Week 2 – Nationwide Shutdown – Italy and the Coronavirus Epidemic

Week  2  of the COVid-19 infection in Italy was a  key moment in the natural history of this epidemic. When it started, we didn’t know if the number of infections would continue to grow exponentially or if we were approaching the peak. 

Image result for mountains wreathed in mist and fog

No peak in sight!

As  week 2 ends, the curve of infections and deaths still  runs up like in Week 1.

The number of infected people has more or less doubled and deaths have tripled in number. Even the Pope was alleged to be infected!

Here’s how it went.

Day 10 – 1st March 2020

1,694 people infected;  34 dead;  83 recovered;

NB 639/1694 patients (38%) in hospital; 140/1694 patients (8%) in ICU

Image result for Italian coronavirus doctors

La Scala Opera House  in Milan stayed closed as some of the staff and performers were infected. Football matches were cancelled.Schools and universities were shut for another week in Friuli-Venezia- Giulia, a region that was infected with 6 new cases (4 due to meeting a positive person from Piedmont at Udine University on 20th February). Schools were closed in the province of Pesaro and Urbino (24 cases, 15 getting better). Sicily reported 6 cases.

Government Recommendation: “Shelter in Place”
Since all the victims to date have been over 65 years of age, people in that age-group  are advised to stay at home, cut back on their social activities and avoid anywhere they might meet sick people e.g. hospitals, clinics,  GPs surgeries, etc.

Day 11 – 2nd March 2020

1,835 infected; 52 dead; 66 recovered; 

NB 742/1,835 (40 %) hospitalized; 166/1,835 (9 %) in ICU

Image result for Italian coronavirus doctors

Although the numbers indicate the disease is still spreading, this rise was expected. These people were probably infected a week or two ago, (as the incubation period lasts for up to 14 days), that is, before the “limit and contain” strategy became operative.
The main issue is how the NHS can cope and continue coping. Look at how about 40% of  ill people need to be kept in hospital.They’re not in for “overnight observation“. They’ll be there for quite some time because the disease lasts from 3 to 6 weeks on average for these severe and critical patients (compared to only 2 weeks for the mildly ill)

Remember: Up to 9-10% of  patients become severely ill and need the ICU. They  may need to stay there for up to 6 weeks.And more keep arriving every day. 

 Some doctors and nurses have been infected and are very unwell. Others are working heroically long hours.

Image result for Italian coronavirus doctors

Military medical staff are being called in to help in civilian hospitals. 80 military barracks are being prepared for “convalescing” patients i.e. those who can leave hospital but are not yet well enough to go home.

A high school closed in Rome.First cases were reported in Sardinia and the Molise region.

Day 13 – 3rd March 2020

2,263 infected; 80 dead; 160 recovered;

NB: 1,034/2,236 (46%) hospitalized; 229/2,263 in ICU (10%)

1,000 individuals  quarantined at home.

Image result for self isolation at home

Remember: self-isolation means staying alone in a single bedroom and using a separate bathroom to the other people in the house or flat, whether family or friends. Given contemporary living arrangements due to high rents and house prices, self-isolation is not always possible.

An air-force base and a prison-hospital for the mentally ill who are a danger to society (now housing only 11 inmates) are being prepared for the infected who cannot quarantine properly at home.

The Italian Health Authorities have to decide whether to constitute a new “red zone” around Bergamo, as many cases are being reported  there.  

Remember:The limit and contain” strategy is suitable only for small, circumscribed areas. It seems to have had a short shelf-life as cases are coming in from Regions all over Italy .

Query: What will happen as more and more cases are being reported, though sporadically, all over the country?

Day 14 – 4th March 2020

3,089 infected; 107 dead; 116 recovered (276 in total)

NB: 1,346/3,089 (43.6%) hospitalized; 295/3,089 ( 9.5%) in ICU; 

1,065 quarantined at home 

By now the infection has spread to all Italian regions except the small, northern, poorly populated Val d’Aosta, bordering on  France and Switzerland (white rectangle in picture above).

Update 5/3/2020: 2 cases in val d’Aosta. The epidemic is everywhere in Italy

Despite this, the government’s decision to close all schools and Universities throughout Italy until mid-March came as a shock to many. It brought people face to face with what was actually happening. Because it was no longer happening somewhere in the north of the country. All of a sudden it was happening to us – the parents, teachers, students and schoolchildren.

University lecturers started asking “Our lessons are cancelled but what about our meetings?”

All public and private conferences, congresses, meetings and events are cancelled.

No sports matches/events will be held for 1 month. League matches will be played with no spectators

Cinemas,theatres, gyms, leisure centres etc risk being closed nationwide.

The shut-down will create difficulties for working parents, who will find it hard to make alternative child-care arrangements.

Queries: How can anyone be sure high school and university students will stay at home or that they won’t meet and spend time together? Will social media be enough to keep them indoors?

The Vademecum

Image result for vademecum
The government has also set out a list of “Dos” besides hand washing.

1) the elderly over 75 years of age should stay at home; people over 65 should go out only as and when really necessary and should avoid peak times in the park, the supermarket, shops or the pub. 

A grumpy 72-year old muttered

“I’m sick of this virus! They needn’t tell me who to shake hands with. I’ll go in and out of my own house when I want”

“You’ll soon be sick with this virus if you do”

Image result for exasperated woman

said his daughter

2)everybody should avoid crowded places or gatherings of people like parties

3)no greeting kisses, hugs or handshakes when you meet friends

4) everybody should keep a 1 metre distance when socialising

5) stay at home if you have a temperature 

 Some of these habits may have already become part of your behaviour pattern.

Recommendation: They all should. The elderly and people who are at risk due to pre-existing conditions should pay particular attention to them as the Italian mortality rate is highest among these categories of people. Just  be on the safe side.

Final Comments:The Italian Government’s  nationwide shut-down is certainly a radical, drastic strategy.Without imposing a curfew or placing police and army blocks at the end of every street, it is designed to restrict and limit inter-person contact to the maximum.  Its damaging effects on the country’s economy cannot be underestimated.

But the nation’s health comes first.

In fact, article 32 of the Italian Constitution states:
The Republic safeguards health as a fundamental right of the individual
and as a collective interest

If the shut-down  is successful, the number of infections should begin  stabilizing in week 3, then plateau and start to drop  very gradually down to zero, with an increase in the number of people getting better . Experts are saying it may take months.

Refs and Pics




Click to access costituzione_inglese.pdf

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