ROME – The reopening of the virus in Italy was supposed to be accompanied by a series of measures to limit infections at the epicenter of the pandemic in Europe: the distribution of millions of low-cost surgical masks to pharmacies across the country, a pilot project 150,000 antibody tests and eventually the launch of a contact tracking app.
Neither of these is in place as Italy experiments with its second week of loosening restrictions and anticipates reopening of stores on Monday and in some regions, bars and restaurants.
Italy's emergency commissioner Domenico Arcuri became defensive on Tuesday to respond to mounting criticism of his Phase II launch.
He insisted that "Italians know what to do,quot; to protect themselves, even if they do not have the tests, masks, location of contacts or other measures that the public health authorities considered necessary for Italy to reopen.
"Sometimes I make mistakes for which I expect criticism and, if necessary, reprimands, from the Italians," Arcuri said. But he turned the blame on the others and repeated that he was working only in the public interest.
Italy is by no means alone in getting out of the confinement without all its infection prevention pillars in place. And no country has had a plan to handle the COVID-19 outbreak or reopening phase.
But Italy's problems epitomize the challenges many countries face in trying to balance economic and health care needs while reassuring terrified citizens with promises that were perhaps overly optimistic.
France's promise to "protect, test and trace,quot; everyone who comes in contact with a coronavirus patient received a setback on Monday when the constitutional court rejected part of its new virus law. The court objected to contact tracking language and ordered the government to be very careful in protecting privacy.
The law, which went into effect on Tuesday, calls on teams of healthcare workers to track patients' contacts with COVID-19 and share those data on a government server, with or without the consent of the patients.
French President Emmanuel Macron has also repeatedly promised that France could screen up to 700,000 people per week. The national health authority told The Associated Press on Tuesday that France averaged around 200,000-270,000 tests per week.
Britain, which has the highest number of official deaths in Europe with more than 32,700, has increased its tests from 5,000 per day in March to about 100,000 per day now. But he abandoned contact tracking after the spread of the virus overwhelmed his ability. A contact tracking app is in the testing stage and 18,000 people are being recruited to do the tracking job now.
Spain, which like Italy was one of the most affected countries from the beginning, is still solving protocols for monitoring contacts and has no immediate plans to implement an application. Although the virus testing capacity in Spain has improved, the government has largely left the search for contacts to already stressed local health centers.
Germany, which prides itself on its comparatively low death rate, has involved more than 10,000 people in the search for contacts. An application is planned but there are still weeks to go. Meanwhile, Turkey has credited its army of contact trackers for its success in curbing the spread of the virus. Around 5,850 teams approached and evaluated about 470,000 people suspected of being infected.
Italy abandoned any concerted effort to locate contacts when its north was overwhelmed in late February. But health-care officials say contact tracing, as well as evidence, protective masks, and social estrangement, remain key to further reopening.
Italy's mask problem started when Arcuri, the emergency commissioner, set a fixed price [.50 euros plus tax] for surgical masks that Italy only started producing in the country in recent weeks.
Producers resisted the low price, and two distributors who had promised to bring 12 million masks to pharmacies ended up without having them ready. Another 19 million reached supermarkets, but pharmacy shelves remained empty.
Deputy Minister of Health Pierpaolo Sileri acknowledged that the mask distribution plan had become a "disaster,quot; after three-quarters of the 12 million masks had not been certified.
Arcuri also promised that Italy would distribute antibody tests to laboratories on May 4 for a pilot project of 150,000 people. Testing has not yet started. More delays are expected as health authorities communicate with the 150,000 people identified as potential subjects, selected for their demographic and geographic distribution. Then they must agree and schedule the appointment.
Arcuri insisted that his team has "done our part,quot; in selecting the type of test and said the delays should be reviewed by the government's privacy guarantor.
He also said another 5 million virus test kits were distributed to Italian regional health authorities to help increase capacity and isolate new potential groups.
Italy was hampered during the outbreak by testing limitations, and ended up only testing those who went to the hospital or showed strong symptoms. It has increased capacity and is now leading Europe in per capita testing, with more than 2.5 million tests conducted to date.
But regional officials say they cannot run any more tests because they did not receive the additional reagent needed to process the results.
Arcuri said the reagent is running out worldwide and is now asking domestic manufacturers to increase production "in the coming weeks and months."
Like other European governments, Italy has been competing to develop a contact tracking application. But privacy, logistics and technical concerns have hampered the launch.
Paolo De Rosa, technical head of the innovation ministry, told the Corriere della Sera newspaper that the Italian version was expected to be implemented in late May.
Like many others in Europe, Italy's "Immuni,quot; app will be based on a decentralized system that uses an Apple-Google software interface that experts say is best at preserving privacy. The applications use low-energy Bluetooth signals on cell phones to anonymously track approaching users and send an alert if any user tests positive.
De Rosa said testing would begin Friday, according to a preliminary version.
"We are working in your interest," said Arcuri. "We accept all criticism as long as it is constructive."
Corbet reported from Paris. AP reporters contributed from across Europe.
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