#InThisTogether: 31 AUG 2020

With everything going on during the COVID-19 crisis, we wanted to share some of the stories about what Cook people are doing during this difficult time. All around the Cook world, we are #InThisTogether, and we would love to hear stories about how you and your coworkers are stepping up to make a difference. If you have a story to share, please email us at BlogEditor@CookMedical.com.

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A Cook employee who embodies our ideals

Written by Vanessa Marenco, Reimbursement manager – Italy.

Understanding the outbreak in Italy

“We are aware of how difficult it is to change our habits. However, there is no time. Numbers show that the contagion curve is spiking up: ICU admissions and deaths are substantially increasing too. We all have to give up something for the good of the country,” said Mr. Giuseppe Conte, Prime Minister of Italy.

Earlier this year, on a Sunday evening, I watched the prime minister’s prime-time press conference from my apartment in Turin, Italy. The following day, our country became the first western country to enact stringent shelter-in measures to stop the spread of the COVID-19 outbreak.

In February, 11 towns in the northern regions of Lombardy and Veneto became the first “red zones” of the country: they were placed under quarantine after being identified as the centers of the two main Italian initial COVID-19 clusters.

On March 8, 2020, the whole region of Lombardy and 14 additional northern and central provinces in Piedmont, Emilia-Romagna, Veneto, and Marche were put under lockdown. A day later, more than 60 million people were placed in lockdown. The harsher restrictions came just hours after the authorities announced that 9,172 people had been infected by the virus, 1,598 more than the day before.

“There is no time.”

Those four words conveyed a sense of urgency and criticality I had never experienced before in my life. At that point, we could not have imagined the impact and extent of the pandemic would have on our lives, our psyches, and our everyday activities. I remember asking myself that Sunday evening, then again and again in the coming months, whether my fellow country people, protective of their individual freedom rights, would step up and make the necessary sacrifices?

In retrospect, I feel we all did it in the end, and while it was surreal and painful at times, we all did our part. That announcement and those four words reminded us that we were a community of individuals, and that we were all in this together. On that night, I hoped that the months to follow would bring us all strength and kindness.

One Cook employee that truly embodies that strength and kindness is Andrea Mesiano.

Overcoming abundant obstacles

Andrea, a Vascular clinical specialist based in Italy, overcame a great many obstacles and struggles during the the COVID-19 crisis in Italy. Before, during, and after the peak of the pandemic, he supports our customers in some of the most problematic areas of Italy, including Lombardy. This area continues to be the hardest-hit region in the entire country, having the most cases, as well as the most virus-related deaths.

During these challenging months, his first support request came at the end of February.

“One of the hospitals in Brescia requested my support in a thoraco-abdominal aortic procedure. It lasted around 8 hours,” Andrea said.

The case took place only a couple of weeks before the Italian authorities announced the lockdown measures on March 9. On that occasion, his customers told him that they had seen an unusual high number of complicated pneumonia cases in their areas weeks before the outbreak started in Lombardy.

“It wasn’t easy, I must admit it, and it was scary,” said Andrea. “I thought of the patient who had to undergo the procedure, and of the physicians that had to perform it, but also of my family.”

Andrea knew that he would have to self-isolate himself after this visit—and after the ones to come. During the lockdown months, he barely saw his parents, who are in their 70s, and he knew that he would have to take all the necessary precautions towards his wife and his three children moving forward.

Serving and supporting patients

Along with cases in Lombardy, Andrea also supported a few aortic procedures in Bergamo. This northern city and its surrounding provinces became the national grieving symbol of the pandemic, and globally, it is one of the areas most-impacted by COVID-19, with over 13,600 cases and more than 3,000 deaths, according to Italy’s regional health authority’s epidemiological data¹.

Access to hospitals was (and still is) permitted only at the written request of the healthcare professionals and their administration. The local Cook management then authorized (and is still authorizing) the emergency on-site visits.

In the face of so much adversity, Andrea still felt that his direct managers were always there to support him.

“They left it completely up to me: if I was not comfortable attending the emergency cases, they were not going to force me to attend them, as my health and safety were the most important aspects,” he said.

In March and April, other emergency aortic cases took place in Verona, county seat of Veneto, which is another of the hardest-hit Italian regions. When the head physician rang him about these procedures, Andrea immediately asked about the guidelines adopted by the hospital. He knew that the doctor’s assistant had tested positive for COVID-19 in the previous weeks. Moreover, many COVID patients were being transferred for care from bordering Lombardy hospitals to this facility. The surgeon helped set Andrea’s mind at ease by telling him that all his crew had undergone regular swabs, and everybody had tested negative. He also confirmed that they would provide him with personal protective equipment (PPE), including masks, goggles, and overalls. Most importantly, the hospital also confirmed in writing that the patients treated in that procedure tested negative to Covid-19, and this helped Andrea even further.

Italian healthcare providers managed to make fast changes in these complex months. Safety protocols were rapidly put in place everywhere to tackle the pandemic. Containment measures within hospitals included setting up dedicated pathways and wards to identify and care for COVID cases. COVID-only hospitals were set up as well to allow the management of regular patients elsewhere. Increasing disinfection, sanitization, and other cleaning procedures has become part of the “new normal,” too. Along with that, swab tests are now performed before and after any regular procedure, and in any case before the patient is sent home.

Becoming kinder and even more supportive

Doctors, nurses, and anesthesiologists went through something inconceivable, both psychologically and logistically. Andrea noticed hospital staff members working on adapting to this unprecedented upheaval, and to the ever-changing protocols put in place to ensure safety and to manage the emergency. But more than that, he noticed that the clinicians really came together in a special way.

“One of my main customers told me that there were weeks in which he was on call for 33 shifts in a row,” Andrea said. “But still, the relationship among clinical workers became stronger. They somehow got kinder and more supportive of each other.”

Sources

1. Covid-19 Regione Lombardia Web site [in Italian]. https://experience.arcgis.com/experience/0a5dfcc103d0468bbb6b14e713ec1e30/. Updated June 30, 2020. Accessed June 15, 2020.

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