How one Italian town managed to stop the coronavirus in its tracks

Transcript

At the beginning of the coronavirus pandemic, the small Italian city of Vò had the dubious honour of being the site of the county's first COVID-19 death.

Since then, Italy has seen more fatalities than any other country, with latest figures showing that 6,820 people have died from the infection in barely a month. The total number of confirmed cases hit 69,176 on Tuesday.

But Vò has become a beacon of hope. Doctors there have been able to stop the spread of the coronavirus that causes COVID-19, and their work has become a model for other communities struggling to contain it

"We managed to eradicate coronavirus from Vò, achieving a 100 per cent recovery rate for those previously infected while recording no further cases of transmission," Italian health officials Antonio Cassone and Andrea Crisanti wrote in the Guardian newspaper. 

Crisanti, a professor of microbiology at the University of Padua who led the experiment, spoke to As It Happens host Carol Off. Here is part of their conversation.

What is the situation in Vò? Is the virus still contained there?

Yes. The good news is that we haven't had new cases in Vò since we did the last survey. 

There was one case, but it was a relative of an infected person that was living in the same household. So that's quite, let's say, expected that these people are at very high risk. 

You're surrounded by parts of Italy that had a drastic infection. So how did you do it? What is the secret that Vò had that the others didn't?

The secret is that, first of all, Vò was the first place where the epidemic started. And on that occasion, the city was locked down, and everybody was tested. 

So what happened [was] we could identify from the very beginning all those that were in the position to transmit the disease to others. They were isolated. Then nine days after, we did a second survey. We identified another eight people that were all asymptomatic. And then we put them in isolation as well.

So what's different between what you're doing and what, say, we're doing here or other places are doing? We're having a lot of ... isolation [and] places are locking down. They are not testing everybody that's in that locked-down place. And so, how important was that testing to the success that you've had?

We believe that that was crucial because we could identify all the people with the potential to transmit. They were isolated. And, in principle, they couldn't transmit the disease to others. 

Now, if you do only the lockdown, [that] can not necessarily lead to complete suppression of the disease. 

I want to draw a comparison. If you remember the Diamond Princess. They started with few cases. They did the tests only to those [who] were symptomatic. So you develop a symptom, you test positive, you were taken out of the ship. 

But day by day, cases, if you remember, they increased up to more than 700. So in this way, they couldn't stop the disease. That couldn't stop the disease in spite of the fact that they were isolated, they were kind of quarantined. And the reason why they couldn't stop it is because the ship was full of asymptomatic people that [were] spreading the virus. 

This is a very interesting comparison, because on one hand, you have a community of 3,000 people living in a small village, which was locked down. On another hand, you have a ship with a community, again, about 3,000 people, which was locked down. 

[When you started this in February], the protocol was that you tested people only if they … were returning from a foreign place, or from China, or if they had symptoms. ... You ignored that and went to everybody.

Yeah, we ignored that because we weren't convinced that the disease was transmitted only by symptomatic individuals. We found this quite implausible. And so this is the reason why we tested everybody.

You're talking about a town, Vò, of 3,000 people. Is it possible to turn that model, to do what you did in Vò, to a much larger population? Entire regions of Italy, or regions of Canada? 

What has been done in Vò, it proved to be extremely effective at the beginning of the infection. So if you have a cluster of cases, then the best thing to do is to lock down the place, stand still, and test everybody. Especially at the beginning of the infection, that's the best thing you can do.

Now, when the epidemic is more widespread, then ... you have to combine several measures. Because at that point, you fight on several fronts. You have to deal with people that are healed. You need to have a hospital resuscitation unit. You need to implement quarantine, which unfortunately can never be 100 per cent because people have to go out to buy food, to buy medicines.

But if you do active surveillance, let's say, around the people that are present with symptoms, rather than leaving them home and making no tests, I think what you should do [is] go home to their place, make the test, make the test to the relatives, make the test to friends and family, and to the neighborhood. 

If you do this systematically, you can then beat the disease. 

If you could give some advice to us in Canada from the mistakes and the learnings that you had in Italy, what would you tell us?

I would suggest you do not underestimate. You act aggressively around each single case and cluster. 

If you have a couple of cases in a condo, you lock down the entire condo and you test everybody. If you have a few cases in a neighborhood, then you lock down the neighborhood, and you test everybody.

That's the way to do it. 

Written by Sheena Goodyear with files from Reuters. Interview produced by Chris Harbord. Q&A has been edited for length and clarity.