COVID-19: from hospitals to courts

Michele Usuelli1 raised two questions to the international scientific community. First, whether there were errors in the management of the COVID-19 health emergency in Lombardy, Italy. Second, whether having 20 regional health services across Italy is useful in controlling a pandemic. The answer to the first question will be useful to medical science and the civil conscience (by improving the decision making process) in Italy. Unfortunately, the process of a commission of inquiry is much slower than that of a pandemic, and therefore it is unlikely that the evidence gained will be useful during this pandemic. The answer to the second question is self-evident. Unfortunately, a strong political movement is pressing to accentuate the transfer of fiscal resources from the national level to the regions where income is produced. If the tax income remained in the region that produced it, then there would be no national budget. This transfer would increase health inequity, with an unfair burden of this pandemic on people who are disadvantaged2 and an inevitable negative effect on the health of the population.3 In the meantime, emergency conditions have changed the traditional way that doctors operate. Intensivists who treat patients with COVID-19 have high levels of compassion fatigue and occupational stress; they do not have daily contact with the patients’ relatives anymore and can inform families only at the end of therapy if the treatment has not been successful.4 The scarcity of interaction with relatives could increase misunderstandings and the risk of malpractice litigation, which is already high in Italy.5 We reasonably expect that the pandemic, in addition to many grievances, will leave many claims for compensation