SEBUAH KOTA KECIL DI ITALIA BERHASIL MENGATASI PENULARAN COVID-19

Penyebaran virus corona: Sebuah kota kecil di Italia berhasil mengatasi penularan Covid-19 dengan eksperimen yang ‘tak ada duanya di dunia’

Sampai sebulan lalu, Vo’ Euganeo merupakan kota kecil yang indah di kawasan Veneto di Italia utara.

Letaknya di perbuktian, satu jam berkendara dari kota Padua. Vo’ yang berpenduduk 3.300 orang, terkenal dengan minuman anggur prosecco, taman alami dan mata air panas.

Tak ada yang membayangkan kota indah ini menjadi pusat pertama epidemi di Italia.

Namun lebih sedikit lagi yang membayangkan Vo’ Euganeo menjadi lokasi bagi sebuah “eksperimen ilmiah yang unik”.

Positif

Di awal Februari, dua warga bernama Adriano dan Renato dirawat di rumah sakit karena pneumonia.

Dokter tidak melakukan tes virus corona karena tidak ada gejala, dan menurut protokol saat itu tak perlu tes.

Sampai dua minggu kemudian, karena mereka tak kunjung sembuh, dokter melanggar protokol dan melakukan tes.

Hasilnya: positif.

Dua pria bertetangga ini segera dipindahkan dan dirawat di Unit Penyakit Menular di Rumah Sakit Padua.

Namun masih ada misteri: dari mana asal infeksi mereka?

Kematian pertama

Baik Adriano, 77 tahun, maupun Renato 83 tahun, tidak bepergian ke China dan tidak kontak dengan orang dengan gejala.

Saat itu, penularan antarmanusia hanya diketahui bisa terjadi lewat kedua cara itu.

Yang pasti, sesaat sebelum sakit, kedua pria ini menghabiskan waktu berjam-jam main kartu di bar setempat.

Kesehatan Adriano turun drastis dan pada tanggal 21 Februari, ia meninggal dunia dan kematian Adriano merupakan yang pertama di Italia akibat virus corona.

Malamnya, Wali Kota Vo’, Giuliano Martini yang juga pemilik salah satu apotik di kota itu, mengumumkan karantina.

Pihak berwenang menutup sekolah, bar, toko-toko, dan halte bus. Misa gereja dan pesta dilarang, serta warga tak boleh keluar rumah.

Tanggal 23 Februari, pemerintah Italia dan pemerintah setempat menerapkan karantina untuk Vo’ Euganeo dan mengirim polisi dan tentara untuk menutup akses ke sana.

Keluar masuk kota dilarang kecuali untuk truk pemasok supermarket, toko roti dan apotik.

“Seperti di perang,” kata Martini dalam percakapan telepon dengan BBC Mundo.

“Dikurung dan dikepung oleh tentara negeri sendiri rasanya lebih buruk daripada dipenjara”.

Meski begitu, bagaimana virus bisa menyebar di kota kecil ini masih belum terjawab.

Eksperimen inovatif

Untuk mengetahui, tanggal 23 Februari, petugas kesehatan membangun pusat analisis di sekolah untuk menjalankan tes guna mendeteksi penyebaran.

Tes dijalankan bagi seluruh penduduk yang menginginkannya.

Dalam waktu enam hari, praktis seluruh penduduk dengan sukarela menjalani tes dengan alat yang disiapkan oleh Fakultas Kedokteran Universitas Padua, dipimpin oleh Profesor Stefano Merigliano.

“Ini tidak mungkin terjadi tanpa adanya semangat kerja sama seluruh warga,” kata wali kota dengan bangga.

Petugas berhasil mendeteksi adanya virus pada 89 orang, dan mereka segera diperintahkan untuk mengisolasi diri di rumah selama 14 hari.

Ada hal yang menarik: sekitar 50% sampai 60% dari yang positif ini tidak menunjukkan gejala.

“Ini tidak pernah terjadi pada sejarah epidemi di abad lalu,” kata profesor Merigliano kepada BBC Mundo.

“Besarnya persentase mereka yang tak bergejala atau asimptomatik ini sangat berbahaya,” kata Profesor Andrea Crisanti, profesor epidemiologi dan virologi di Universitas Padua dan Imperial College London, “karena pasien akan terus menjalankan kegiatan mereka sehari-hari lalu menulari sejumlah besar orang.”

Saat itu Merigliano dan Crisanti mengusulkan ide kepada Gubernur Veneto, Luca Zaia, untuk mengubah Vo’ Euganeo menjadi “laboratorium eksperimen yang unik di dunia”.

“Kita memiliki kondisi yang unik untuk bisa memahami perilaku virus ini,” papar Merigliano.

“Ada sampel yang konsisten dari orang-orang yang dikarantina. Kita tahu status kesehatan mereka, kita bisa mengendalikan pergerakan mereka, dan tahu dengan siapa saja mereka berhubungan. Ini laboratorium sempurna!”

Dengan persetujuan pemerintah setempat, pada tanggal 6 Maret, 12 hari sesudah pemeriksaan pertama, satu tim dari Universitas Padua datang untuk mengendalikan wabah di Vo’ Euganeo.

Saat itu, infeksi di Italia sudah mencapai 4.636 kasus terkonfirmasi, dengan 197 kematian.

Kasus baru yang dites positif pada tanggal itu di Vo’ ada delapan orang, enam diantaranya terhubung ke orang yang terinfeksi pada pemeriksaan pertama.

Isolasi pun diberlakukan kepada mereka.

“Sebelumnya hanya perkiraan,” kata Crisanti.

“Saat itu kami secara ilmiah masih mencoba membuktikan dua soal mendasar terkait periode inkubasi virus, dan strategi menahan penyebaran harus memperhitungkan besarnya jumlah pasien yang tak memperlihatkan gejala”.

Untuk paham fokus eksperimen, Crisanti membandingkan kasus Vo’ Euganeo dengan kasus kapal pesiar Diamond Princess, yang sempat ditahan selama dua minggu di pelabuhan di Jepang ketika dideteksi ada penumpang yang tertular.

“Di atas kapal ada 3.000 orang penumpang dan awak,” kata Crisanti, “jumlah ini sama dengan populasi Vo’ Euganeo. Namun mereka memutuskan untuk melakukan tes kepada orang yang bergejala saja.”

“Sesudah dua minggu karantinaada 542 kasus positif dilaporkan,” kata Crisanti.

Pembukaan kembali

Tanggal 8 Maret, dua minggu sesudah kematian Adriano, karantina Vo’ Euganeo dicabut. Kehidupan mulai berjalan normal dan pada tanggal 14 Maret, tak ada kasus baru.

Hingga tanggal 20 Maret, penularan terdeteksi lagi.

“Ini sudah diduga,” kata Crisanti. “Berdasarkan ukuran apa karantina dicabut?” tanyanya.

“Jika karantina didasarkan hanya pada penurunan jumlah pasien, berarti yang tak bergejala dikecualikan. Ini artinya, wabah akan kembali”.

Crisanti mengakui bahwa eksperimen di Vo’ Euganeo – yang memakan biaya US$160.000 (sekitar Rp2,4 miliar) dibiayai oleh pemerintah setempat – tidak bisa diterapkan di kota yang lebih besar.

Namun ini bisa memastikan pengendalian penyebaran virus di tingkat lingkungan tempat tinggal, dengan cepat mengidentifikasi wabah dan mengisolasi kemungkinan penyebaran.

Menurut Crisanti, ini sama dengan apa yang dilakukan di Korea Selatan.

Sementara ini, wilayah Veneto meluncurkan program yang juga dipimpin oleh Profesor Crisanti untuk melakukan pemeriksaan kepada orang-orang berisiko tinggi seperti petugas kesehatan, polisi, pegawai supermarket dan supir bus.

Tujuan tes ini, menurut pemerintah setempat, adalah melakukan tes harian kepada 13.000 orang sebelum akhir pekan ini.
sumber: bbc

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