On 31 January, the first two cases of COVID-19 were confirmed in Rome. A Chinese couple, originally from Wuhan, who had arrived in Italy on 23 January via Milan Malpensa Airport, travelled from the airport to Verona, then to Parma, arriving in Rome on 28 January. The next afternoon, they developed a cough, and by evening the man had a fever; the couple were taken to the Lazzaro Spallanzani National Institute for Infectious Diseases where they tested positive for SARS-CoV-2 and were hospitalised. On 2 February, a team from the same institute composed of scientists Maria Rosaria Capobianchi, Francesca Colavita, and Concetta Castilletti isolated the genomic sequence of the virus and uploaded it to GenBank. On 31 January, the Italian government suspended all flights to and from China and declared a state of emergency with the duration of six months. Prime Minister Giuseppe Conte said Italy was the first EU country to take this kind of precautionary measure. The government also introduced thermal scanners and temperature checks on international passengers arriving at Italian airports.
The pandemic outbreak put pressure on the Italian healthcare system. In order to deal with the numbers of COVID-19 patients, intensive care units were expanded, and new hospitals were created, especially in Lombardy. In Emilia-Romagna, professor Marco Ranieri developed a method to double the efficiency of ventilators in ICUs. The lack of a single protocol for hospitals was considered to be a problem. Due to hospitals overcrowding with coronavirus patients, thousands of cancer patients experienced difficulties in getting access to treatment and transplants, with their lives put at even higher risk. Dozens of cancer hospital sections were indeed wither dedicated to host coronavirus wards, or closed after personnel got infected. According to a study, cancer patients represented 17% of coronavirus fatalities in Italy. A letter published on the New England Journal of Medicine Catalyst Innovations in Care Delivery claimed that one of the reasons for the high death count in the area of Bergamo was hospital contamination. Progressively, different hospitals became dedicated to COVID-19 patients only, and more rigid separations were set up between hospital sections and triage structures. In some regions, hotels were used to host healthcare workers or patients, and in Liguria a ship was adapted to host people in quarantine. On 1 April, the first Italian drive-through testing facilities opened in Alessandria and in north-western Tuscany.
At least ten different clinical trials were ongoing in Italian hospitals at the beginning of April. The supercomputer of ENEA in Portici was used to run advanced simulations related to other possible drugs. Some of the treatments employed for COVID-19 patients involved the administration of antiviral drugs. Remdesivir was tested with promising initial results in Naples. Despite doubts from the scientific community, Avigan (favipiravir) was also included in testing protocols by Italian Medicines Agency even though it was not authorised in Europe. Similarly to France, hydroxychloroquine (the less toxic version of the malaria drug chloroquine) was also tested. Plasma treatment already tried in China (transfer of antibodies from recovered COVID-19 patients to sick people) was tested at the hospital of Pavia (and later in Mantua) under the supervision of professor Cesare Perotti; the first two donors involved in the research programme were a married couple, both doctors and among the first COVID-19 patients reported in the province.
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