{"id":20430,"date":"2020-03-30T13:14:30","date_gmt":"2020-03-30T11:14:30","guid":{"rendered":"https:\/\/www.siccr.org\/en\/?p=20430"},"modified":"2020-10-06T13:52:37","modified_gmt":"2020-10-06T11:52:37","slug":"letter-from-the-front-line","status":"publish","type":"post","link":"https:\/\/www.siccr.org\/en\/2020\/03\/letter-from-the-front-line\/","title":{"rendered":"Letter from the front-line"},"content":{"rendered":"<p>Dear Colleagues,<\/p>\n<p>I would like to share my experience of these days, in a moment that is putting a huge strain on all of us, as doctors, men and women facing a pandemic that is spreading in 200 countries around the world, with an ever-growing case fatality rate.<!--more--><\/p>\n<p>Since 21 February 2020, Italy has rapidly become the worst-hit country, burdened by the highest death toll which is about to triple that of China. But a particularly alarming figure is the rate of infection among health workers, which reaches 9% in our country.<\/p>\n<p>Last March 19, following the latest directives of the Treviso Hospital &#8211; where I work at the IV Surgery Unit &#8211; I was tested for COVID19 by nasopharyngeal swab, while yet asymptomatic. I emphasize that the Veneto region has implemented, since the early stages of the epidemic, an extended population screening policy, with over 18,000 tampons per million inhabitants performed on March 28.<\/p>\n<p>I cannot hide the regret mixed to a sense of confusion felt at the news of testing positive. The &#8216;quarantine&#8217;, a term that until recently I heard so infrequently pronounced, had just begun for me. But on March 20, upon awakening, the anguish was gone. I was reflecting on the latest evidence about the crucial role of asymptomatic subjects in the spread of the epidemic, reported on <em>Science<\/em> a few days earlier by Li and coll., who claimed that 86% of all the infections recorded in China before the closure of Wuhan on January 23 was undocumented, and that this group had been the source of infection in 79% of documented cases. I was trying to selfconvince myself of being part of the &#8216;dangerous&#8217; asymptomatic group and that a hashtag and &#8216;istayhome&#8217; was enough to sort everything out. But I remember going to bed more tired than usual and, on the night between 20 and 21 March, the onset of chills and the reading of 38.6 \u00b0C on the thermometer erased my name from the asymptomatic group once and for all. <\/p>\n<p>In the morning I had no doubts: although in the absence of evidence that hydroxychloroquine may affect outcomes in such an early stage of the infection, I decided to start it according to the dosage suggested by Yao and coll. in a study published in <em>Clinical Infectious Diseases<\/em> on March 9 (Fig.1). The onset of nausea and two vomiting episodes characterized the first part of the day. The temperature, however, never reached its initial peak nor crossed 37.7 \u00b0C even during the following day, when I start getting infrequent dry cough and diarrhoea. Although I already felt much better than the previous day, I was beginning to realize that I had lost both smell and sense of taste, a quite odd sensation in the absence of a stuffy nose.<\/p>\n<p>While the anosmia was complete (to the point of not perceiving the smell of perfume), the sense of taste was not completely abolished; I therefore prefer to name it dysgeusia rather than ageusia: indeed, I could perceive saltiness and sourness, but no trace of the sweet and bitter, let alone the umami &#8230; I have not got any improvement as yet, but according to Claire Hopkins, president of the <em>British Rhinological Society<\/em>, who is collecting data from patients with anosmia in several countries, I should be able to recover within 2 weeks after the onset (hopefully!).<\/p>\n<p>Driven by my experience and the circumstances that we are all experiencing, I decided to promote an anonymous survey, in a concrete attempt to describe the situation of Italian health workers (doctors, nurses and socio-health workers) who are facing the COVID19 emergency.<\/p>\n<p>I would be honoured to receive your contribution and infinitely grateful if you could help spreading the link to join the survey:<\/p>\n<p><a href=\"https:\/\/qmul.onlinesurveys.ac.uk\/icovid19\" target=\"_blank\">https:\/\/qmul.onlinesurveys.ac.uk\/icovid19<\/a><\/p>\n<p>In whatever circumstances, we are proving that we cannot betray our mission.<\/p>\n<p>Good luck everyone<\/p>\n<p>Ugo Grossi,<\/p>\n<p>Y-SICCR<\/p>\n<p><img decoding=\"async\" src=\"https:\/\/www.siccr.org\/wp-content\/uploads\/2020\/03\/GROSSI_Covid-19_marzo2020.png\" style=\"width:500px;\"><\/p>\n<p><a href=\"https:\/\/www.siccr.org\/wp-content\/uploads\/2020\/03\/GROSSI_Covid-19_marzo2020_Engl.pdf\" target=\"_blank\">Download the attachment<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dear Colleagues, I would like to share my experience of these days, in a moment that is putting a huge strain on all of us, as doctors, men and women facing a pandemic that is spreading in 200 countries around the world, with an ever-growing case fatality rate.<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4],"tags":[],"acf":[],"_links":{"self":[{"href":"https:\/\/www.siccr.org\/en\/wp-json\/wp\/v2\/posts\/20430"}],"collection":[{"href":"https:\/\/www.siccr.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.siccr.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.siccr.org\/en\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/www.siccr.org\/en\/wp-json\/wp\/v2\/comments?post=20430"}],"version-history":[{"count":4,"href":"https:\/\/www.siccr.org\/en\/wp-json\/wp\/v2\/posts\/20430\/revisions"}],"predecessor-version":[{"id":20951,"href":"https:\/\/www.siccr.org\/en\/wp-json\/wp\/v2\/posts\/20430\/revisions\/20951"}],"wp:attachment":[{"href":"https:\/\/www.siccr.org\/en\/wp-json\/wp\/v2\/media?parent=20430"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.siccr.org\/en\/wp-json\/wp\/v2\/categories?post=20430"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.siccr.org\/en\/wp-json\/wp\/v2\/tags?post=20430"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}