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Covering Coronavirus: Cremona, Italy

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ARCHIVE: It feels like a hole that Italy just can't plug: the daily loss of hundreds of lives. Coronavirus fatalities in this country of 60 million people, now higher than in China, with a population of 1.5 billion. It's brought one of the world's best healthcare systems to its knees.

RANEY ARONSON: This is the Frontline Dispatch. I’m Raney Aronson, executive producer of Frontline.     

ARCHIVE: Across Europe, it's been another day of grim statistics and images as the virus spreads. More than 100,000 people are infected right across the continent.

ARONSON: Life in Europe has changed almost beyond recognition in just a matter of days – and nowhere is this more the case than in Italy. 

A country in complete lockdown; streets deserted. Overwhelmed health workers battling to save lives. 

For Americans watching, it’s hard not to wonder whether we’re peering into a similar future.

SASHA ACHILLI: It’s my story, it’s your story. It feels really, really close to home and I feel as an Italian right now, I feel like there’s no other place I’d want to be. 

ARONSON: That’s journalist and producer Sasha Achilli. Right now she’s filming for us in Northern Italy — which has just become the global epicenter of the pandemic. Sasha was born and raised there, so what’s unfolding has become a personal story for her. In 2014 she was part of the team that led our investigation into the Ebola outbreak in West Africa, and the questions she raised then about our preparedness for the next big disease outbreak are now more relevant than ever.

MAX GREEN: The FRONTLINE Dispatch is made possible by the Abrams Foundation, committed to excellence in journalism. And by the WGBH Catalyst Fund.

ACHILLI: Yeah, hi Raney.

ARONSON: Sasha, it's so good to hear your voice. How are you?

ACHILLI: I'm okay. Yeah, it's been really strange. Very emotional.

ARONSON: Yeah, tell me a little about how it is there, I know this is a personal story for you as well.

ACHILLI: Yeah, so as we were planning this filming trip, the borders of Europe just started closing down, and Italy had already been on lockdown but just a few days before it seemed much easier to fly in because some of the airports in Lombardy were still open to fly through Germany, so from London there were still flights going through Germany to the north of Italy. 

And the night before I was due to travel, although the airports in the North closed down, and so the flights were all canceled. So all of the sudden, the country that is just south of the UK that normally takes me two hours to get to to come and see my family, it was going to take me basically a day and a half to get to my destination which is Cremona up in Lombardy.

Landing in Rome was quite surreal, Raney. 

ARONSON: Tell me about that.

ACHILLI: I landed in Rome and there were taxis running. So I took a taxi to a hotel that had been booked for me near Central Station. And we were driving at 7 p.m., which is normally rush hour. I mean, it's always rush hour in Rome, it's hectic, it's full of traffic, it's loud. Romans are known for being really, really loud. And it was so sad to be driving through the streets of Rome, and just very, very few cars, very very few people. Everything closed. It was just like a bad dream.

ARONSON: I guess, when you landed, did you wonder what was going to meet you when you actually made it to the place you were going, in terms of the clinic? Can you talk a little bit about, just, emotionally preparing yourself for what was to come?

ACHILLI: Normally, you know, I've worked in various countries, in various, either conflict zones or during the Ebola outbreak. And before deploying on a shoot there's always a sense of nervousness, because you just never know what to expect. But also, a sense of excitement, and in a way, when you're going to a completely foreign place, you do feel like an observer. And so, that sense of excitement prepares you emotionally for the situation and the place you're going to. 

I can't say I felt excited, at all, about coming here. I feel really compelled to, I feel like it's important, I've never actually filmed in Italy; the stories that I've done have always been elsewhere. I've never actually made a story about my country. And, all I knew was what my family was telling me about, like, everyday life. But it was kind of hard to believe. And then, you know, landing in Rome was the first, kind of, shocking impact. And I had a good cry as soon as I arrived to the hotel.

It's just so close to home. And knowing that, you know, leaving London as… in the time that Europe was closing its borders, and the time that the British government had just started taking action to close things, you know, close schools, or tell people not to go outside too much, and avoid... you know, engage in social distancing. So landing in Italy was like landing in the future for the other countries. Like, what the UK will look like in three weeks time. I'm pretty sure about that.

ARONSON: I want to talk a little about the clinic, and why this clinic, and just paint a picture for what you're seeing there and experiencing.

ACHILLI: Yeah. So, I came across this hospital because about a week ago, a photograph went viral. And it showed a nurse who had completely, out of exhaustion, collapsed over her computer. It was this very powerful image that was circulating and it went viral. 

And I found out who the doctor was who took that photograph, who's a woman named Francesca Mangiatordi, and she works in the emergency ward of that hospital. And um, she took that photo, and I managed to find her contact, got in touch with her, and it turns out that she's working in this hospital, which is in one of the towns in the epicenter of the outbreak in Italy. And it was the second town that had been very badly hit from the beginning of the Italian outbreak. And she's a month into the outbreak in this town. 

ARONSON: Sasha, do you know, in circumstances like that, how doctors like the one that you're following, how are they making decisions about who they treat and who do they turn away?

ACHILLI: Well, so, I've spoken to Francesca about it. And Italy has a public health care system, which is free to the people. And the policy is that, no matter what age you are, you will get the same treatment and level of care to anybody else. And it's a country with a very old population. 

And all of a sudden, the doctors who are used to providing healthcare for everyone, no matter who you are, are now having to make decisions like, choosing the 35 year old who is in critical condition over the 80 year old. And it is really difficult, because it's just not... Francesca said this to me, she said, 'We have been taught to give the same level of care for the 94 year old, you keep them alive no matter what.' And I remember when my grandmother was sick at the age of 96, the doctors were doing everything to keep her alive. That's the culture, and now they're having to make decisions — if you have a younger person who's ill, then they will give a ventilator to the younger person over the older person.

ARONSON: So when you’re in the clinic, are you seeing this actually happen?

ACHILLI: We haven’t managed to film in the triage section yet but she’s spoken to us about it and we’re in obviously the emergency unit with her so she receives critical cases and the critical cases tend to be older. So when we were filming with her yesterday, a lot of the patients in her clinic, in her area were elderly. But there is a rise in cases of younger people. And in the intensive care unit, we’ve heard of a 35-year-old and a 21-year-old who’ve been admitted to intensive care. 

ARONSON:  So you’re inside the clinic. What are you filming? And who are you seeing as they’re coming through?

ACHILLI: We're seeing hallways with patients, the doctors are struggling to figure out where to put them. We're seeing older people who are mostly hooked up to ventilators, who are still conscious but they're struggling to breathe. And doctors that are completely overwhelmed. And also, there used to be 11 of them in the unit, and now there's five of them, because six of the nurses and doctors have all fallen ill, or are currently being tested because they have fevers and symptoms.

ARONSON: How are they protecting themselves? Do they have enough protective equipment?

ACHILLI: They have enough protective equipment at the moment, and they wear... you know, they're completely hooded from head to toe. They're constantly changing their gloves, and sanitizing and doing everything they can to keep themselves clean and protected at all times. But the problem is, when you're dealing with so many cases coming in, 12-hour shifts, double shifts, you know, it's easy to make mistakes. You do what you can. I mean, what's so horrible about COVID is that it's not just physical contact, it's contact with surfaces that have been touched. And you know, the problem they're dealing with is, it's still a hospital, it's still an emergency center. You have people coming in for other problems, who, if they get admitted, risk getting the disease.

ARONSON: Right. I mean, that's something that we're seeing across the world, that people are still getting sick.

Sasha, tell me a little bit about — and of course, we're seeing pictures of you in your own gear, and we have protocols in place from FRONTLINE — but I would really love to hear, how are you protecting yourself?

ACHILLI: In our hotel and on the streets, as soon as we're outside of our rooms, we have to wear masks and gloves. We are using hand sanitizer on our gloves continuously, on our hands continuously. We're changing our gloves continuously, and the masks. In the hospital, we're dressing exactly like the doctors and nurses are, so we've been given headgear. We don't film using our own clothing. We've been given other clothing, and basically a plastic cloth that we're wearing and covers for our shoes. It's a deeply uncomfortable way of working, and we're constantly sanitizing the equipment.

ARONSON: Right. And do you feel that you are safe yourselves? Are you concerned?

ACHILLI: I feel as safe as I can be. I'm not scared, but I am fully aware of the possibility of being infected.

ARONSON: I was thinking a lot about your reporting and the work you did for us in West Africa during the Ebola crisis. And that work was so extraordinary. Can you talk a bit about the differences and just your observations on how Italy is dealing with this versus West Africa. You really have done quite a bit of reporting in this area.

ACHILLI: Everybody keeps asking me, ‘Why Italy? Why has it got so bad in Italy? Why is it that two days ago Italy surpassed China in the number of deaths?’ And I don't really have an answer for that, but the assumption I can make is that the disease, the virus was circulating in Italy way before it was ever detected, and that feels really familiar to what happened in Sierra Leone.

ARONSON: Hm. Interesting.

ACHILLI: Epidemiologists here haven't been able to — at least as far we know from what's been released in the public — is they haven't been able to trace down patient zero in Italy. And the difference is that there are many people who are asymptomatic who can be spreaders but don't have symptoms. And that is what's so different and terrifying about this virus versus Ebola. With Ebola, it was almost easier to trace contacts and isolate people once there was a recognition.

ARONSON: Right. You could see it. Right, you could actually see what was going on. Can you tell me a little bit about, you know, obviously we're looking in on Italy from afar right now. The stories are really terrifying. Is it actually, like, a real portrayal of what's going on?

ACHILLI: Yeah. I think, you have... there's different aspects that are terrifying. As I described, you know, arriving in a completely deserted Rome, there's the reality that people right now, in Italy, are in lockdown. A lot of towns and cities are run and controlled by the military. There are police everywhere. 

To go out, there has to be a justification, you have to have a self-declaration paper justifying why you're outside. The only reasons you're allowed to go outside is either for work, for a medical emergency, or to return to your residence or to buy groceries. And you have to be doing one of those things.

ARONSON: Have people broken that?

ACHILLI: Yes, and there are people who've been criminally charged.

ARONSON: I wanted to ask if you could look at Italy, and then you're looking at the US as we're starting to see growing cases. What is the advice you're hearing from the doctors to those of us who are living in America.

ACHILLI: They're saying, 'Get ready.' 

You know, watching the American response, watching the British response, watching the European response, they're all saying, 'That's how we reacted initially.' Initially it was like, 'Don't go to restaurants, and don't go to pubs, and try to isolate yourself as much as possible.' But it wasn't enforced. And so, at the beginning it was all quite casual, and then that just gave opportunity for the virus to spread and spread and spread. And the doctors are saying, 'Absolutely self-isolate, and do it in the interest of yourself, but also in the interest of everybody else around you, and who you love. Because this is very, very real. And to prepare.'

ARONSON: Right, right. Don't ignore this, right? And prepare.

ACHILLI: The Italians have come to the decision that it requires extreme measures to try and control this. So it's just better as citizens that we just take it ourselves and do it, and self-isolate, and stay at home.

ARONSON: Sasha, I assume that one of the hardest things is to be in northern Italy and not be able to be with your family. Can you talk a little about that? I assume that you're not going to go see them after this is over.

ACHILLI: No. So, my movements here are restricted. I can be here because I'm here as a journalist and I'm working. And I can be here because I'm an Italian citizen so they couldn't turn me away at the airport. However, because I'm no longer resident here, I'm resident in the UK, I have to return to the UK after five days and go into 14 days isolation. So, obviously my time here is limited, and I won't be able to see my family. But even so, like, I'm working in a highly infectious place inside a hospital and it would be deeply irresponsible of me to go see my aunts and my father and my mother, who's 70. So technically in the high-risk category.

ARONSON: Right, right.

ACHILLI: My sister said, 'Yeah, I don't know when I'll see you again.' And that's very true.

ARONSON: Sasha, what is the hardest part of covering this story for you? As an Italian, but also as a journalist?

ACHILLI: It feels, um, it feels like I'm... you know, with every story I am, in a way, living the story. But I'm also an outsider, and I'm an observer. This feels... it's, it's my story, it's your story. It feels really, really close to home. But I also, you know, I feel as an Italian right now I feel like there's no other place I'd want to be. 

I never thought that I would be making a film like this in Italy. I feel immensely proud of the way that the Italian doctors are doing everything they can, um, I feel really proud of that. It feels...  it feels important. Um, and you know, I told my family I'm coming and they weren't very pleased. But they also understood why I am. It's not good enough to go to West Africa and tell the story over there as an outsider. This is exactly where I need to be right now.

ARONSON: Well, we can't thank you enough for being there and witnessing what's going on, in both Italy but also your home country. We'll be talking throughout your time there. And thanks again for joining us.

ACHILLI: Thank you, Raney.

ARONSON: Take good care.

ACHILLI: Thank you. You too.

ARONSON: Find more of our reporting on the global Coronavirus pandemic online at FRONTLINE DOT ORG.

This podcast was produced by Max Green and James Edwards.

Dan Edge is FRONTLINE's senior producer. Sarah Childress is our senior editor, and Andrew Metz is FRONTLINE’s Managing Editor. I'm Raney Aronson, FRONTLINE's executive producer. The FRONTLINE Dispatch is produced at WGBH, and powered by PRX.

Stay tuned to our “Covering Coronavirus” series in the coming weeks.

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