A year ago, on a hot July day, agencies, websites, follow-up news and all newspapers published a story that greatly affected the whole public opinion, like a thunderbolt from the sky. On the afternoon of July 27, Giuseppe de Dono, former chief of pulmonology at Carlo Puma Hospital in Mantua, the person who first started treating Covid with hyperimmune plasma transfusions, committed suicide, with very positive results.
It has been a controversial treatment, as often happens with innovative therapies, for which there is still no international scientific confirmation. But a type of therapy that in the history of medicine boasted similar precedents, albeit not completely overlapping, that exploited the principle of the immune response. Immunotherapy is a treatment method based on the use of substances that affect the immune system to induce, amplify or suppress the immune response on the part of the body and strengthen its natural defenses.
De Donno has provided infusions to patients with Covid-19 from blood taken from people infected with and recovering from the coronavirus. As is normal, the blood taken has been adequately processed before being transferred to the patients. The initial scientific hypothesis was that their blood had a sufficiently high content of the antibodies, which would allow patients in similar circumstances to react faster and better, obviously after taking the necessary precautions.
As is generally the case in all scientific communities, de Dono, an expert clinical pulmonologist and chief medical officer of Mantua, compared and shared an experimental protocol with a fellow immunologist, a professor at the University of Pavia. Together with Massimo FranciniHead of the Department of Immuno-hematology, he began treating COVID-19 patients with the new treatment, defined as hyperimmune plasma therapy. In a short time, two years ago, this practice became the most effective weapon against the Corona virus, especially when taken in the early stages of the disease. De Donno became the most famous of Italy’s primaries, disputed in newspapers and television programmes.
Although he was a very private person, he immediately emerged as a person who, compared to other mostly fellow virologists, not only elucidated scientific theories and commented on the dramatic data of the spread of the virus; He can talk about the positive results he was getting. This earned him appreciation and admiration. Gratitude and hope, but also obviously a good dose of jealousy and envy, as well as unanswered scientific questions. It should be noted that it was in any case an experimental protocol that would have required a series of confirmations from a scientific point of view, even if the clinical results bode well for its efficacy, above all to obtain permission from the ethics committee. But the urgency of the moment prompted us to skip some methodological steps, to be as close as possible to the patients.
to make technique hyperimmune plasma Obviously, blood donors for recovered Covid were primary, and they had to have certain characteristics, starting with the fact that their plasma had to be certified to make sure it contained hyperimmune antibodies. Initially, there were several donors whose plasma was frozen, and a plasma bank was set up in Mantua, which is necessary to preserve it and possibly help other hospitals that requested it. But getting donors and volunteers with these characteristics on a regular basis was certainly not easy. There was an objective shortage of plasma compared to the number of patients infected with the Coronavirus in that period, but above all, requests for plasma from other hospitals all over Italy began to arrive, in quantities far beyond what could be satisfied.
After an initial phase of ecstasy for the undoubted results achieved – even if it was in medicine post custom It doesn’t mean that anymore true custom -, began the first criticism, bewilderment: not all patients recovered, many continued to die, despite the undoubted positive results, so began to collect negative testimonies, which in many cases amounted to real ostracism. In fact, not everyone in the field of medicine agreed on the method used, even among colleagues from pulmonologists, infectious diseases, immunologists, etc. Controversy arose in all its forms. News spread that the research protocol and related clinical trial, developed in collaboration with the University of Pavia, did not appear to give the expected results. Ultimately, the research conclusions do not seem to confirm De Donno’s initial hypothesis, despite the fact that there have already been many patients who have recovered from Covid with this specific treatment.
De Dono found himself shattered on the one hand by the expectations of patients and their families, and on the other hand by increasingly aggressive criticism from colleagues and relatives of deceased patients. The controversies that arose seemed increasingly threatened and a real media war erupted on social media, which today can only be understood by remembering the emotionally frenetic climate that prevailed at the time. The irony was that rather than estimating how many people were cured of the new treatment, the focus was mainly on the number of those who did not. Among those who did not have access to treatment or simply did not recover.
Hostilities also multiplied in his hospital and his image was absorbed into the image of a swindler, bragging as in other circumstances: in the meantime, suspicion spread of the existence of powerful economic interests, from which he could have profited, including the plasma trade. The extrajudicial lynching soon became ransom, because the pandemic as a whole showed no signs of abating; vaccination campaign General ViglioloAnd hospital doctors’ bewilderment could not compare de Dono’s hypothesis to other, more clinically effective programs based on specifically approved drugs. The number of daily deaths is confirmed by television images of coffins awaiting burial or even long military trucks departing from Bergamo. The news broadcast at all hours of the day was the Bulletin of New Patients, Topics in Intensive Care and the Dead: Minister Speranza often appeared on television in the company of the finest scientists, to call for caution, to remember the famous rules must be respected and to urge the implementation of strict lockdown. It seems that there is no pity for those who made concrete promises, which in fact were not fulfilled. As if it was wrong “too”: from miracle to scandal, ignoring how science usually goes by trial and error and how biological phenomena never respond to a priori determinism.
At the beginning of June last year, certainly tired and indignant, frustrated with the volatility of human approval, de Dono resigned from the Hospital of Mantua, leaving his primary position, to resume his career, as a general practitioner in Porto Mantofano on July 5. But a few weeks were enough for him to see for himself how the media aggression against him showed no sign of abating; The job change, from hospital to local doctor, from specialist to general practitioner, couldn’t adequately protect him from the culture of doubt that had invaded the web, but became increasingly difficult to accept in the area where he lived and cared for his new patients. On July 27 of the same year, he hanged himself, and although the circumstances of the suicide are not entirely clear, it is easy to imagine that the unit in which he fell was still filled with hostile ghosts that he felt threatened.
A sad story in which respect is required for the man who could imagine new solutions where others saw only obstacles and knew how to risk putting his wits in the search for the impossible; Brave enough not to succumb to death without fighting for his illness. but at the same time a fragile man who, like everyone else, needs the support and solidarity of his colleagues; He is left alone by those who should have helped him the most, while the battle for the epidemic is not only erupting, but also the personal confusion of those who, despite the positive results obtained, fear that they have “everything wrong” And they no longer see possible solutions, if not death. for him. He was the one who fought to wrest many Covid patients from death.
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