On the night of May 2, a well-known local musician, Andrea Nocerino, arrived in the parking lot of the main hospital in Cremona, in Northern Italy, where 80 medics and support staff – about 20 of them Canadian – had opened a COVID-19 field hospital.
Wearing a mask, he unpacked his cello from its yellow carbon case and set up in the “safe area” among the 14 white tents erected by the Christian relief charity Samaritan’s Purse. The doors of the tents were opened and Mr. Nocerino played a romantic repertoire by Gabriel Fauré, Camille Saint-Saëns, Johann Sebastian Bach, Sergei Rachmaninoff and Giacomo Puccini.
The night was warm and clear and the stars were shining, remembered John Troke, 43, the hospital’s Canadian nursing team leader. “He was playing between the tents,” he said Tuesday. “He played for the patients and staff, and it was a beautiful moment. Only about 10 days earlier we were in a very harsh environment, and his performance sort of marked a transition point for us. The worst was behind us.”
This week, the Samaritan’s Purse field hospital is being dismantled, sanitized and packed up (a second field hospital, in New York’s Central Park, is also being taken down). On the weekend, the charity’s DC-8 cargo plane will collect the equipment and the exhausted team members from nearby Verona and fly them back to their home base in North Carolina. Only one team member became infected with COVID-19 – a remarkable achievement given the high infection and fatality rates among front-line Italian doctors – and made a full recovery.
Bev Kauffeldt, 48, the Yukon-born team leader who spent 14 years in Liberia with her husband fighting Ebola and other infectious diseases, said the mission was both a success and a great learning experience. Cremona – best known as the birthplace of master luthier Antonio Stradivari – was so grateful that the mayor, Gianluca Galimberti, made all the team members honorary citizens.
The little concert was Mr. Nocerino’s expression of gratitude for the team, which had treated 282 patients since March 20, all but 25 of whom survived. He later learned that two intensive-care patients were dying as he played – his cello may have been the last sound they heard, if they could hear at all.
“The medics worked all the time and had no life beyond their hospital,” said Mr. Nocerino, who is 28 and from Naples. “They made a great sacrifice for us. They were saviours, a gift to Cremona.”
The Samaritan’s Purse hospital was designed to take the pressure off the main hospital, which was completely overwhelmed by mid-March by novel coronavirus cases. Cremona (population 72,000), about 100 kilometres southeast of Milan, lies in the heart of Lombardy, which remains the hardest-hit spot in Europe. It has seen half of Italy’s 31,000 confirmed coronavirus fatalities.
The hospital team members, who were mostly from Canada, the United States and Britain, arrived with their own equipment, including ventilators and water purifiers, to ensure they would not drain resources from the deluged Cremona hospital.
“What shocked me when we arrived was that this was not just the flu,” she said. “It’s a very serious and deadly disease. The hard part of infectious diseases is that the patients have to be isolated. I would say this disease is evil in that it doesn’t allow their loved ones to be with them.”
A big part of the job was trying to lift the morale of the very ill but recovering patients and comforting those who had no hope of survival. “There were many times when our medical staff were praying and singing for the patients at their bedside, so when they passed, they were not alone," she said. "We would hold their hands.”
Ms. Kauffeldt and Mr. Troke said they will be able to deploy the lessons they learned in Cremona elsewhere, although they do not know yet where their next assignments will take them.
Ms. Kauffeldt said she learned that COVID-19 patients have to be as active as possible to keep their muscles and lungs from deteriorating, making them vulnerable to other illnesses after beating the virus. “We tried to get them moving, walking around so their muscles didn’t atrophy, and blowing through a straw,” she said. “It helps their overall recovery and has psychological benefits for them, too.”
Mr. Troke, who is from Winnipeg, said the team learned that the effective treatment of ICU patients requires a very high ratio of nurses to patients – one to two or three – given the enormous demands of the job. The patients’ oxygen flow and supply of anesthetic drugs have to be constantly monitored, and the nurses have to make sure the patients "sit up and breathe and cough so they can get the phlegm out of their lungs,” he said.
The last patient was discharged from the Samaritan’s Purse hospital on May 7. Some of them were simply moved to the other side of the parking lot to the main hospital, where the coronavirus case load has fallen to 100 from about 450 in the past couple of weeks. One patient who went to the main hospital had been with them since Day 1.
In Italy, the pandemic peaked in late March, with almost 1,000 deaths a day. The daily death toll has now fallen below 200, and Italy has been slowly reopening its economy, even if the health authorities are well aware that a second wave of infection is inevitable if Italians do not respect physical distancing and mask guidelines.
Ms. Kauffeldt and Mr. Troke are leaving Cremona with mixed emotions.
“In the six weeks the nurses got to spend with the patients, they got to know them like family,” Mr. Troke said. “It was a hard time for both patients, nurses and doctors to see the patients leave. It was like having to transfer a family member to another facility. … We saw a lot of misery and death, but we also saw a lot of miracles.”
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