COVID-19: from hospitals to courts
Authors: Nicola Magnavita, Francesco Chirico, Angelo Sacco
Journal: The Lancet (2021)

Michele Usuelli1Usuelli M The Lombardy region of Italy launches the first investigative COVID-19 commission.Lancet. 2020; 396: e86-e87Summary Full Text Full Text PDF PubMed Scopus (19) Google Scholar raised two questions to the international scientific community. First, whether there were errors in the management of the COVID-19 health emergency in Lombardy, Italy. Second, whether having 20 regional health services across Italy is useful in controlling a pandemic. The answer to the first question will be useful to medical science and the civil conscience (by improving the decision making process) in Italy. Unfortunately, the process of a commission of inquiry is much slower than that of a pandemic, and therefore it is unlikely that the evidence gained will be useful during this pandemic. The answer to the second question is self-evident. Unfortunately, a strong political movement is pressing to accentuate the transfer of fiscal resources from the national level to the regions where income is produced. If the tax income remained in the region that produced it, then there would be no national budget. This transfer would increase health inequity, with an unfair burden of this pandemic on people who are disadvantaged2Chiriboga D Garay J Buss P Madrigal RS Rispel LC Health inequity during the COVID-19 pandemic: a cry for ethical global leadership.Lancet. 2020; 395: 1690-1691Summary Full Text Full Text PDF PubMed Scopus (63) Google Scholar and an inevitable negative effect on the health of the population.3McCartney G Hearty W Arnot J Popham F Cumbers A McMaster R Impact of political economy on population health: a systematic review of reviews.Am J Public Health. 2019; 109: e1-e12Crossref PubMed Scopus (83) Google Scholar In the meantime, emergency conditions have changed the traditional way that doctors operate. Intensivists who treat patients with COVID-19 have high levels of compassion fatigue and occupational stress; they do not have daily contact with the patients' relatives anymore and can inform families only at the end of therapy if the treatment has not been successful.4Magnavita N Soave PM Ricciardi W Antonelli A Occupational stress and mental health among anaesthetists during the COVID-19 pandemic.Int J Environ Res Public Health. 2020; 178245Crossref Scopus (95) Google Scholar The scarcity of interaction with relatives could increase misunderstandings and the risk of malpractice litigation, which is already high in Italy.5Fileni A Magnavita N Mirk P Iavicoli I Magnavita G Bergamaschi A Radiological malpractice litigation risk in Italy: an observational study over a 14-years period.AJR Am J Roentgenol. 2010; 194: 1040-1046Crossref PubMed Scopus (18) Google Scholar We reasonably expect that the pandemic, in addition to many grievances, will leave many claims for compensation. We declare no competing interests. The Lombardy region of Italy launches the first investigative COVID-19 commissionDuring the first months of 2020, Italy had the highest number of cases of COVID-19 in Europe and in the world. Lombardy, with a population of 10 million people, was the region of Italy hit the hardest by the pandemic. According to the Italian Ministry of Health's COVID-19 dashboard Lombardy had 114 800 cases and 16 994 deaths as of Oct 13, 2020, which is one third of all cases and half of all deaths in Italy. Full-Text PDF COVID-19: from hospitals to courts – Author's replyI thank Nicola Magnavita and colleagues for raising important points regarding my Correspondence.1 Full-Text PDF