Time.news – Milan, April 28 – The Ministry of Health decided to ‘narrow’ the notion of a suspected case of coronavirus between on 22 and 27 January 2020 presumably based on an evaluation discretionary and not a “review” of this notion by the WHO as written in a document signed by Francesco Maraglino, director of the ministerial office ‘Transmissible diseases and international prophylaxis’. He tells the Time.news Consuelo Locati, the lawyer at the head of the pool of lawyers involved in the civil case brought before the Court of Rome by 500 relatives of the victims of Covid against the government.
“The definition was changed because we weren’t ready”
“This would have compromised the immediate detection of the infection, the epidemiological surveillance and therefore would have facilitated the latent spread of the virus, especially in Lombardy and in the Bergamo and Brescia areas. The Ministry of Health should explain to citizens on the basis of which premises it took the initiative to narrow the definition of the case, in the absence of any indication from the WHO, binding the detection of the virus only to those who had had contact with China in the previous 14 days “.
The issue is also the subject of investigations by dethe magistrates of Bergamo who investigate for culpable and false epidemic in relation to the reopening of the hospital in the municipality of Bergamo after the discovery of the first cases of contagion. The pool of prosecutors led by Antonio Chiappani wants to understand on the basis of which indications ‘from above’ the health workers acted.
“I can’t say for sure if there was this WHO document or not, I looked for it without finding it – he explains to Time.news Giuseppe Marzulli, at the time medical director of the health center of Alzano Lombardo, heard as a witness by the prosecutors -. What I know for sure is that the ministerial circular of January 22 gave correct indications allowing doctors to suspect cases of Covid even in the absence of travel. If this definition had remained correct, the doctors could have asked to swab even those who had abnormal pneumonia in the absence of other circumstances “.
Even Marzulli, like Locati, speculates, specifying that it is his “opinion”, that the restriction of the notion of case “was chosen by the Ministry on a discretionary basis because otherwise a quantity of tampons would have been necessary that was not there”.
The “unobtainable” document of the WHO
In this ministerial circular of January 22, we read that not only the cases of those who have “an acute respiratory infection (SARI) with fever and cough that required hospitalization, without other etiology that fully explain the clinical presentation should be reported “,” Who has a history of travel to Wuhan in the 14 days prior to the onset of symptoms “, who carries out the profession of” health worker who has worked in environments with patients with severe acute respiratory infections “, but also those of people who “Manifest an unusual or unexpected clinical course, especially a sudden deterioration despite adequate treatment, regardless of the place of residence or travel history, even if another etiology has been identified which fully explains the clinical situation ”. “Mysteriously”, Locati comments, in the circular of 27 January 2020 these last cases disappear and only the first remain.
On 21 April 2020 Maraglino in an email to the secretariat of Deputy Minister Pier Paolo Sileri refers to the “passage of the definition of the case” in the circular of 22 January “which invited to report as suspect the case of a person who manifests a clinical course without taking account of the place of residence or travel history “and that of January 27 in which this phrase” disappeared “. Maraglino explains that “the case definition is given by the WHO e we (like the other states) change it accordingly “and that on January 21, the WHO revised the definition of the case, which we incorporated in the circular of January 27”. But, according to Locati, this is not the case.
“The interim guidelines that did not restrict the definition”
“After long searches, we have not found this document that would change the cards on the table. On the WHO website there are three interim guideline documents dated 11, 15 and 31 January. In all of these, in defining a suspected case, reference is also made to people suffering from an acute severe infection without taking into account the place of residence or a suspected ‘history’ of travel “.
“In the ministerial circulars there are references to documents that we do not know exist and that are certainly different from the WHO interim guidelines in our possession issued until January 30, 2020 – continues Locati -. Perhaps because there was knowledge of the scarcity of laboratories, and that they had not stockpiled or procured swabs and reagents for epidemiological tracing? Suffice it to say that out of a population of 10 million inhabitants there were only them three of laboratories in Lombardy, as the Ministry itself attests in the circular of 22 February 2020, in which, moreover, it seems to attribute the authorship of the change in the definition of the case. Too bad that to date almost 116,000 victims, whom we lawyers represent, legitimately demand that every act be justified by documents, serious and dignified as well as decent ”.
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