Protecting our health care workers while protecting our communities during the COVID-19 pandemic: a comparison of approaches and early outcomes in two Italian regions, Italy, 2020

Nancy Binkin; Stefania Salmaso; Federica Michieletto; Francesca Russo

Differences in population density and social factors, as well as the greater initial number of cases in Lombardy and greater numbers of initial foci, may have played a role in the observed differences in outcomes (3). However, health care system organization and the strength of the public health infrastructure ultimately appear to have played an important role in the differences in outcomes observed to date between Lombardy and Veneto (3, 4, 16, 17) . As stated by clinicians from one of the most heavily affected hospitals in Lombardy, "Western health care systems have been built around the concept of patient-centered care, but an epidemic requires a change of perspective toward a concept of community-centered care." (17) Veneto's greater integration of its public health and hospital services at local level and strong public health infrastructure potentiated the implementation of a community-based approach. This approach was based on sound epidemiologic principles of aggressive testing, contact tracing, and limiting contact with health care settings wherever possible through mobile diagnostic teams and careful home follow up and was facilitated by rapid communication through an informatics system that tied together the laboratory, GPs, and the local public health units.