Humanitas' Italian doctors are three months ahead of their Latin American counterparts in the fight against the pandemic. A video conference between the two shared how they organized their hospitals, care for their staff, and treat most effectively.
The “pan” in pandemic comes from the Greek, meaning “all”, “of everything”, or perhaps most-fittingly in the medical preventions of the day, “involving all members”. It was in that spirit that on May 15, Humanitas Research Hospital doctors Salvatore Badalamenti, Director of Emergency Medicine, and Michelle Ciccarelli, Director of General Medicine and the Pneumonology operating unit, discussed in a global webcast some of the life-saving techniques and learnings they and their staff encountered in fighting Covid-19 in Italy.
The audience, made up of over 70 doctors working in Techint Group communities across Argentina, Brazil and Mexico, listened to the two medics recount the experience of treating the disease as it made its entrance into Europe. Afterward, the doctors were invited to ask questions on treatment practices, differences in regional presentations of the disease or pathologies, and successes or challenges with different medications used in the fight.
To carry out the teleconference, a special room was set up in compliance with established prevention protocols and maintaining preventive social distance.
A frontline testimony
In tracking the history of the pandemic thus far, Badalamenti highlighted the sharp rise in February that changed the Italian situation dramatically. “In the first or second week of February, we weren’t even talking about Coronavirus in our country,” said Badalamenti. “In the middle of February, we encountered the first patient detected with coronavirus. From there, things grew with great velocity, we had to care for our patients, and saw the changes day to day.”
To properly handle that growth, protecting both fellow nurses and doctors while treating the most urgent cases, Humanitas Rozzano needed to change the attitude and practicalities of its hospital practice. “We are a treatment hospital [for cancer and cardiac issues to name some], but we became one of infectious disease,” explained Badalamenti. “We changed medical departments and 300 of our 600 hospital beds had to be changed over for Coronavirus treatment.”
As the epidemic in Northern Italy progressed, treatment protocols at Humanitas were implemented, monitored and changed as new findings came to light. In particular, the initial treatment as a solely respiratory disease changed to treat the now more-evident inflammation issues affecting patients.
“As this progressed, we have seen a different list of symptoms,” said Ciccarelli, making the treatment course difficult. Nevertheless, several innovations were made and used. “We made a video tutorial, for example, in the management of patients with noninvasive care: avoiding intubations by the use of a helmet,” Ciccarelli explained. “The goal is working toward proper pulmonary care without invasive measures; to avoid the ICU.”
Ciccarelli told the other medics that in early stages of the Italian epidemic, the Italian governmental decrees meant that ER-presenting cases were near exclusively Covid-19 pneumonia. “We quickly learned that antivirals only help if a patient is treated before that first week of major infection, before the development of inflammation.”
This conference is part of the actions that Ternium has taken in response to COVID-19, within the communities near our plants.
Learning from experience
In San Nicolás, Argentina, the meeting took place at the Hotel Plaza, where a special room was set up for the participants taking into account social distancing measures and the provision of sanitizer.
Juan Manuel Desposito, director of the Gomendio de Ramallo Hospital, expressed his appreciation with the meeting between health professionals. "These meetings are very relevant because they help us understand the work methodology that was carried out in places where the disease had more difficult consequences, and to be able to be prepared."
For his part, Pablo Gavazza, Director of the San Felipe de San Nicolás Hospital, was interested in “…the synergy that they achieved at Humanitas between the different medical specialties that focused on direct treatment of the coronavirus. A path that we should repeat in our communities.”
From Monterrey, Mexico, participants from the Ternium affiliated Hospital Clínica Nova took part in the conversation. Dr. José Luviano, Head of Hospital & Critical Areas said the experience will help to align treatment plans at his clinic. "It is very important to follow these guidelines, especially in a disease that is not known, in which there is no treatment and everything is experimental," said Luviano. "Knowing the experience of other countries allows us to standardize treatments and adapt our local protocol,."
In Campana, Argentina, participants gathered at the TenarisUniversity campus at Siderca to participate in the conversation.
"Today's talk gives us a great overview of what was lived and continues to happen in Europe, comparing Argentine medical protocols with those of other regions in search of best practices," said Christian Celiz. Regional Manager of Medical Services, Argentina. "We were able to incorporate medical and cultural experience, and strategies to have fewer infections in the health field and to be able to control this pandemic, using the best resources.”
"It has been a very positive meeting because they are specialists who are three months ahead of the treatment of this pathology. The problem came to them suddenly, instead, we have been preparing for months and we have the resources to face it, ” said Dr. Gabriel Espósito, head of Intensive Care at the Municipal Hospital San José de Campana, an establishment that has received significant assistance from Tenaris during the pandemic, tripling its capacity of beds with mechanical respiratory assistance.
In offering to those in Campana why the Techint Group saw the need and opportunity to offer such a resource to the doctors and health authorities, Erika Bienek, Community Relations Director, said it aligned perfectly with the community commitment of the companies.
“This pandemic has been a particular challenge because needs arose in many communities, at the same time and with intensity,” said Bienek. “The emergency is not only sanitary but also economic and educational. However, the company's vision is to always be present.”