COVID-19: Lessons from the Italian Reproductive Medical Experience
Antonio La Marca, M.D., Ph.D.1,2
Craig Niederberger, M.D.3
Antonio Pellicer, M.D.4
Scott M. Nelson, M.D., Ph.D.5,6,7
1 Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
2 Clinica Eugin Modena, Modena, Italy
3 Department of Urology, University of Illinois at Chicago College of Medicine, Chicago, Illinois
4 Instituto Valenciano de Infertilidad (IVI) Rome, Italy
5 School of Medicine, University of Glasgow, United Kingdom
6 NIHR Bristol Biomedical Research Centre, Bristol, United Kingdom
7The Fertility Partnership, Oxford, United Kingdom
By the time you’re reading this, much will have transpired. That’s the story with the exponential spread of an infection across the globe: it all happens so fast.
On December 31, 2019, the Health Commission of Hubei Province, People’s Republic of China, announced a cluster of unexplained cases of pneumonia. The virus was isolated, its genome was sequenced, and it was identified as the 2019 novel coronavirus (2019-nCoV). On February 11, 2020, the International Committee on Taxonomy of Viruses defined the virus as “acute severe respiratory syndrome coronavirus 2” (SARS-CoV-2) with the associated respiratory disease COVID-19 (CO-rona VIrus D-isease 2019). The COVID-19 pandemic brought unique challenges to the global healthcare community, with rapid escalation of the number of affected individuals and associated mortality over a handful of weeks. Clinical and public health guidance has tried to minimize the potential health impact using the best available scientific advice and evidence to inform decision making to help contain the virus, delay its spread, and mitigate its effect on those infected with it. Countries have adopted their own timing of risk-reduction strategies reflecting their differential risk assessments, with Italy having the largest number of affected cases outside of China. The impact and reorganization of clinical services that have been required by Italy will likely be faced by those around the globe in the weeks ahead given the anticipated trajectory of COVID-19.
The COVID-19 epidemic in Italy started on January 30, when two tourists tested positive. An outbreak was subsequently detected in a few patients in Lombardy on February 21, which quickly became 60 patients the next day. As of March 17, 2020, there were 31,506 positive cases from the 148,657 swabs tested, with 2,941 people who have fully recovered since testing positive and 2,503 who died. Among the measures to contain the infection, as early as February, 11 municipalities had been quarantined. Nobody could enter and leave those territories. Following the expansion of the areas with confirmed infection, the area of limitation of human activities was extended to various northern regions including Lombardy, Emilia, and Veneto, and from March 9, the entire country with 60 million citizens was placed in lockdown.