COVID-19 Pandemic by Unknown

COVID-19 Pandemic by Unknown

Author:Unknown
Language: eng
Format: epub
Publisher: SAGE PUBLICATIONS PVT LTD
Published: 2020-11-30T16:00:00+00:00


Lessons (Hopefully) Learned and Possible Future Directions

Converging Crises

At the beginning of the COVID-19 pandemic, Italy was a country still recovering from the 2008 financial crisis. The adoption of harsh austerity policies has led to substantial cut in public expenditure (Pavolinia et al., 2015). A longer time frame and research efforts are needed to assess the links between welfare retrenchment and its consequences on all public infrastructure, critical to counter the impact of the COVID-19 crisis, for example: the NHS, the educational system and the social service sector. At the state level, low productivity growth, high public debt, strong social inequalities among groups and territories, and poorly integrated social policies were issues still not addressed (European Commission, 2020). Moreover, both locally and globally, environmental issues, ranging from pollution to anthropogenic climate change, may have played a role in the actual crisis (Wu et al., 2020). Some aspects of the COVID-19 crisis have been attributed to sfortuna (bad luck), such as its timing and a lack of scientific knowledge about the virus. In any disaster many variables are not under the full control of policymakers. Nevertheless, decades of studies on disaster management help to develop a more complex analysis, highlighting the importance of actions for prevention and preparedness. The analysis of the ‘Italian case’ highlights several areas of rapid response to the crisis, but few actions in the mitigation stage, both at the national and at the global level (Djalante et al., 2020). The WHO's Health EDRM model and the Sendai framework stress the importance of a cultural shift in disaster management, that should be risk-based, proactive instead of reactive, inclusive and community-centred.

Towards a Proactive and Community-centred Model of Health Care

Expenditure for public hygiene services underwent the most significant budget cuts (Signorelli et al., 2016). The primary care sector has been only modestly addressed by reforms and policy initiatives (Ferrè et al., 2014). However, these sectors turned out to be essential in the response stage. In particular, in the territories where a community-centred approach to health care was more developed, health services seemed to have performed better in responding to the pandemic (Nacoti et al., 2020). In Veneto, the regional governments have invested in integrated health care at the territorial level and several prehospital facilities (Antonini et al., 2020). Its response to the pandemic has been based on more extensive testing of symptomatic and asymptomatic cases, proactive tracing of potential positives and a stronger emphasis on home diagnosis and care. The set of policies enacted in Veneto are thought to have considerably reduced the burden on hospitals and minimised the risk of COVID-19 spreading in medical facilities, a problem that has impacted hospitals in Lombardy, where a more hospital-centred approach was adopted (Nacoti et al., 2020).

To date it seems clear that early case-finding, testing, tracing and care are essential to stop transmission. Physical distancing restrictions are just one of many other measures needed. The availability of human and material resources is the base to avoid decision-making based on priorities dictated by budget restrictions.



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