COVID-19 UPDATE: ITALY HAS LESSONS FOR THE WORLD
by the Team
MONACO. Since mid February the Monegasque authorities were vigilant and in constant contact with the French and Italian authorities. On Feb. 26, the measures announced by the Princely Government were yet subject to adaptation depending on the evolution of the health situation.
In the meantime, as Italy’s coronavirus infections ticked above 400 cases and deaths hit the double digits, the leader of the governing Democratic Party urged people “not to change our habits in Milan.”
That was on Feb. 27.
Not 10 days later, as the toll hit 5,883 infections and 233 dead, the Democratic Party boss, Nicola Zingaretti, posted a video informing Italy that he, too, had the virus.
On March 1st, a journalist working at the Montecarlotimes’ headquarters read a post on QUORAM entitled “Gunnison, Colorado: the town that dodged the 1918 Spanish flu pandemic”. During the usual briefing about the monthly Editor’s pick, the Team reasonably decided to down play the threat, fearing to spread panic.
Spanish influenza victims crowd into an emergency hospital at Camp Funston, US Kansas, in 1918 – Photograph: Associated Press
In fact, someone argued that yet on Feb. 25, the Team had published a post titled “CORONAVIRUS COVID -19 LATEST UPDATE” – Sourced from U.S. New York Times, by Hillary Leung, Sanya Mansoor, Amy Gunia, Jasmine Aguilera, Tara Law and Josiah Bates – dated feb. 12, 2020 3:45 pm et I – originally published: Jan. 27, 2020 – The subtitle read:”Global Death Toll Surpasses 1,100 as Slower Pace of New Confirmed Cases in Outbreak’s Epicenter Offers Some Hope”
Nobody could have foreseen the panic and the escalation that caught people off guard so quickly.
What happened next in Gunnison, a farming and mining town of about 1,300 people is instructive amid a new global health emergency a century later as the world struggles react to the emergence of a new coronavirus. Gunnison declared a “quarantine against all the world”. It erected barricades, sequestered visitors, arrested violators, closed schools and churches and banned parties and street gatherings, a de facto lockdown that lasted four months.
Gunnison emerged from the pandemic’s first two waves – by far the deadliest – without a single case. It was one of a handful of so-called “escape communities” that researchers have analysed for insights into containing the apparently uncontainable. The Spanish flu had infected hundreds of millions of people in Europe, Africa, Asia.
The Italian Story
Today, March 26 Italy had 74.386 recorded infections and more than 7.503 dead, and the rate of increase keeps growing, with more than half the cases and fatalities coming in the past week. Italy has surpassed China as the country with the highest death toll, becoming the epicenter of a shifting pandemic. On Friday, March 20 night, the authorities tightened the nationwide lockdown, closing parks, banning outdoor activities including walking or jogging far from home. On Saturday night, Prime Minister Giuseppe Conte announced another drastic step in response to what he called the country’s most difficult crisis since the Second World War: Italy has closed its factories and all production that is not absolutely essential, an enormous economic sacrifice intended to contain the virus and protect lives.
For the coronavirus, 10 days can be a lifetime.
On Jan. 21, as top Chinese officials warned that those hiding virus cases “will be nailed on the pillar of shame for eternity,” Italy’s culture and tourism minister hosted a Chinese delegation for a concert at the National Academy of Santa Cecilia to inaugurate the year of Italy-China Culture and Tourism. “The state is here,” he said in an effort to reassure the public. But the tragedy of Italy now stands as a warning to its European neighbors and the United States, where the virus is coming with equal velocity. If Italy’s experience shows anything, it is that measures to isolate affected areas and limit the movement of the broader population need to be taken early, put in place with absolute clarity, then strictly enforced.
Despite now having some of the toughest measures in the world, Italian authorities fumbled many of those steps early in the contagion – when it most mattered as they sought to preserve basic civil liberties as well as the economy. Italy’s piecemeal attempts to cut it off – isolating towns first, then regions, then shutting down the country in an intentionally porous lockdown – always lagged behind the virus’s lethal trajectory. “Now we are running after it,” said Sandra Zampa, the under secretary at the Ministry of Health, who said Italy did the best it could given the information it had. “We closed gradually, as Europe is doing. France, Spain, Germany, the U.S. are doing the same. Every day you close a bit, you give up on a bit of normal life. Because the virus does not allow normal life.” Some officials gave in to magical thinking, reluctant to make painful decisions sooner. All the while, the virus fed on that complacency. Governments beyond Italy are now in danger of following the same path, repeating familiar mistakes and inviting similar calamity. And unlike Italy, which navigated uncharted territory for a Western democracy, other governments have less room for excuses. Italian officials, for their part, have defended their response, emphasizing that the crisis is unprecedented in modern times. They assert that the government responded with speed and competence, immediately acting on the advice of its scientists and moving more swiftly on drastic, economically devastating measures than their European counterparts. But tracing the record of their actions shows missed opportunities and critical missteps. In the critical early days of the outbreak, Mr. Conte and other top officials sought to down play the threat, creating confusion and a false sense of security that allowed the virus to spread. They blamed Italy’s high number of infections on aggressive testing of people without symptoms in the north, which they argued only created hysteria and tarnished the country’s image abroad. Even once the Italian government considered a universal lockdown necessary to defeat the virus, it failed to communicate the threat powerfully enough to persuade Italians to abide by the rules, which seemed riddled with loopholes. “It is not easy in a liberal democracy,” said Walter Ricciardi, a World Health Organization board member and a top adviser to the health ministry, who argued that the Italian government acted on the scientific evidence made available to it. He said the Italian government had moved at a much faster clip, and took the threat much more seriously, than its European neighbors or the United States.
Still, he acknowledged that the health minister had struggled to persuade his government colleagues to move more quickly and that the difficulties of navigating Italy’s division of powers between Rome and the regions resulted in a fragmented chain of command and inconsistent messages. “In times of war, like an epidemic,” that system presented grave problems, he said, adding that it perhaps delayed the imposing of restrictive measures. “I would have done them 10 days before, that is the only difference.” Ms. Zampa, the health ministry under secretary, said in retrospect she would have closed everything immediately. But in real time, it wasn’t that clear. Politicians across the spectrum worried about the economy and feeding the country, and found it difficult to accept their impotence in the face of the virus. Most importantly, Italy looked at the example of China, Ms. Zampa said, not as a practical warning, but as a “science fiction movie that had nothing to do with us.” And when the virus exploded, Europe, she said, “looked at us the same way we looked at China.” But already in January, some officials on the right were urging Mr. Conte, their former ally and now political enemy, to quarantine schoolchildren in the northern regions who were returning from holidays in China, a measure aimed at protecting schools. Many of those children were from Chinese immigrant families. Many liberals criticized the proposal as populist fear-mongering. Mr. Conte declined the proposal and responded that the northern governors should trust the judgment of education and health authorities who, he said, had proposed no such thing. But Mr. Conte also demonstrated that he was taking the threat of contagion seriously. On Jan. 30, he blocked all flights in and out of China. “We are the first country in Europe to adopt such a precautionary measure,” he said. Over the next month, Italy responded swiftly to coronavirus scares. Two sick Chinese tourists and an Italian returning from China received care from a prominent infectious disease hospital in Rome. A false alarm led authorities to briefly confine passengers on a cruise ship docked outside of Rome.
‘Patient One,’ Super-spreader
When a 38-year-old man went to the emergency room at a hospital in Codogno, a small town in the Lodi province of Lombardy, with severe flu symptoms on Feb. 18, the case did not set off alarms. The patient declined to be hospitalized and went home. He got sicker and returned to the hospital a few hours later and was admitted to a general medicine ward. On Feb. 20, he went into intensive care, where he tested positive for the virus. The man, who became known as Patient One, had had a busy month. He attended at least three dinners, played soccer and ran with a team, all apparently while contagious and without heavy symptoms. Mr. Ricciardi said Italy had the bad luck of having a super spreader in a densely populated and dynamic area who went to the hospital not once, but twice, infecting hundreds of people, including doctors and nurses. “He was incredibly active,” Mr. Ricciardi said. But he also had not had any direct contacts with China, and experts suspect he contracted the virus from another European, meaning Italy did not have an identifiable patient zero or a traceable source of contagion that could help it contain the virus. The virus had already been active in Italy for weeks by that time, experts now say, passed by people without symptoms and often mistaken for a flu. It spread around Lombardy, the Italian region that has by far the most trade with China and the home of Milan, the country’s most culturally vibrant and business-centered city.
“Who we call ‘Patient One’ was probably ‘Patient 200,’ ” said Fabrizio Pregliasco, an epidemiologist. On Sunday, Feb. 23, the number of infections clicked past 130 and Italy sealed of 11 towns with police and military checkpoints. The last days of Venice Carnival were canceled. The Lombardy region closed its schools, museums and movie theaters. The Milanese made a run on the supermarkets. But while Mr. Conte again commended Italy for its firm hand, he also sought to downplay the contagion, attributing the high numbers of infected to Lombardy’s overzealous testing. “We have been the first ones with the most rigorous and accurate controls,” he said in an address to the nation. “We have more people infected because we made more swabs.” The next day, as infections surpassed 200, seven people died and the stock market plunged, Mr. Conte and his health aides doubled down. He blamed the Codogno hospital for the spread, saying it had handled things in “a not-completely-proper way” and argued that Lombardy and Veneto, another northern region, were inflating the severity of the problem by diverging from global guidelines and testing people without symptoms.
As Lombardy officials scrambled to free up hospital beds, and the number of infected people rose to 309 with 11 dead, Mr. Conte said on Feb. 25 that “Italy is a safe country and probably safer than many others.” But those reassurances from leaders confused the Italian population. In Milan, only miles from the center of the outbreak, the mayor, Beppe Sala, publicized a ‘‘Milan Doesn’t Stop’’ campaign, and the Duomo, the city’s landmark cathedral that is a draw for tourists, reopened. People went out. But on the sixth floor of the regional government headquarters in Milan, Giacomo Grasselli, who is the coordinator of the intensive care units throughout Lombardy, saw the numbers going up and quickly realized that it would be impossible to treat all the sick if the infections continued unabated. In Rome, officials “were convinced that the situation was less serious and they did not want to hurt our economy too much,” said the Lombardy regional president, Mr. Fontana. Together with Giacomo Grasselli, he appealed for tougher national measures in video conferences with the prime minister and other regional presidents, arguing that climbing numbers of cases threatened to collapse the hospital system in the north, but that his requests were repeatedly turned down. The government started providing some economic assistance, which would later be followed by a 25 billion euro ($28 billion) relief package, but the nation became divided between “those who saw the threat and those who didn’t” Ms. Zampa said that it was around that time that government learned that infections in the town of Vò, the virus epicenter of the Veneto region, had no epidemiological link to the Codogno outbreak.
Finally, the country’s experience shows that steps to isolate the coronavirus and limit people’s movement need to be put in place early, with absolute clarity, then strictly enforced.
Back to the world, tonight at 11,30pm also South Africa, the origin country of H.S.H Princess Charlene, will be lockdown for 3 weeks.
South Africa President Cyril Ramaphosa Speech
A week after declared the coronavirus pandemic a national disaster and announced a package of extraordinary measures to combat this grave public health emergency, the response of the South African people to this crisis has been remarkable. As millions of people have understood the gravity of the situation, Montecarlotimes’ Team wishes to participate in Princess Charlene’ terrible double concern. In addition to her compatriots and family members residing in South Africa, her husband Prince Albert is the first head of state who has publicly said he contracted the virus. He is continuing to work from his home office in the palace and is in constant contact with members of his government. In a statement, Albert II urged residents of his tiny Mediterranean principality to respect confinement measures. In fact, to slow the spread of COVID-19, all movement outside the home have been prohibited from midnight on March 18 until March 31 2020 inclusive, with exceptions for the reasons listed below, when all prevention and hygiene measures designed to limit the spread of the virus must be followed and all gatherings of people must be avoided:
- Essential travel between home and place(s) of work (employees must carry a certificate justifying their travel, which can be downloaded here)
- Travel to purchase supplies required for work and essential supplies from local shops and businesses that are authorised to remain open to the public
- Travel for health reasons
- Travel for critical family reasons, to assist vulnerable people or look after children
- Brief outings close to home for individual physical exercise (all group sporting activities are prohibited) and to walk pets.
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Main sources: The Guardian, by Rory Carrol Twitter @rorycarroll72 – New York Times by Jason Horowitz, Emma Bubola and Elisabetta Povoledo