Police investigation into Italian care homes finds coronavirus violations

Inspections by the Italian Police health force -- Nuclei Antisofisticazione e Sanita (NAS) -- found that 17% of the first 600 elder care homes to be inspected had failed to follow national coronavirus protocols.

These violations included a lack of protective equipment for staff, and an absence of dedicated quarantine space to isolate suspected coronavirus patients, NAS said.

Fifteen facilities have been closed and their patients relocated, NAS told CNN. Sixty-one people have been referred to judicial authorities which, because of the nationwide lockdown that has closed courts, will investigate using best practices until the lockdown is lifted. Following that, a full judicial process will be carried out. Another 157 people linked to elder care facilities were fined, amounting to a total of more than $78,500 (72,000 euros).

The NAS announcement came on Wednesday, as Pope Francis prayed for the elderly in nursing homes at his morning mass, which was live streamed from Rome.

"Pope Francis's intention for Wednesday's Mass was for the elderly, especially those who are isolated or in nursing homes," the Vatican press office said in a statement. "Many of them, he said, are afraid of dying alone. But 'they are our roots, our story, our history.'"

The elderly are more at risk for severe and fatal coronavirus infections, and have been particularly hard hit in Italy. But there is little public information on how the virus may spread through nursing homes and residential senior centers. Italy's health authority does not count deaths in elder care homes as Covid-19 deaths -- even if patients are suspected to have died with the virus -- and testing for the virus on the deceased in care homes is not standard practice.

The NAS's focus on elder care homes in Italy follows the death of more than 60 residents at one facility and a criminal investigation into another: the Pio Albergo Trivulzio home in Milan, which is under scrutiny for "more than 100 deaths," according to Milan's Public Prosecutor Mauro Clerici.

Authorities are looking at charges related to contributing to the spread of the virus and manslaughter in the Pio Albergo Tivulzio case, he said. "The investigation is underway into what crimes may have been committed in accordance with existing legislation as applied to a pandemic," Clerici told CNN. No arrests have been made and no one has yet been charged in the case. Under Italian law, authorities have up to a year to press charges after the initial investigation is launched.

The facility told CNN it would not comment on the ongoing investigation. "The rules regarding masks were followed," a spokeswoman of Pio Albergo Trivulzio told CNN. She added that the number of deaths in the first quarter of 2020 were in line with those in the same period last year.

Italian Carabinieri, Italy's national military police, told CNN that it has also begun carrying out checks in elder care facilities to ensure that visitor access, the management of personal protective equipment, staff training and quarantine spaces are in accordance with a decree issued by Prime Minister Giuseppe Conte on stopping the spread of the novel coronavirus. The checks have already resulted in fines, and the complete closure of at least one facility.

The umbrella group for Italian nursing homes (Associazione Nazionale Strutture Terza Eta) told CNN that it will work to provide additional training and support for all member care centers.

Elderly care centers are "biological time bombs," Raffaele Antonelli Incalzi, head of Italian geriatric society SIGG, said last week. That is partly due to the fact that overcrowded hospitals are moving elderly patients into unprepared care facilities in order to free up space for urgent treatments, he explained.

"Creating modules for Covid in care homes (RSA) means putting elderly residents at risk who are the weakest link in this pandemic," Incalzi said.