During the pandemic, nursing home residents have only been able to see relatives through a window. Picture: Chiara Goia/The Washington Post
During the pandemic, nursing home residents have only been able to see relatives through a window. Picture: Chiara Goia/The Washington Post

How the Covid-19 pandemic devastated an entire generation of Italians

By The Washington Post Time of article published Mar 3, 2021

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Chico Harlan, Stefano Pitrelli

Cremona, Italy - In one of the hardest-hit parts of the West's most aged nation, the coronavirus blitzed through a generation in a matter of weeks. It killed more than 100 of 400 residents in the local nursing home. It forced this city to rush-order eight refrigerated trailers to hold the corpses. It created a horrifying landscape of ambulances racing to the private homes of seniors, who were dying at a rate 400% above the norm.

"The pain was atrocious," said Gilberto Anelli, 82, who lost his wife of 57 years and now starts every morning speaking to her photograph.

As a global event, the coronavirus pandemic has upended nearly every person's life. But in the country that was Europe's first major epicentre, a year of data and personal accounts show how the virus concentrated its blow on a single, already-vulnerable age group, causing a historic spike in elderly mortality.

All the while, the very measures designed to keep the elderly safe have erected a wall around them. Survivors in places such as Cremona are trying to cope with a mass death event that has also left many feeling cut off, depressed and without purpose.

Not every aged country has been ravaged. Japan is one notable outlier. And some nations with younger populations, including the United States, have suffered extraordinary blows because of government mishandling and pervasive health problems. But in Italy, health experts say, demographics amplified a death toll that is approaching 100 000, among the highest of any country.

In that way, the virus has proved different from other cataclysms, including wars and the 1918 flu pandemic, which levied heavy tolls among the young. In many European countries, the median Covid-19 victim has been older than 80.

In Italy, the average is 83, and the dichotomy between generations is especially stark. Even with the virus raging, the 2020 death rate for Italians 50 and younger fell compared with previous years, with lockdown measures keeping people off the roads and indoors. But the country's overall death rate nonetheless spiked some 15%.

Those 80 and older - a group that makes up 7% of Italy's population - have so far accounted for 60% of the nation's covid-19 deaths.

Fulvio Signori, 86, lost his circle of friends at the nursing home to Covid-19. Picture: Chiara Goia/The Washington Post

"It was just devastating here," said Emilio Tanzi, director of the Cremona nursing home, which at one point had 24 bodies on hand. Its morgue holds a maximum of nine.

One of the surviving residents, Fulvio Signori, 86, said he had generally been surrounded by friends before the pandemic. They would gather in his room after dinner, as he played old recordings of his own music.

A retired singer, Signori spent his career on cruise ships, performing in tight pants and technicolour tops. He travelled around the world the equivalent of 17 times, he said. He met Jacqueline Kennedy. He spent several months in the 1980s posted in Las Vegas, a city he described as full of "smiles and malice."

In the nursing home, his regular audience before the pandemic, his network of support, consisted of a retired electrician, a retired bank employee and a retired bus driver.

"They all died within a month," he said.

He said that now, when he plays his own music, he sometimes turns up the volume hoping somebody in another room might hear.

In a year when the virus seemed like it might be anywhere, the key to survival has created its own kind of pain: isolation from everyone else, including children, grandchildren and friends. Cremona, a city devastated last March, avoided a similarly catastrophic second wave, in part because so many of the oldest citizens had decided to shield themselves. But the deep cost of that strategy became apparent in recent weeks, as those 80 and older took what for some were their first tentative steps out of their homes and apartments, arriving at a sixth-floor hospital wing marked, "Anti-Covid Vaccination."

In waiting rooms, before and after receiving shots, those people described a year that had gradually dampened their hopes for the last stage of their lives. One said her existence had become "nothingness." Another said she had been "closed totally in the house." For some, the closest regular contact with others came via the TV. One man, who hadn't been out of his house since a fall flu shot, arrived at the hospital too overwhelmed to even speak. His son, who was escorting him, said his father was lucid but no longer accustomed to other people.

More than 100 of 400 residents at the Cremona nursing home have died of Covid-19, the disease caused by the novel coronavirus. Picture: Chiara Goia/The Washington Post

Audilia Ruggeri, 93, said she'd lost her social "point of reference" early in the pandemic, when a local senior centre closed. It had been a place where she'd see friends, have coffee, play cards for a couple of hours. She tried to replace those gatherings with long days of phone calls, but the telephone, Ruggeri said, only worked "up to a point," and the centre showed no signs of reopening.

Weeks ago, she started crying more often. Ruggeri said it was an accumulation of boredom and sadness. Her daughter moved in temporarily to stem her slide.

"I think I just succumbed," Ruggeri said.

In Cremona, even the first vaccine doses given to the elderly didn't spur the elation and optimism seen elsewhere in the world. Two dozen people older than 80, speaking at the hospital vaccination clinic, described their vision of what might come next with a sort of weary flatness. Seeing family more regularly would be great. Same with taking small trips to the mountains or the beach, if possible. But the vaccination campaign, in Italy and across Europe, has been slow. Only one-quarter of Italians 80 or older have received at least a first dose, and the vast majority of those younger are nowhere close to eligible. A slow return to normal is costlier for seniors who have less time to wait.

Fulvio Signori, 86, was a singer on cruise ships for much of his life. Picture: Chiara Goia/The Washington Post

Gioconda Brunelli, 87, a former Swiss Air Lines employee, said she'd been "saved" during 20 years as a widower by staying active: socializing, volunteering, paying home visits to cancer patients.

These were the things that made life worthwhile, and these were the things that have stopped.

"This upturned my world," she said of the pandemic. "We look at each other now and we're in the middle of nothingness."

Gilberto Anelli had always told family members he'd rather die than live without Gabriella, his first and only partner, whom he'd met when both were teenagers. Last March, covid-19 hospitalized and killed her in a week. The disease seemed poised to kill Anelli, too. He spent 57 days in a hospital, and when he began breathing on his own again and realized he would survive, he felt an even deeper anguish.

He'd need to figure out life without her.

"Hell," Anelli called it.

At a rehab clinic, he told a doctor he feared entering into a "tunnel of grief" and never coming out of it. After his release, he resumed his life not at his old home, but at a new one - in a room at a suburban house belonging to his daughter and son-in-law. Anelli described himself in those first weeks as a "zombie," almost unable to speak.

"I would never laugh," Anelli said. "I wouldn't move. I was on the armchair or the sofa. I was looking at the floor and thinking about my wife."

A health worker takes a break on a hospital balcony in Cremona, where vaccinations for the elderly have just begun. Picture: Chiara Goia/The Washington Post

He was thinking about all the things he'd lost. He and Gabriella had been so bonded to one another that he never saw much use in making friends. If one was going to the grocery store, the other came along, too. They spent summers along the Adriatic Coast and weeks at a time on cruise ships - memories that Anelli returned to when he started wondering why he'd been "abandoned."

He spent three sessions with a psychiatrist, and anti-depressants she prescribed helped him to sleep and stay calm.

But she also told him to find new joys, and that proved harder. He no longer liked to read; he feared any page in any novel might trigger a memory of his wife. He had no interest in puzzles or crosswords. Travel, too, was trickier. He hasn't yet been vaccinated.

The only tasks he would take on were those involving his body, not his mind. As the months went on, he taught himself to knead and bake bread using a cast-iron pan. He also started taking extended walks. He hasn't left the family property since October, but it is big, containing an abutting family-owned factory that produces cleaning accessories for double-pane glass.

After the workers leave, every afternoon, it becomes his personal rehab space.

His workouts are always the same. They last one hour and eight minutes. He wears worn leather loafers. He counts his laps, up and down past the workstations, past the products stamped with serial numbers. His heavy breathing is the only noise.

"It's 110 meters from one end to the other," he said.

Gioconda Brunelli, 87, cycles to the hospital for her first coronavirus shot. Picture: Chiara Goia/The Washington Post

Nearly a year after Gabriella died, this is what Anelli calls his new "routine." Exercise at 4:30 in the afternoons, clearing his mind. Pills before bedtime. Then mornings, when he sits in an armchair, looking at his wife's photograph and a vessel containing her ashes, telling her about the dreams he just had, his bread and his life without her.

"I am metabolizing my grief," Anelli said. "I don't think it will ever fully go away."

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