We spoke to a physician in Italy about his perspectives on the COVID-19 crisis in his home country.
Hi Dr. Meani, thank you so much for taking the time to talk to me. The COVID-19 pandemic has left us all in fear, especially for those who are elderly or have pre-existing conditions. Knowing that we fit this demographic adds an extra layer to this difficult time.
I know you are a medical doctor treating COVID-19 patients in Italy. I know that you also live with type 1 diabetes. I thought since you are so personally and professionally immersed in what is going on right now, that it might be nice from our readers to hear your perspective.
How long have you been type 1?
I was diagnosed in 1995 when I was seven years old.
Did that play into your decision to become a doctor?
Absolutely. Being diabetic made me soon realize how crucial your doctor is. It’s not only a matter of knowledge and experience. What I especially appreciate was that the different doctors I met were able to take care of me with a holistic approach. You might handle diseases as appropriately as you can, and yet neglect all other patient’s needs. I decided to become a doctor because I was fascinated by the idea of taking care of patients and not only illnesses.
When you heard about COVID-19 heading your way, were you nervous? For your family? And for your work as a doctor during this pandemic? Did you feel your hospital was prepared for the outbreak?
It was on February 21st. I was in the emergency department. My patient, who suffered from acute myocardial infarction, was transferred to the nearest cardiologic hospital since our Cath Lab was not available.
A suspected COVID-19 case was detected there. Therefore, COVID-19 came to us like a tsunami. How could you be really prepared for a tsunami?
From that day, our life completely changed. Certainly, I was, and I still am, scared for my family and myself, as a diabetic. However, I met a lot of people stepping up along my way. First of all, my sister who is a type 1 diabetic, too. She was sick at the begging of this pandemic, facing her illness with incredible courage. This gave me the strength to face this period and say “yes” to my call of duty.
What is the main concern you have as a doctor for you, your family and your patients if they contract COVID-19?
This is a completely new disease. We hardly have any clue at all. We were used to knowing what we treated; this time is different. Day by day, I discovered how the insecurity made me scared more than the disease itself. The sense of impotence was, therefore, my major concern for myself, my family and my patients.
If your patients are nervous that they have COVID-19, what is your advice? What symptoms should they look for and who should they call?
COVID-19 may present several symptoms that are also common with seasonal flu and influenza. The virus may involve the respiratory tract, causing pneumonia and acute respiratory distress syndrome. As a result, we should consider severe cough and shortness of breath (dyspnea) as important warning signs. In that case, we must call our general practitioner as soon as possible or go to the emergency room.
However, my first advice is to be rational: don’t panic! Approximately 8 out of 10 patients are asymptomatic or showed mild symptoms. Among those who require hospitalization, only 5% need intensive care management.
Is there anything to have on hand that you would recommend for people living with diabetes?
It is unknown whether or not people with type 1 diabetes face a higher risk of catching the novel coronavirus. However, once contracted, the infection may be harder to treat because of glucose fluctuations and the occurrence of other complications. Therefore, glucose monitoring is crucial and any actions favoring satisfactory metabolic balance should be encouraged. Eating a healthy, balanced diet and doing at-home physical activities are strongly recommended. Telemedicine with a diabetologist is a useful tool for maintaining diabetes under control.
Furthermore, people with diabetes must strictly respect some rules, including frequently cleaning their hands; practicing social distancing; and wearing a face mask in public, especially in high traffic areas. Last but not least, in case of symptoms, one should seek medical care early. Contact your general practitioner via phone or portal first.
I can’t imagine how stressful this time has been for you. How have you been able to rest, take care of your family and your patients?
Fortunately, there’s a silver lining in all this. Going through this challenging period made me realize how crucial my private life is for having a balanced life. I live with my girlfriend, also a medical doctor coping with the COVID-19 outbreak. She has been always supporting me and my choice to keep on fighting, helping me with diabetes management more than I could ever expect. This is the reason why I can keep going, I can take care of my family and my patients.
Self-care is so important, how has working on the front lines affected your mental and emotional health right now? What are you doing to make sure you take care of yourself?
My own balance is the most demanding challenge in this period. As a medical doctor on the front lines, I’m absorbed in taking care of patients each and every day, thus getting exposed to the worst part of this illness. As a first step, I tried to raise an emotional wall in front of me in order to feel strong and untouchable and prevent the pandemic from having any mental impact on me. Nevertheless, as a human being, I realized I kept feeling emotions, and I had to express those emotions. This, in turn, led me to embrace the fact that acknowledging my weaknesses [is] the real key to survival. Although we are all hit by this virus, my secret is to accept my weakness and try to pay much more attention to my emotional states and feelings.
In this regard, physical activity considerably helps me maintain my mental health. I could never emphasize how grateful I am to my girlfriend’s grandparents for buying us a beautiful spinning bike.
For the countries that are behind you in getting through this pandemic, what are some insights you can share? What can we expect our next few weeks to look like?
It’s a really difficult question. It’s hard to come up with any advice or prediction. We are still facing the outbreak here and its behavior is different among places and countries. I truly hope that people throughout the world are brave enough to step up as they did in Milan, and I’m certain they will.
A lot of people call us heroes, but I just think we are people who are committed to carrying out our own duties. And these should not be called heroes.
Thanks so much for taking the time to talk to me! And from all of us here at Diabetes Daily, thank you for all you do!
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