Pandemic, the lesson of Carlo Urbani. His wife Giuliana: “In times of emergency many people offer the best of themselves”

Fate sometimes does indeed seem to play with numbers, oblivious, or perhaps in the knowledge of the fact that certain dates tragically overlap, thereby forcing us into reflection. The name of Carlo Urbani, just like Covid-19, circulated worldwide, reminding us that good timing, in the face of health emergencies, can correspond to safety. Native of Castelplanio, in the province of Ancona, infectiologist, consultant for parasitic diseases to the World Health Organization, Urbani chaired the Italian branch of Médecins sans Frontières (MSF) since 1999 and was the first to identify SARS (Severe Acute Respiratory Syndrome), remaining himself lethally infected with the disease after nineteen days of isolation: it was March 29, 2003. Like many doctors and nurses, more than one hundred, whose lives we remember in these days for having died in assisting the sick, also for Carlo Urbani the primary commitment until his last days was to care for other people's health. Carlo Urbani asked his colleagues from Germany and Australia who rushed to the hospital to harvest the tissues from his lungs for research purposes. SIR interviewed his wife Giuliana Chiorrini, President of the Red Cross Committee of Castelplanio, seventeen years later that tragic day. She described a tragedy that, today more than ever before, is a reminder of the fundamental role played by healthcare workers in every society, notably through their contribution to humanity over and above their professional role.

Let's go back to that February 28, 2003 when, in Vietnam, your husband was called to the hospital in Hanoi to examine a suspected infection. What was the first "impact" with what would later turn out to be a deadly virus?

My thoughts go back to that period especially these days. Same season, same dynamics: in Hanoi the nightmare began at the end of February and lasted until the end of April. Same feelings, same fears. When it all began we didn't realize that it could be so serious: at first everything was under control but as the days went by the situation rapidly worsened. Carlo became increasingly worried that the epidemic might spread quickly. In addition, the fatigue and the critical conditions inside the hospital were making him nervous. In particular, my husband complained that the local government was not listening to him given that he had immediately requested to enforce a state of preventive alert, demanding that the borders be closed to avoid the spread of the virus. I remember him staying in the hospital overnight to keep everything under control: he described the nurses' despair at the risk of being infected, and he was afraid of not being able to stop the spread of the virus. However, Carlo knew how to reassure us, as he always did in the last days of his life, even when, after being hospitalized, he no longer had the strength to speak. The hardest moments were when he left for Bangkok and then fell ill. We were alone at home, in Hanoi, with no news about his health condition. Every day we anxiously awaited his phone call until I decided to leave, sending our children back to Italy while I joined him in the hospital. Those days were so painful that I would rather not remember them. But I recall every detail: living in a foreign country, the road to the hospital of which I can still vividly picture every corner, accompanied by sadness and anguish.
That' s why today I often think of those who contracted this terrible disease, I know their suffering, I know what they are feeling.
My husband had the opportunity of not dying alone, while many Coronavirus patients die alone, without a beloved one at their side.

During the flight to Bangkok your husband noticed the first symptoms: as an expert, he immediately understood the situation and did not hesitate to give directions to contain the infection...

As Pascale Brudon, the then WHO delegate in Hanoi, recently wrote: "When Carlo appeared in my office on the first floor of the WHO headquarters in Hanoi on March 11, before catching the plane to Bangkok, I would never have imagined that it was the last time I would see him and that he was going to die two weeks later, precisely because of the disease that he himself had helped to identify, SARS...". None of us thought we would never see him again. He had greeted me in the morning accompanying our children to school, he was fine, but perhaps he sensed the danger since that day he greeted them without kissing them, as was his habit before every departure. During the trip he immediately realized that he had contracted SARS and, upon arrival at the airport, he instantly alerted his colleagues, urging them to keep their distance and take the necessary precautions. I can just imagine his mental state: to realize, as a doctor, that he would have to suffer like the many people he had treated in previous days... I shudder every time this terrible idea comes to mind. Now I often think of all those people who become infected, of all the healthcare workers who, more than others, are aware of the danger they are facing, and all those who succumb to the Covid-19. It's a continuous thought.

The world is now battling an even more devastating virus than the SARS, claiming impressive numbers of victims. But the sacrifice of the unforgotten doctor from the Marche region has not been in vain. What lesson will we learn from this pandemic?

Carlo had fought in every way the outbreak of the new disease in Vietnam. Certainly his sacrifice, like all the research he had done, continuing to work from his room while in solitary confinement with fever and cough, advising his colleagues on which therapy to follow, made it possible to mitigate the damage, although I do believe that even the SARS was underestimated at first. At the time, as soon as Carlo understood that the Hong Kong patient was not suffering from a common flu, he took all possible precautions, imposing a strict separation of ordinary patients from those suspected of having been infected with this unknown disease. Furthermore, he and his medical staff initiated extremely thorough infection control practices: more visits, face masks, gloves, guards in front of the doors of the rooms where the patients were admitted and isolation of the hospital. Together with the WHO, he had already declared a global emergency alert in mid-March. Thanks to all these measures, at the end of April Vietnam became the first country to successfully contain the SARS outbreak. Thus the WHO protocol was created. This led to the battle against Ebola. Probably, there are no "recipes" applicable to all situations. I believe that without Carlo's contribution this pandemic could have claimed many more victims. At the same time, this emergency must make us understand that we must be better prepared. Over the past weeks we saw the gap separating the various European nations, the different reactions whose repercussions will be felt in the coming months. The lesson has not been learnt as it should have…

Before dying, Dr. Urbani confided that it was not death that frightened him, but the sorrow of having to depart from your children, Tommaso, Luca and Maddalena. It is also thanks to them that today his memory continues to thrive. What message of hope, also on behalf of the Italian Association Carlo Urbani, would you like to send to all the health workers engaged in the front line? 
In the last few years we returned to Vietnam and Taiwan, where the figure of Carlo Urbani is held in high esteem. He is credited with having saved the population from a tragedy of much greater magnitude. In truth, they are the ones who are surprised by the warmth with which Italy remembers Carlo. Aicu (www.aicu.it) not only keeps his memory alive but also ensures that his projects are not discontinued.

In times of emergency, many people give the best of themselves. This is a good thing, because it brings to the fore people's true nature. This is true, for example, of doctors, nurses and all those working in health care facilities. Today they are depicted as heroes, but in many other circumstances they are the targets of groundless attacks. I personally wouldn't call them heroes, as Carlo wasn't a hero either. They were - are and will be - people who, in time of need, bring out the best of themselves. So, while there are those forced to stay at home where they live out their "heroism", healthcare workers’ presence in the front line up to 14 hours a day stirs a deep emotion in us all. However, it should be understood that an emergency is not only such when it affects us personally and when it inspires our most praiseworthy disposition. Unfortunately, emergencies are always occurring throughout the world, as me and my family well know. When all of this over we must continue extending our watchful gaze to the sufferings of humanity, even if they don't affect us directly.
Francesca Cipolloni