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Dr Elisa Perego Profile picture
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Feb 20 • 9 tweets • 3 min read
Three years ago today the first known Italian patient tested positive for SARS-CoV-2: "Patient 1" was M.M. a 38 marathon runner who wasn't recovering from an "atypical pneumonia". He hadn't been to China. It was the day many understood Europe had fallen.

tg24.sky.it/salute-e-benes…
M.M. was swabbed for SARS-CoV-2 despite not having been in China by anesthesiologist Annalisa Malara MD, whom I want to remember for her intuition, courage and promptness. By alerting the world of local transmission in Lombardy, she contributed to bring Covid into the spotlight
Dr Annalisa Malara probably saved the life of "Patient 1" M.M. and many other lives who could have been lost if "silent" SARS-CoV-2 hadn't been finally recognized within one of the most connected areas in Europe, the Lombardy region in Italy
It was still to late to stop the Great Lombardy Wave of early 2020 because of poor pandemic policy, which hadn't implemented surveillance for SARS-CoV-2 spread. This is despite the world's knowing of the dangers of this SARS virus since at least 31 December 2019 and January 2020.
Poor policy across the world since before the pandemic was officially declared in March 2020, has brought a cluster of SARS-like pneumonia in China to become one of the most tragic public health disasters in recent history. Poor policy is still implemented today. Never forget.
I say "the day many understood Europe had fallen" because Italy's Patient 1 had been sick for days when he tested positive. He hadn't been in China. He was in a small city, Codogno: all of this could only mean one thing: a cluster. "Silent", undetected community transmission
We soon learned "silent" undetected community transmission was totally widespread in Lombardy and other nearby areas. The Bergamo area in Lombardy was soon to become the shocking epicenter of this early pandemic tragedy

nytimes.com/interactive/20…
Other regions and cities in Europe and abroad soon emerged as further devastating areas of unleashed SARS-CoV-2 spread: Paris, Madrid: where corpses had to be amassed in the local ice rink, London, New York. So many places.

cnn.com/2020/03/24/eur…
We should not forget where this pandemic is coming from. Who did the right thing soon at the beginning. The lives lost. The long-term sick (#LongCovid #longhaulers). The disaster. Those who were wrong. Those who did not say the truth. Those who made a fortune out of tragedy.

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More from @elisaperego78

Dr Elisa Perego Profile picture
Feb 22
There are many infectious diseases where the early phase is "mild" or asymptomatic. But the prolonged pathology is not, and can be severe in the long-term. Examples are HIV/AIDS or EBV/multiple sclerosis. Don't necessarily trust SARS-CoV-2 if the early infection is uneventful 🧵
Pathogens have, obviously, their own specific features and mechanisms of actions. SARS-CoV-2 is not EBV/ Epstein Barr virus or HIV. What I'm saying here, is that the immediate clinical manifestations of an infection aren't necessarily indicative of overall severity
Since early 2020, we have known that SARS-CoV-2 can manifest with pauci-symptomatic/asymptomatic early pathology, which can kill or disable with time. Covid can manifest with an early mild flu-like illness (prodromal phase) which progresses to death

thelancet.com/article/S0140-…
Read 13 tweets
Dr Elisa Perego Profile picture
Feb 22
Queen Consort Camilla is forced to pull out from another public appearance as she remains not recovered from Covid. Camilla's Covid case was revealed 10 days ago after it was initially thought, or reported, she had "a cold" or "the flu"

news.sky.com/story/queen-co…
While, as usual, I wish everyone fast recovery, it's key to remember Covid is not the "common cold". Even if you're ill enough to have to have to stay home "only ten days", and you can be reinfected, how many have paid sick leave or help to cover this?

tg24.sky.it/mondo/2023/02/…
And many people are sick for much longer than ten days. Camilla herself is still not recovered. Covid remains a leading cause of death and disability. Curbing transmission is imperative
Read 4 tweets
Dr Elisa Perego Profile picture
Feb 22
“Despite being put on anticoagulants, the patient was still developing clots. A second said she’d seen something similar. And a third.”

“That’s when we knew we had a huge problem.”

C. Coopersmith MD and a chat of doctors treating Covid—April 2020

washingtonpost.com/health/2020/04…
"Increasingly, doctors also are reporting bizarre, unsettling cases that don’t seem to follow any of the textbooks they’ve trained on.. patients with startlingly low oxygen levels —so low that they would normally be unconscious or near death— talking and swiping on their phones."
"Asymptomatic pregnant women suddenly in cardiac arrest. Patients who by all conventional measures seem to have mild disease deteriorating within minutes and dying at home."
Read 5 tweets
Dr Elisa Perego Profile picture
Feb 22
"I still feel it. Covid. When I run. It's hard. Now it's better but I was pretty sick for a few days. I lost my sense of taste and smell. A fever."

Football star K. De Bruyne on his experience with prolonged symptoms and poor form in 2021

#LongCovid

ilnapolista.it/2021/12/il-lon…
Summary and translation from an interview with football star K. De Bruyne from 2021. In the UK, Kevin suffered from a relatively rough acute phase

"I had to isolate for ten days to not infect my family. It was hard to see them only beyond a glass. The first 4 days were hard."
"On the fifth day I felt better, but it took time to get my sense of taste and smell back. It felt a bit like a flu initially, but I'm not sure because I never had the flu before. Then, I [apparently] recovered and came back to football training, but it wasn't easy."
Read 7 tweets
Dr Elisa Perego Profile picture
Feb 21
#LongCovid has never been about respiratory symptoms alone. We knew Long Covid was about, among other things, cardiovascular disease and coagulation problems in spring to summer 2020 already. We underlined Covid was multi-system disease early on

theconversation.com/we-got-some-ke…
#LongCovid was openly recognized by the WHO in August 2020, after intense advocacy by Covid survivors from the first wave. I was at that WHO meeting myself. By late 2020 we perfectly knew Long Covid was going to be a disaster, and it was in the published literature
Organ damage following SARS-CoV-2 infection was already evident in early to mid 2020. The first publications with the findings and autopsies from the first wave were being published already in 2020. We knew how dangerous this virus was very early on

science.org/doi/10.1126/sc…
Read 8 tweets
Dr Elisa Perego Profile picture
Feb 21
"I had to think the impossible. His pneumonia wasn't responding to any standard treatment.".
An interview with Dr Annalisa Malara MD, the anesthesiologist who discovered the first, local Covid case in Italy three years ago, on 20 February 2020

rainews.it/articoli/2022/…
"I had to take personal responsibility to order that SARS-CoV-2 swab. It wasn't the standard procedure [the patient hadn't been in China]. His clinical records were later requested by the authorities [the NAS specifically]. But, thankfully, everything went ok"
"At university, they taught me to think of everything, to think out of the box. The patient was sick with a flu like illness on 14 February 2020. On 18 February he came to the emergency and he had this "mild" pneumonia. He was soon declining fast. They sent him to my ICU."
Read 8 tweets

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