.
Doubts about the use of AstraZeneca under the age of 60 had taken root in the preceding weeks. And not without validity. In a crescendo directly proportional to the decrease of the emergency. In many European countries, the question has been asked to what extent it was convenient to administer a vaccine with a low risk of adverse effects, but found, in age groups where the risk of mortality from Covid is close to zero. If the paradigm shift had been taken politically and explained in advance to the population, the gradual divorce from AstraZeneca would have been the landing of a vaccination strategy which, under the given conditions, must build on experience. The opposite happened: the second dose was banned with a ban that citizens and the scientific community interpreted as an emotional reaction. Thus the vertigo of the alternate scientists was added to the emptiness of politics.
Draghi’s dutiful patch is not without side effects. By making the second heterologous dose optional, he denies the Minister of Health, but also the scientists. And it puts in the hands of the citizen a choice that the latter does not have the tools to make. But at least it counteracts the public perception of being treated like guinea pigs, and avoids the risk of a mass syringe leak, which no country can afford. Because the Delta variant in London proves that a partial vaccination does not fully protect against hospitalization and death.
This story clearly demonstrates that Healthcare struggles in the face of the emergency, and ignores everything that the emergency hides. The success of the vaccination campaign is a de facto commissioner of the Ministry of Health. The whole country feels on the broad shoulders of Mario Draghi and General Francesco Paolo Figliuolo. But vaccines are not all health, and sooner or later the knots will come to a head. The nodes say that the number of beds per hundred thousand inhabitants in Italy is much lower than the European average: 314 against 500. That intensive care has not doubled, as Speranza enthusiastically announced on May 13 a year ago, but they are grew by only 922 units. That the hospital specialists are 130 thousand, 60 thousand fewer than Germany and 43 thousand fewer than France. That the twenty thousand new hires during the pandemic are trainees and sometimes not even trainees. That the limited number in medical schools is a corporate absurdity ignored by ministers. That spending on health is the lowest among Western European countries. Lastly, local medicine is the most deficient point of the system. Because the affiliated white coats do not enter the emergency and do not act as a filter between the disease and the hospital.
Faced with this havoc, the former premier Giuseppe Conte should explain how he managed to renounce the loans of the Mes, to please the grillino fanaticism. And the new prime minister Mario Draghi should ask himself if 8 percent of the funds of the National Recovery and Resilience Plan are enough to heal such a disastrous healthcare, to modernize hospitals, to enhance and train professionals, to re-establish basic services, to update the logistics. Sustainability is both the slogan of the time and the magnet of European resources. Which will largely end up in ecological transition. But isn’t the relationship between the quality of health therapies and the growing health expectations of the population perhaps a theme of sustainability? Or should we hope to fight cancer by reducing pollution, because we have stopped treating it?