COVID-19: An Italian EMT Tells His Story

As you may know, Italy has been hit very hard by the COVID-19 pandemic. My EMS station and hometown are located about 10 miles from Codogno, the first Italian city put under quarantine.

Since day one sirens have broken the silence of our rural provinces almost every day of the week. We’ve received clear instruction about how to treat COVID-19 cases (the correct use of PPE, how to properly sanitize our ambulances, and the initial instructions for BLS units to act) since the outbreak in China, but I never thought we would have the highest death toll in the world (now more than 7,500 and counting).

Since most workplaces have been closed, my colleagues and I have dedicated all our time to this emergency. (Italy does not have paramedics, and in many places EMT volunteers cover eight-hour shifts each day, except for the weekends, when three crews provide 24-hour coverage.) Living in a rural town, we never experienced such a number of calls, 30–50 per week. Almost immediately hospitals created two types of ER that we colloquially call “the dirty one” for confirmed or suspected cases and “the clean one” for patients who have no fever.

We have Army physicians and nurses helping us triage, and anyone who enters the ER must first have their temperature checked in a military tent. The Italian Army is playing a crucial role and also building field hospitals in Crema and Piacenza.

Now we face another big problem: response times for other types of calls. Recently in the city of Lodi, a 53-year-old woman had a heart attack, and EMS showed up 40 minutes after the call. That’s because the system is saturated. That’s why we stopped transporting patients with minor illnesses. After we report to dispatch, they consult a physician who decides if the patient should be treated at home or not. If we don’t transport the patient, then we leave as soon as possible to respond to other calls. In the past few weeks all our response times have been at least 20 minutes.

Sometimes it looks like we are in the middle of a battlefield. Empty streets everywhere, Army trucks transporting coffins to other regions because here we have no more room in cemeteries and crematories. You see lots of your fellow citizens dying. The days go on and on, but it feels like everything happened a week ago.

I’m not scared anymore. I think you have to cohabit with fear if you want to find some kind of equilibrium. Before this experience my dream was to become an emergency nurse, and after all this madness I’m more motivated than ever.

People are starting to give us free coffee and free meals, and dentists are giving us hundreds of surgical masks. Some have even applauded us. I wonder if those are the same people who before this pandemic were the ones spitting on us, yelling and cussing at us. And I wonder if they will do the same when this ends.

I hope the Italian state will recognize EMTs as professionals in the EMS field. Paid EMTs here are considered “generic workers” by the Italian law. I hope things will change because there’s what I call the Italian paradox: We have some of the best hospitals in the world, and yet our EMS system is pretty obsolete, especially in southern Italy.

Angelo Bonfanti is an EMT in Italy.