The COVID-19 pandemic took one of its biggest tolls on Italy, and especially in the northern area, in Lombardy. In this region, on 14 July 2020, 95,118 positive cases have been registered since the beginning of the emergency, three-times more than the number of cases in the second region on the list, Piedmont (1). The name Bergamo, a town in Lombardy, has become very popular all around the world, unfortunately because the area was among the most affected by COVID-19 since the end of February 2020.
The situation experienced in Bergamo by the population and by the healthcare professionals who suddenly found themselves challenged to deal with a new, undefined disease, has been summarized by Professor Anna Falanga during the SSC session on Hemostasis and Malignancy at the recent ISTH 2020 virtual Conference (2).
The Papa Giovanni XXIII Hospital, the main hospital in the area, was almost completely re-organized with several medical and surgical units dismantled to make room for new COVID-19-dedicated areas in several departments (adult and pediatric internal medicine and surgery, intensive care, the sub-intensive critical care, and the Emergency Department). The first COVID-19-positive patient in Bergamo was documented on 21 February 2020. In less than 1 month, five COVID-19-dedicated units with 48 beds each, were progressively activated, with an extraordinary effort by the healthcare personnel, who were specifically trained for the emergency. These new units were filled immediately with new patients in a 72-hour time frame. A brand new hospital had to be set up in an exhibition area just outside Bergamo, to help allocate the number of patients who required health assistance.
Despite all these efforts, a great proportion of people, the ones with non-severe symptoms, still had to stay at home and receive dedicated assistance there. The situation started to improve from the end of May, with 3 months living in an unprecedented critical situation.
Evidence from the hospitalized patients in Bergamo could confirm the thrombotic feature of COVID-19 (increment of consultation for thrombotic events in hospitalized patients) and the problematic situation of the most vulnerable patients, i.e. those with co-morbidities and especially those with cancer.
Concerning the latter, very little information was available on cancer patients with COVID-19 and how they dealt with the disease and with the routine procedures necessary for cancer treatment. In Bergamo, the concomitant cancer and COVID-19 infection is being studied by two independent cohorts of patients:
- One cohort includes cancer patients who follow regular treatment at the oncologic unit, investigated for SARS-CoV-2 positivity;
- Another cohort includes cancer patients who were hospitalized with severe symptoms of COVID-19.
The analysis is still ongoing, as is the COVID-19 pandemic, which has now entered a new phase in Bergamo and, in general, all over Italy.
Based on the experience in Bergamo and on the situation of other Italian centers, practical suggestions on how to implement cancer care during the pandemic outbreak have been reported (3).
Such recommendation must be constantly implemented with the new knowledge and kept in mind by both the healthcare professionals and the patients as a guideline to assure a safe treatment to cancer patients, in the actual Italian COVID-19 phase. The Bergamo experience provides a practical example and a comparison to other situations, as the COVID-19 emergency is still ongoing in several countries around the world.
- Lambertini M, Toss A, Passaro A, et al. Cancer care during the spread of coronavirus disease 2019 (COVID-19) in Italy: young oncologists’ perspective. ESMO Open 2020;5:e000759. doi:10.1136/ esmoopen-2020-000759