How Pandemics Change History
newyorker.com
newyorker.com
How much this is enforceable remains to be seen. What's worse, there was already histeria caused by a leak of the document before it was completed (and people blaing the "lack of responsibility" for the leak, when such things have been going for more than a decade...), with people rushing to stations trying to get away.
There is no clear communication (the same government ministers saying different things over the course of a day), there's the "emergency department" (Protezione Civile) that is not able to keep up, there's blaming the victim ("Act responsibly", "You must change your way of life", said from people who have never understood how normal people live and work).
This has been a mess from a policy and communication perspective. Not surprising from a government that was elected "to give politicians a lesson", "to crack open the Parliament like canned tuna", and in the supreme name of "honesty" was built out of complete incompetents.
I'm truly hoping that we'll get out of this... despite them.
Don't they have a freaking advisor that understands the exponential function? It doesn't seem that hard to look at the graphs and see that we are heading the same way as Italy.
I think I'd prefer the way of acting of the Italian government who at least seem to be trying to do things. Although who knows. The grass is always greener at the other side of the fence.
Good luck with the situation there for you and your loved ones.
I understand that Singapore is a very small country and ran way differently than my own, but please look up what the PM there said when he addressed the country on COVID-19 matters and compare it (if you can find a subtitled version) with what our "Giuseppi" said. A world of difference.
Of course now they must do something. But way before the outbreak, local administrations of the now-locked regions who asked for quarantine controls from people from Wuhan and China in general were called "Sinophobes" and the government was far more eager to lock down direct flights from China (useless if you go via hub) as opposed to quarantining or at least tracing those people, and of course to show all support for Chinese people. (Note that I do not condone Sinophobia at all: but a matter of public health policy - like everything, improvable - was just framed as racism).
Ok, this might have not helped at all given that the current theory is that SARS-CoV-2 came to Italy from Germany. But the government was too eager to return to the "important affairs" (meaning, discussing whether a member of the coalition would leave the majority or not). Then when the first cases arrived, there was a total "tug of war" with the legislation ("close down", "ok, maybe not", "maybe yes", "SHUT DOWN EVERYTHING").
So nothing Singapore or South Korea-like. COVID-19 worries me, but I'm far, far more worried about this government.
Are you still going to work?
Are supermarkets open? Are restaurants and cafes?
Is public transport running?
I'd be just fine for some days. But by the end of a 2-week quarantine, I'd be eating much more poorly than I would the first week. And I'd be lucky: I have a well-stocked kitchen. I eat a lot of beans and lentils and rice and have all three around. There is pasta here. I make bread most days: I'd certainly have to ration the dried yeast, though.
I'll run out of milk and vegetables (I don't use a lot of frozen ones). If the timing was wrong, I'd run out of flour.
Other folks would fare worse, though. So much worse, just because of what they have in the house. I'd definitely run out of canned tomatoes, even if I used only half. My food wouldn't taste.. wonderful, per se, but I'd survive.
But I'd be lucky: I have this stuff around. Not everyone does and lots of folks would be learning to cook with weird stuff. Some folks simply wouldn't have food.
I'd really like to believe this - and I hope it is the case.
But geez, we let folks die of starvation on the best of days. We let folks eat literal trash. We let folks have cases of malnutrition, too, without fixing things. The only thing I think that saves folks in the states is that during a lockdown, it is the government's responsibility to do stuff - but I'm not really convinced so many governments have stuff in place.
I particularly like this family, as they show what they cook everyday.
https://www.youtube.com/channel/UCsa3H2gvWgP5mm4OUcu7rLA
Early on, when they could still go out, the husband would visit various supermarkets that were open and before you entered, the greeter would take your temperature.
Then when the lockdown intensified and the people were restricted to their apartment complexes, designated sellers would visit the apartment complexes every day at a specific time so you could buy things.
I was surprised to see so many fresh vegetables.
"It's not quite a complete lockdown - planes and trains are still running and access will be permitted for emergency or essential work reasons."
"Restaurants and cafes in the quarantined zones can open between 06:00 and 18:00 but customers must sit at least 1m (3ft) apart"
Some of these measures are quite onerous and I can expect that many smaller establishments will prefer to close than try to enforce them: how can a bakery, for example, make sure that "not many people enter at once" ("restricted access", says the document, or at least my poor translation from "bureaucrat-speak") and that "distance is at least one meter" between people?
Personally, I can work remotely if need be (haven't done that in about ~10 years, but technically, I can). I've yet to see what my workplace will do, though.
PS: for the HN crowd, you can look up data by region in Italy here: https://opendatadpc.maps.arcgis.com/apps/opsdashboard/index....
Bear in mind that the numbers on the map are incorrect (as opposed to tables): they're the cumulative sum of current cases + deaths + recoveries.
You make them queue in front of the bakery keeping a distance of a meter between each other?
The official document enforcing the "red zone " for this morning is here: https://drive.google.com/file/d/1Y3Vl8VmAww2sGfFBSH9Vfa4fwQ8...
It's in Italian, you may try a machine translation if needed
It is still far from the lockdown in Wuhan where people are not allowed to leave their appartments and get food delivered by the authorities.
I am in Copenhagen where the latest is that the government has adviced against gatherings of more than 1.000 people causing some football matches to be on TV only and some concerts to lower their number of attendees to 950.
I'm surprised people are surprised that such a thing leaked. This has been going on for years, except, no one batted an eye.
> We are Italians and we are unable to respect the rules.
As an Italian too, I don't like this generalization. You can make people more willing to follow rules if you approach them correctly. Going full-paternalistic mode (like this government has been doing) or even blaming them ("don't play dumb", is that something one would expect from a PM?) isn't going to help.
And why that happened? Because whoever is in charge of making sure that the population is reassured (and that's different from pretending that nothing is happening) did not do that.
(Personally, I believe that it's those who not do what should be done are the actual outliers, although the media does an excellent job at cherry picking bad apples).
Then again, the world is not really structured to letting someone with light fever lay in bed for two weeks so maybe it's the same thing.
However this does not mean that asymptomatic transmission does not happen, the article said that the study had been supposed to be true for confirming what a lot of people had suspected.
I can't remember the article, I didn't bookmark, also I'm not sure what computer it was on.
"The main way the disease spreads is through respiratory droplets expelled by someone who is coughing. The risk of catching COVID-19 from someone with no symptoms at all is very low. However, many people with COVID-19 experience only mild symptoms. This is particularly true at the early stages of the disease. It is therefore possible to catch COVID-19 from someone who has, for example, just a mild cough and does not feel ill."
[citation needed]
It's not as simple as "work or doesn't work". It slows down the spread, for a certain cost. Whether it's worth it or not is a matter of appreciation. Just like the speed limits. Decreasing speed limit saves lives, so it works, but do we want to do it?
> Do they not have the same public health experts
Ultimately, the final decision is taken by politicians, who answer to the public.
I think some experts are too fond of their theory, the beauty and sophistication of it, and forgets about the problem that it tries to solve.
Lock-down does work, but only if you can execute it effectively. Apparently that is conditioned on individual countries. Some countries can't make it work, doesn't necessarily means others cannot.
China has taken drastic measures of quarantine and they seemed to have worked reasonably well: the bulk of the cases have remained in Wuhan and Hubei.
That seems to created a political issue in the West with, I feel, a lot of reluctance to be seen praising China or copying China because the Chinese government is the boogeyman.
Certainly in Europe it seems to me that governments are neither prepared not willing to take decisive measures, or (like Italy now) they start taking them late.
So far the West is striking out on most of these measures, either for lack of political will or for technical incompetence.
Europe had been trying to keep the borders open while France and Germany forbade exporting masks, respirators and other equipment to Italy.
They have closed borders way too late. Italy won't be able to build a hospital in a week, won't manufacture quarter million tests per day, won't make special squads that will trace every single person suspected of transmitting the disease. Won't enforce total lockdown.
In my opinion Europe is in it for a long time with way too many victims.
It is just very expensive.
From the doc above, CDC estimates 5% Nationwide will require ICU care. That's 18.5 million people. We have 100k beds. The US medical establishment does not have the surge capacity for an epidemic of this scale. All of our manufacturing is in China too - and medicine and semiconductors and just about everything else.
Only a monumental Civic movement will make containment possible and, as the article suggests, the pandemic will expose the rot that has gutted this country over the last few decades, as the system shuts down in an attempt to contain the pandemic, when the hospitals are quickly overwhelmed.
This is undoubtedly a historic event. Based on the other countries this has happened in, we are 1-6 weeks, most likely 1-3, away from full outbreak and the start of widespread business closures and possible food scarcity in some regions. Stores and truckers may be hard to keep open if no one wants to risk getting sick.
The only hope is to slow it with non-medical measures. Check the progression dashboard for your country: https://coronavirus.arik.io/ You can see which countries are serious (most of Asia - graph looks linear) and which aren't (US and most of Europe - graph looks like a hockey stick).
> Most people infected with COVID-19 virus have mild disease and recover. Approximately 80% of laboratory confirmed patients have had mild to moderate disease, which includes non-pneumonia and pneumonia cases, 13.8% have severe disease (dyspnea, respiratory frequency ≥30/minute, blood oxygen saturation ≤93%, PaO2/FiO2 ratio <300, and/or lung infiltrates >50% of the lung field within 24-48 hours) and 6.1% are critical (respiratory failure, septic shock, and/or multiple organ dysfunction/failure). Asymptomatic infection has been reported, but the majority of the relatively rare cases who are asymptomatic on the date of identification/report went on to develop disease. The proportion of truly asymptomatic infections is unclear but appears to be relatively rare and does not appear to be a major driver of transmission.
and that's why they are trying to slow it down, we'll get it but in stages so those in dire need will get care and survive.
First, I think the 5% refers to 5% of persons infected with the virus, not to 5% of the entire population of the U.S., although this is the least clear part.
Second, the "critical care" part refers to "being admitted as an inpatient" (not being admitted to an ICU), as distinct from an outpatient office or ER visit.
I don't think the authors meant to suggest that the CDC believes that 5% of the U.S. population will require ICU care during this epidemic.
>As the virus continues to spread nationally
And then the numbers are listed as
>80% of the population may experience mild symptoms, such as fever or flu-like symptoms that they treat at home
If it were as you say, they would write x% of the infected population, or something to that effect. Then again, given all the incompetence I've witnessed lately across the news, it wouldn't surprise me if they ambiguously wrote it by mistake.
In any case, you'll note that China just shut down it's entire industry for two months over this. That's not something an authoritarian state does lightly. Especially considering it may, say, make it obvious that sending all of your production offshore to China is a national security threat.
Edit: Italian Prime Minister just made a 2AM press announcement of the Isolation of Lombardy. That's 16 million people. We're approaching the right ballpark here. 8% of the Iranian parliment have confirmed cases. Two are already dead. This is everything we've been warning you about.
Especially when the "80%" is followed by:
> 80% of the population may experience mild symptoms, such as fever or flu-like symptoms that they treat at home
> 15% may seek medical care, such as visiting an Urgent Care or Emergency Department
> 5% may require critical care, meaning being admitted as an inpatient
This source from business insider reports that the US gov is preparing for 96 million infections. 5% is almost 5 million hospitalizations.
At this point you people just don't want to believe. This is not yet another flu scare. This is the real fucking deal. A historic pandemic. Prepare while you can. Just look at what's going on in what, 10 countries now? Millions of people placed on lockdown in Western nation's now? Italy just locked down 16 million people on Lombardy. French PM says he doesn't think the virus can be contained.
It is only prudent at this point to stock up on nonperishables. This isn't just to protect yourself - if you get the virus it will be responsible to sequester yourself in your home to protect the population. The irresponsibility of those who refuse to take this seriously and prepare is putting all of us at risk now. The U.S. is NOT EQUIPPED to handle this kind of outbreak. The system WILL BE OVERWHELMED in the next 1-6 weeks. And if China, SK, et al. are any indication, it will drag on for months.
We’re just saying not 100% of people are going to be infected. Even your business insider article is not saying that. Stop moving the goalpost. Sometimes we're wrong or we misread something, and that's okay.
It’s still undoubtedly a monumental event in history, but we will make it through.
The total number of places available in a given country in ICU's is (assuming a perfect world) the exact needed amount for "ordinary" cases + some slack, let's say 10%.
So you cannot count the total number of available beds as if they were free, as 90% (or change the percentage according to the specific country) are always, constantly, in use for patients affected by other - totally unrelated to Covid-19 - issues.
Part of these "ordinary" cases can be reduced (as an example by delaying a number of not-really-urgent surgery interventions) but this is also not without consequences.
5% Nationwide will require ICU care. That's 18.5 million people.
It says "5% of those who contract Covid-19" would require ICU, which is .5% of those exposed to Covid-19, which is itself a small subset of the population.
You're off by well over two orders of magnitude!