麻豆传媒

Last week, , the chief of cardiac surgery at in Milan, used his Green Pass to see a movie in a theater for the first time in about 2 years.

"To see a movie in the theater was quite incredible," Menicanti told 麻豆传媒. "It was a great moment ... and a great movie," he said of the latest .

It was a bit of a process to get in, given the line for the Green Pass check, but that's life in Italy today. Citizens need their -- which requires either vaccination or frequent testing -- for work and to get into most public indoor spaces, and masks are still commonly worn. But there's a general feeling of safety, Menicanti said.

"Now the situation is almost normal," he said, "and this is a great thing."

That's quite different from some 20 months ago, when Italy was the epicenter of Europe's COVID outbreak, with the first cases detected in Codogno in February 2020. The country has totaled some 4.6 million cases and 131,000 deaths, competing with the U.S. in deaths per million inhabitants (about 2,170 since the pandemic began), which is among the highest of any European country.

Now Italy, a country of 60 million, sees about 3,000 new cases per day, with just 45 daily deaths on average.

In the Lombardy region, where Milan and Codogno are located, out of 10 million inhabitants, 403 are currently hospitalized and 55 of those patients are in the ICU, Menicanti said.

"It's a very small number and all trends are decreasing," he added.

That's despite all schools being open for more than 2 weeks, although teachers must be vaccinated and precautions such as masking, distancing, and temperature checks are in place.

Vaccination rates are high, above 80% in many regions, Menicanti said, although there are differences between northern and southern regions, and there's still a contingent that's opposed to the Green Pass and vaccination mandates.

Nonetheless, the majority of the population has accepted vaccination, he said, even after initial hesitancy as regulators investigated blood clotting concerns with the AstraZeneca vaccine.

"Surely some people have died after vaccination, there's no question, but the numbers have been very low, so I think the risk is accepted," Menicanti said.

That will make the upcoming booster campaign relatively easy, he said. Third doses will first be available to the elderly and high-risk workers like healthcare professionals, "just as we did the first time," with a larger roll-out to the general population following. "Because the benefit of vaccination is evident, I'm confident most people will take it," he noted.

Healthcare workers in particular will likely take the booster, as there have been some breakthrough cases, albeit a "small number, and the course of disease was very easy, without complications," Menicanti said of his colleagues' experience.

In addition, the memories of those dark days are still fresh.

Maurizio Cecconi, MD, of Humanitas Research Hospital in Milan, and president of the European Society of Intensive Care Medicine, that, early in the pandemic, "Even if many still claimed it was just a flu, our hospitals in Lombardy were facing something anomalous."

"I had the feeling that none realised that it was already in this part of the world," Cecconi told BMJ.

"It was terrible," Menicanti said, describing how during the first wave his hospital was turned into a COVID hospital, with all surgery halted except pediatric cardiac surgery. Those who needed surgery were sent to other hospitals, but those facilities were also full, "so surely some people were killed by diseases not related to COVID."

With Codogno just 15 miles away, "we received patients from that part of Italy. The mortality at the time was very high. It was like a bomb that exploded in that part of the region."

During the second wave last winter, the hospital became a hub for cardiac surgery: "We worked a lot because we were receiving patients from all regions."

The country's third wave began its descent in April, and since then, "we've been fully open." The current 3,000-case daily average is up from a nadir of about 1,000 during the summer, but trends seem to be stable now.

"All people hope it's over, though some are very cautious about that," Menicanti said. "We hope not to repeat the experience. It's true we're now much more prepared. But it was really, really bad."

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