Policy responses for Italy - HSRM


Policy responses for Italy

1. Preventing transmission

The section on PREVENTING TRANSMISSION includes information on key public health measures that aim to prevent the further spread of the disease. It details how countries are advising the general public and people who (might) have the disease to prevent further spread, as well as measures in place to test and identify cases, trace contacts, and monitor the scale of the outbreak.

1.1 Health communication

A report from SOCINT, the Italian intelligence services, warned the Parliament about the large amount of fake news that Italy has been subject to, which has destabilized public opinion significantly.
Topics mostly tackled regard fake information on the origin of the virus, state of research on drugs and vaccine and conspiracy theories according to which a cure would be already available but is being covered up by governments. According to the report, similar streams of fake news have circulated in Europe in Italian, English, French, German and Spanish too and more than half a million people seem to be involved through a series of accounts that spread serial disinformation on Twitter between France, Italy and Germany.
In this regard, in April the Government had already set up a task force called "Monitoring unit to contrast the spread of fake news related to COVID-19 on the web and on social networks". The task force's operational activity program, signed by 12 health communicators and experts on debunking health issues misinformation, was published on 9th June. The task force suggested three areas of intervention: 1) promotion of access to a unique institutional hub of communication based on contents deemed more scientifically reliable, taking into account the continuous and rapid evolution of knowledge on COVID-19; 2) increase of citizen awareness on the cognitive mechanisms behind the use of information and the risks of disinformation; 3) implementation of a quantitative analysis of the phenomenon of disinformation, alongside the development of data-driven communication strategies. This last point can serve to orient contents of FAQs according to which topics are mostly researched by the general public; it can also serve to quantify the incidence of fake news in public debates on the largest social-networks; finally, it can also serve to evaluate the impact of institutional communication, in order to guide the design of new and more effective communication campaigns.

On 5th March, the Ministry of Health (MOH) specified essential behaviour concerning hand hygiene, respiratory etiquette and physical distancing through its official website. Among other precautionary measures, correct behaviour implies frequently washing hands, avoiding hugs and handshakes and maintaining a safe distance between people of at least one metre. Furthermore, surfaces should be cleaned with disinfectants containing chlorine or alcohol and face masks are suggested only if there is suspicion of being sick or if assisting somebody who is.

Extensive information on this preventive conduct is broadly disseminated through three main websites run by the MOH, the Department of Civil Protection and the National Institute of Health (Istituto Superiore di Sanità, hereafter referred to as ISS) as detailed below.

Ministry of Health
The MOH has created a new portal on its website dedicated entirely to COVID-19 which presents information about the disease, its symptoms, prevention and treatment possibilities, epidemiological data, public health measures, FAQs and supportive advice. Through other channels such as Facebook, Instagram, Twitter and TV advertising it also releases informative articles, banners and infographics by the hour, promoting the hashtag #iorestoacasa (“I am staying at home”).

Department of Civil Protection
The Department of Civil Protection, the national body dedicated to Risk Prediction and Prevention, Rescue and Assistance, which answers directly to the Prime Minister’s Office and operates in tight collaboration with the regions, provides daily updates on the epidemiological situation through live streams held daily at 6.00 p.m. that can be followed on TV or on their official Youtube channel (https://www.youtube.com/channel/UC4fru33Tzpu0UhCIHChiNFA). Announcements are made by Angelo Borrelli, head of the Department, and also involve the head (or a senior member) of the ISS to answer technical or scientific questions put by the press.  Their website also has a section called “The map of the situation” which represents data regarding each Region’s epidemiological specifics.

National Institute of Health
The ISS has dedicated its epidemiology portal EpiCentro to all COVID-19 integrated surveillance data and has set up dedicated Webinars and Distance Learning courses, which also provide Continuing Medical Education (CME) credits. It has also published a guide with recommendations and advice to manage domiciliary confinement of positive cases or of those who have been in contact (“Interim indications for isolation and in-home healthcare assistance in the current context of COVID-19”).

Specific information for each area is further detailed on Regional Government and local health authorities’ websites.

Regional or private initiatives
• Microsoft has developed Healthcare Bot, a chatbot that supports self-evaluation of symptoms and that has been made accessible for free to Italian healthcare facilities thanks to INAIL (the National Institute for Insurance against Accidents at Work). A ‘virtual assistant’ interacts with users providing information in an attempt to avoid overcrowding of healthcare facilities and optimize workloads for healthcare professionals. Users who suspect that they have been infected are given useful directives regarding appropriate behaviour and precautionary measures. The platform also adapts to the scenarios and protocols of each facility in which it is used and also provides support for clinical triage and risk assessments.
The service, based on AI and the cloud computing technology Azure, is active in two Roman hospitals (the National Institute for Infectious Diseases Lazzaro Spallanzani and the San Giovanni Addolorata Hospital) and in the Pediatric Hospital Gaslini in Genoa. In the first week after its release, which occurred in April, it assisted 10 thousand individuals sending out a total of 42 000 messages.
• The pharma company Bayer has partnered with the Italian startup Paginemediche to introduce a ‘virtual assistant’ to help during initial Covid-19 symptoms, even via teleconsultation. The service, called ‘Ask the expert’, allows users to chat with a specialist through a private encrypted channel, either for free or by paying a fee if responses are needed within 24 hours. It is possible to upload exam results and diagnostic images. The chatbot has been formally adopted by Lombardy and made available on its regional website.

- https://www.epicentro.iss.it/en/coronavirus/sars-cov-2-dashboard
- https://www.inail.it/cs/internet/comunicazione/news-ed-eventi/news/news-chatbot-autovalutazione-covid-19-2020.html 
- https://www.saperesalute.it/disturbi-patologie/chiedi-esperto