Hi there everyone. As you're aware, we're doing some special episodes in the light of the coronavirus outbreak, and in today's episode, I'm delighted to interview an Italian vet, Flavio, about what the situation's been like for him and the rest of Italy and how they see the past, the present and the future in terms of the veterinary life and life in general. Hi everybody and welcome to another episode of Vet Chat today, er, in an interesting world.

I'm delighted to be joined by Italian vet Flavio Morchi, and I am assured by Flavio that that is the correct pronunciation. With an Italian tone of his surname, not just my scouse tones, getting it all wrong and making everything sound like a K. Flavio, thank you so much for joining us.

I, I just wonder, first and foremost, could you maybe just tell us a little bit about yourself? Yes, good afternoon for all of you. I'm Flavio, I'm a vet.

I'm a different young vet. I'm 62 unfortunately. And living in Italy in Ivrea, a little town in the west, northwest Italy, not so far from Turin and the French border.

It's a very, very fine region. It's fantastic. It's well known for the wineries.

I don't know if you know the Barolo wine, Barbaresco, Nabor, and so on, but also a special cooking style concerning the Piedmonttas de la Cocha. Beef bread is fantastic, fantastic stew with this meats and they love it. So you're from an area that's got good food, good wine, beautiful scenery, so there's nothing to really be jealous of for all of those who are stuck in the city and the.

Is it a fantastic town, Liverpool. Flavio, how has it been being, you know, sort of in Italy over the last few weeks? Obviously in the UK where we're a bit behind you time-wise in the disease process with COVID-19.

What's it been like being, being in an Italian situation, in an Italian town in, in this time? Oh, there are a lot of information. There are a lot of information, fake information, real information.

But what's true is that the outbreaks, the outbreak started in January, last January and spread in the, in the big cities in the most industrial, most business-oriented cities like Milan, like Turin, like Bologna. And of course due to the density of population in those cities and the, the number of business contacts, of course, the outbreak spread very, very fast. Now we are counting about 50,000 infected people and unfortunately 8% of that of of those people has already passed away.

So that's the, the reality. And, unfortunately, those people already passed away, are mostly age people, I would say, over 65/70. And let me say you, let me tell you, it's, whole generation disappearing.

It's our, our, my brother, my uncle, grandfather completely disappeared. You can imagine a sort of reports in the city of Berga. Where all the the age people normally died 345 per day, and they are assisting and they are assisting at 50, 70, 80 people died every day.

You can imagine. It's a, I mean, it's a worst scenario, it's an apocalypse, I would say. Well, that's it, and it, you know, it is to many of us, you know, even, even the older ones in the profession nowadays, this is an unprecedented time and you know, obviously the Italians are renowned for being, you know, a sociable people where, you know, you mix together on the streets, you mix together in cafes and restaurants and, you know, obviously the, the climate there is, is beautiful and you can enjoy.

Time out on the streets with each other, so of course, you know, a lockdown where everybody has is shut away in their houses is of course almost unfathomable, you know, when you see the streets of Venice completely empty, you know, it really does bring sort of almost, as you say, post-apocalyptic impressions to it, but how's it affected you personally, being, being locked away, if you like? Oh, very simply, I'm locked down in my home. Like, the, the visitor arresting.

I'm at home. I'm at home, of course, the, the, the, the national government has obliged all of us to stay at home all day long and reducing the, the, the, this lot of opening of magazine of, shops, from 8 o'clock until 6 o'clock in the afternoon. The only shops.

Open at essential services. I would say food, supermarket food, pharmacies, the post office, the hospital, of course, but that's all. What, what about veterinary practises over there?

Veterinary practises are still open because are considered essential services, but the activities, merely reduced to emergencies because, . The travel ban that doesn't allow the pet owner to take the dog in, in vet practise, unless there are a real, real, real serious, serious problem. Otherwise, they can take the, they can take the dog or the cat at home, with the small animal at home and bring it in the hospital, in the vet hospital to, to cure them and treat them and so on.

But, I would say my colleague in in general practise have lost about 90% of the business. Wow. And and the government doing anything over there to support the practises that have lost a lot of business?

Absolutely, yes, absolutely yes, but particularly for the employed of big companies, of course, but for professionals, there is a sort of I would say delayed payments of the most important taxes, the TVA, the taxes on the incomes and so on are already delayed and in the second half of the, of the year. Yeah, yeah. So it sounds very much like the Italian government and, and the British government have taken a very similar, you know, strong step to, to support business over there.

And, and, and one thing we've noticed in the UK in the last sort of days and weeks is a lot of the veterinary practises over here have started using video consults to liaise with clients. I is that something that practises over there have turned to as well? I would say no, because as a physician, you can't run a consultation by phone or by Skype, of course, but in any case, a sort of suggestion or recommendation.

And of course, counselling, yes, we are doing that by phone or by Skype. You're still managing to contact the client and and give them, give them support and encouragement from that side of things. And, and, and, and what about sort of, you know, the veterinary links, obviously people always say, you know, vets and and medics are are very closely linked, and obviously I, I dare say it's very hard.

So many people in the Italian health system who are working themselves very, very hard, and, and many of them of course becoming sick and some, some tragically dying. Has there been any call for the vets over there to help with, with human health? Yes, yes, because the, the, the, National Veterinary Federation has offered.

The opportunity to lend our oxygen enrichment devices of course to enrich and to boost the opportunity to treat all people in emergencies. It's only an offer and for now, the, the, the, the, the Italian Health Ministry is trying to get abroad all the device as possible. Of course, we are we are ready to lend our, our devices to the already collapsed hospital, unfortunately.

And, and. You know, obviously we see on, on daily basis, you know, this sort of mirror image if you like, between the UK following the disease process in Italy, and, and, you know, one of the things that that we concern ourselves with is this sort of almost this expectation with, with what's the, the worst is yet to. Kind of thing.

And what, what would your advice be to people in the UK given that you guys are, you know, 34 weeks further along this disease process, obviously a lot of people are now on lockdown over here as well. But if you were to give bits of advice to people on how to use their time and, and how to, if you like, make them. Of it's not really the right phrase, but to make the most of their time when they're on lockdown.

What what would you say to people in the UK to do? First of all, please do not consider yourself so strong to be you. That's the first recommendation.

And the second, respect literally the basic safety rules, washing hands, avoiding strictly close contact with everyone. And you can imagine the worst scenario in, in a family where there is one member already contaminated and the other is not. So you can imagine, this scenario to be, I mean, I would say separated in, in our home.

Home locked down in our bedroom or I don't know, whatever, sleeping on the, on the sofa, instead of the garage and so on. You talk. It's a very, very, very bad scenario.

But in any case, for people, it is quite important to respect rules strictly because he's a This sort of pneumonia is very, very dangerous because the, the most of the time the symptoms appear after 14 days. But, in the worst scenario, in a few hours, you get sick and you need a respiratory help. And when I say, when I'm saying the spiratory help, it means an oxygen enricher.

In an emergency room in the hospital already collapsed and probably as it happens in every ward, the physician should make a choice on which is the good patient to be treated and the other one not. Yeah, yeah, yeah, and obviously the the psychological knock-on effect of that to, to the physicians especially, you know, that's gonna be lifelong impact, I dare say on their, their mentality, having seen some of the things that they may well have seen in the weeks gone and certainly the weeks to come. And the one thing we've noticed over here.

Flavio is that a lot of people are really learning how to reconnect with one another and you know, we're having video chats with each other, where we're connecting via email, phone conversations. Almost life is, is put on hold over here and it gives us an opportunity I think to to really build bridges and, and, you know. Galvanise friendships with, with, with people that we maybe don't speak to as often as we would like to because life is of course so busy, nowadays, but what, what have you learned from, from the whole experience yourself?

My first learning, my sign if you want, is that as human being, we are only guests on this planet, first of all. So we We consider until yesterday to be omni power to do everything, to eat everything, to go everywhere. In the future, probably we should change our, our, our lifestyle.

As vets, for example, my first learning is that one half concept is the most important concept in the whole medicine. We can't avoid medicine for humans from the animal. Medicine.

If our information coming from China are correct considering this sort of outbreak as sort of zoonosis as we used to, to define in technical words that it means a virus able to jump among the species and especially from animals to humans as for example the distemper, as for example rabius. We can't avoid to consider the global health, including human. Animals, but not only small animals or farm animals, but also wild animals, that's it.

And I think that's it, you know, it will, I dare say this whole outbreak will really change the way that people approach life and approach the world, and do you, do you think that we, you know, we may well have a different approach to life as vets after this outbreak, do you think we might change as a profession? Absolutely, yes. Absolutely, yes.

Absolutely, because, first of all, the small animal are already member, member of families. So as that, we are not only giving professional service, but also a human service because living with a pet is, almost in Italy is living with a For in NIU I would say, or that's it, that's it because people of my age 65, 62, 70, of course, their children are already away working everywhere. They're alone in their houses and a cat or dogs or a rabbit is the only companion of their life.

So, it's a full member of the family. And we are responsible of the, of course, the health of the animals, but also the Who have of the familiar nucleus of the wolf family, that's it. Yeah, and, and do you think Italian owners, pet owners will want a different type of service from their vets, or will they want to go back to how things were before?

I don't know exactly. I don't know, I don't know, I don't know because currently the Skype consultation, I would say the Skype recommendation, the Skype question are rising so much, of course. In the future, probably, most of vets, will start a sort of, communication, I would say, not consultation but communication, scientific communication, using the new media, social media, web, Skype, YouTube and so on, but, it will resist, of course, the, the, the, the, the classic visit in the practise because we can't do it anyway.

You are not a physician if you can't visit physically a cat or a dog or a human being, of course. That's it, and there will always be that need for the physical examination of, of, of, of any patients, but I, I do wonder if it will, you know, evolve how we approach the, the, the lifetime management of our, of our patients. I think that would be really interesting to see whether owners, Go back to how things were or whether they expect things to move forwards, in the aftermath of all of this, I think it will be really interesting to see how that maps out.

What, what, I, I guess probably to wrap up, what, what is, I don't know what a good or a bad outcome is really for Italy. Obviously, you know, the death rate is incredibly high. Italy has of course got a very aged population, as you've said, and may well be, you know, almost as bad as it gets in terms of examples of, of how bad this disease could be.

But, but how do you think this will change Italy after, after the whole outbreak, you know, as it will, it will come to a close, but what will it do to the Italian people? Will it, will it change them? Will it help them evolve, or, or will they say no, you know, we, we go back to how it was.

Frankly speaking, I think that we, we will change our lifestyle. Probably in the future, restaurants will have less table and I would say than before in the room, for example, probably the number of people attending, a soccer, a soccer team will be less than before, of course, because, you can imagine 80,000 people watching. A soccer, a soccer player, a soccer match in Sancio Stadium in Milan.

No, I think that in the future would be impossible, impossible, and that's it. That's, too small example, too little example, but, . I think they are emblematic, a restaurant less crowded, of course, stadium, less crowded and probably also beaches, for example, I don't know, or the, the, the, the, also the, on the ski side, I, I remember, long lanes of people waiting for the ski lift or waiting for, you know, to, to be carried out on the, on, on the slope, but I think in the future, no future is won't be there, won't be so.

And, and do you think veterinary business will recover? Obviously you're saying a lot of these practises that have lost 90% of their business potentially, do you think, is there, is there a possibility that they'll close down or will they, you know, will, will they make it through and, and, and, and hopefully recover in the months and years ahead, do you think? Oh, we will recover surely not.

In the first month, probably gradually by the end of the year, yes, we will recover. Most of the business loss of course but it will take time, ideally, ideally, the Italian government decided to stop the emergency period at the end of July and hopefully before, but, of course, as in China it is happening, in this period, there are so many coming from outside cases, so we should be careful. Even if the, the, the, the contamination will end, the, the, the, the, the outbreak will, will stop, we should be very attentive in the future, in the new cases, rising cases or coming cases from abroad.

So I think that, we will recover as that practises as the Italy, as Italy all over, overall, by the, yes, end of June, hopefully end of August in the worst scenario. But in any case, by the end of the year, we will recover. Is there anything that we as as a UK veterinary community can do to support you as an Italian?

Yes, why not? Yes, why not? The, the opportunity to help us is to reinforce the message to give us some.

Support in terms of professional rules, safety rules, because, unfortunately, among my colleagues, there are several people under evaluating the risk and stay in the practise all day long without face mask and so on, so it's really, really important to Increase the, the culture of of ve professional first of all, and then the others. By the way, if in the future the Italian government may need more respiratory device and the number of those offered by the Italian vet community won't be enough, probably why not. We will ask you and help in this way.

Well, fingers crossed we can all all help in some way and certainly, you know, as you say, one of the best ways everybody can help is just reinforcing that message and educating people well. Flavio, thank you so much for giving up some of your time. I pray that you and your wife Giovanna and your family stay well.

You will be in our thoughts and prayers and and yes, stay safe. Thank you very much thank you for calling. Bye and God bless you.

Enjoy is a strong term for what we kind of hope that you've got out of today's episode, but we do hope that it's given you some insight and that you have taken some solace from it. Many people are doing well and many people are recovering. There are of course people that will be lost in this great tragedy of our time.

But we hope that you continue to follow the guidelines and continue to stay safe yourself and look after those around you. Thanks for listening and do keep an eye out for other episodes that are coming up in the not too distant future. Take care.