Italy pushes back as healthcare workers avoid Covid vaccines

ROME – Giulio Macciò tested negative for the coronavirus and spent weeks receiving treatment for emphysema in a closed hospital under the care of doctors and pulmonologists – and a nurse who had refused to be vaccinated. On March 11, he passed away suddenly. A post-mortem swab revealed he had contracted the virus, as did 14 other patients and the unvaccinated nurse who spent his shifts among him.

“It makes no sense that a person whose job is to cure the sick gives them Covid and kills them,” said Macciò’s son Massimiliano Macciò, who has filed a complaint against San Martino Hospital in the city of Genoa in northern Italy. He believes the nurse, one of some 400 people who refused the Covid-19 vaccination at the hospital, infected his father, who died unvaccinated at 79.

As vaccination rollout gains momentum, companies around the world question whether they can require inoculation from their employees, raising thorny ethical, constitutional and privacy issues in Europe. and the United States. But this dilemma becomes all the more urgent when the person is your health worker.

In Italy, the first Western front in the war against Covid, a wave of epidemics in hospitals where medical workers have chosen not to be vaccinated has raised fears that their position endangers public health. It has also prompted a forceful response from an Italian government struggling to get vaccinations on track.

Prime Minister Mario Draghi is expected to test the legal limits of his government’s ability to resolve the issue on Wednesday by issuing a decree requiring the vaccination of workers in health facilities. It will also allow hospital directors to suspend workers who refuse to do so without pay, according to a Justice Department official who knows the details of the measure.

Some legal analysts have said that requiring the inoculation of Covid-19 for health workers could violate Italian privacy laws, and that firing or forcing anyone who refuses to take unpaid leave could be unconstitutional because of a specific section that protects people who refuse medical treatment.

But recent court rulings have interpreted the law differently, and Mr Draghi has made it clear that for a country that has suffered more than 100,000 Covid deaths, the security breach cannot be tolerated.

“It is absolutely not normal that unvaccinated workers are in contact with sick people,” he said at a press conference last week, while announcing his government’s intention “to” intervene ”when asked about reports of unvaccinated health care workers.

During much of the pandemic, nurses and doctors were national heroes who sacrificed their waking hours, safety and sometimes their lives to protect their compatriots. He shocked Italians that in some large hospitals, up to 15 percent of those healthcare professionals – who had the preference in rolling out vaccination before the elderly – avoided vaccination.

“It’s really humiliating for the class of doctors and health workers to have to force people to get vaccinated,” said Roberto Burioni, virologist at San Raffaele University in Milan.

He added that while it is extremely difficult to fire workers in Italy, he hopes the decree will bite the wages of all vaccine skeptics, especially given the large amount of data showing that the effectiveness vaccines are worth it. He was also concerned that the high number of healthcare professionals refusing to be vaccinated had troubling implications.

“Unfortunately, there are a lot of doctors who are deeply ignorant,” said Mr. Burioni, who suggested that maybe “the selection process to get people to get a medical degree and then a medical license. , is not efficient enough.

While Italian populists, including the Five Star Movement and League parties, have exploited skepticism about vaccines for political ends in recent years, the country is not even considered the most skeptical of all. vaccines from Europe, a dubious distinction which generally falls to France. Italy also saw a rapid start in vaccinations earlier this year precisely because the previous government prioritized medical staff.

In January, Health Minister Roberto Speranza told television that Italy, like its European partners, believed it was better to persuade people to get vaccinated than to ask them to do so. “Those who have had to deal with the virus, our health workers, are even more aware than others,” he said. “I think the will will be enough.”

But anti-vax health workers have struck a deep nerve.

In a nursing home outside Rome, almost all of the health workers chose not to be vaccinated, and a cluster broke out around three workers and 27 of 36 older people. Roberto Agresti, the owner of the house, feared the worst for them. “If we had a law requiring everyone to get vaccinated, the virus would have passed without us even realizing it,” he said.

In the southern city of Brindisi, the local health authority opened disciplinary proceedings against 12 health workers who expressly refused vaccination. He is also investigating why around 140 healthcare workers, including doctors, nurses, pediatricians and specialists, have refused Pfizer vaccines.

“We don’t want to punish workers – we need it,” said Giuseppe Pasqualone, who heads the local health authority. “But the risk of contagion not only for them but also for fragile patients is very high.”

Officials at the San Martino hospital, where Mr Macciò died, said it was not clear whether the unvaccinated nurse was the source of the cluster, but they admitted it was a problem.

Salvatore Giuffrida, the director of the hospital, the fourth largest in Europe, said he was in favor of a mandatory vaccination, as this would also keep medical workers healthy and strengthen the defensive lines as ‘a brutal third wave is spreading in northern Italy.

“We can’t afford not to have them at work,” he said. “The goal is not to lose soldiers in a war in a country that complains that it does not have health workers.”

He estimated that 15 percent of his nursing staff, or about 400 nurses, were not vaccinated. Simply removing these nurses from services, or redirecting them to switchboards as some have suggested, would be “a cure worse than the disease,” he said, as it would result in a reduction of 250 beds.

He and other directors said Italy’s strict privacy laws prevent hospitals from knowing which doctors and nurses are not vaccinated.

Paolo Petralia, director general of Lavagna Hospital in Chiavari, the site of another outbreak this month, said 90% of its doctors had been vaccinated, along with around 80% of nurses and helpers.

“They are protected by privacy laws,” he said, citing a recent statement by the Italian data protection authority that the immunization status of health workers should be unknown. “But this right exists until it does not limit the right of others,” Petralia said.

Some Italian courts have accepted. In 2017, Italy fact some vaccinations are compulsory for children, including for measles, and have prevented the unvaccinated from going to school – a decision supported by the Italian Constitutional Court because it also protected public health. In the northern town of Belluno, a court ruled in mid-March that a nursing home that employed several health workers who chose not to be vaccinated could force them to take paid leave.

Mr Macciò, whose father died in Genoa, said it made no sense that those responsible for caring for his father were allowed to harm him. He said he complained to doctors, who told him their hands were tied because nurses were protected by confidentiality rules.

But amid Italy’s frustration and the new decree, something seems to be changing. Mr Macciò said the police had asked for his help in identifying the nurses he saw while going to pick up his father’s belongings.

“I hope it will result in good,” he said of his father’s death. “These people should change jobs.”

Emma Bubola contribution to reports.

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