Italy's Coronavirus Lockdown Tests the Limits of Democracy
bloomberg.com
bloomberg.com
I'm definitely not happy not to be able to move freely (I like to go bicycling in the countryside and it's Spring) but, to be fair, the only way not to spread the virus is not to let people move around too much. Some politicians here want more restrictions in the areas they administer, others want less. The bet seems to be: we take a big economic hit now instead of a larger one later on if we let the virus run unchecked. Maybe other European countries are taking the opposite bet by not testing for the virus extensively or they are really only at the beginning of the curve. I don't have elements so I won't go further into this. Maybe somebody from other countries will add information about it.
About the reaction of the people here. I asked questions in chat groups of people I meet in RL (Italy is a WhatsApp country). Some 80-90% support these restrictions. Some want more, China style. The news today are that the government will deploy patrols to check people crossing city borders and that they are checking the people at train stations for fever.
The roads are much emptier than usual, probably like what they used to be during the summer vacations many years ago. No problem finding a seat on any kind of public transport. No more supermarket runs, that happened two weeks ago. Restaurants and bars are open only 9-18 but they point is that once you close theaters, cinemas, gims, etc, there is little for people to go to. It's really home-work-home for most of us.
It's going to be a long March, maybe a long April too. Anyway, my parents did they primary school during WW2 with bombs falling from the sky (10k people dead in this city) so this doesn't look as bad.
Democracy does not mean doing whatever one wants with no possibility of restrictions in exceptional circumstances.
I have seen several articles lately that try to paint quarantines, lock-downs, or other temporary restrictions as anti-democratic. This is a fallacy and it is not helpful at all.
The last few words seem like an understatement. It looks like they are trying to strike a balance between competing needs. Even if the attempts at restriction are not effective at stopping motivated individuals from traveling, at the very least these policies further bolster cultural norms discouraging movement and encouraging social distancing.
These days it's hard being in charge when the herd starts panicing. You have to cook up all kinds of bullshit whether it's possible or not to prevent mass madness.
At the same time, there will be massive unintended negative side effects caused directly by the impeded movement, particular for people with existing medical problems.
People are not actively trying to bypass the patrols, they just do not understand that shit is real. Therefore they are not even ready to lie (I would also say that they are not exactly the sharpest, but let's put that aside for a second).
14.3% Case Fatality Rate, 90+ years old
8.2% CFR, 80-89
4% CFR, 70-79
1.4% CFR, 60-69
0.1% CFR, 50-59
0% under 50
Source: https://www.iss.it/primo-piano/-/asset_publisher/o4oGR9qmvUz...
(Official Italian health service, 7 March 2020)
This virus evolves somewhat slowly- up to 2 weeks incubation period plus another 3-6 weeks of illness. But because it spreads during incubation, and has a high R0 value, once it starts spreading it does extremely rapidly in dense areas, after the 1-3 week lull. It is allegedly aerosolized and one paper reported surface contamination for >1 week.
The us is in week ≈2 now. Week ≈3 is where the whole country lights up with outbreak and the government is pressed into extreme measures. This is based primarily on South Korea's timeline.
On the bright side, the sprawl of the US may make this easier to deal with, but you can probably expect some domestic travel restrictions soon. I don't know if states have authority to close borders but I won't be surprised to hear about it.
That should be 'mean'
If it spreads before the coughing starts, i.e. during normal breathing, doesn’t it get out of your body too easily?
See:
- https://www.medrxiv.org/content/10.1101/2020.02.14.20022939v...
- https://www.medrxiv.org/content/10.1101/2020.02.20.20025601v...
> Compared with SARS, COVID-19 was transmitted in a more diverse way, from person to person, asymptomatic infected people and possible fecal-oral transmission, created the conditions for a large-scale spread.
- https://www.medrxiv.org/content/10.1101/2020.02.17.20023721v...
If states in the US do try to lock down their borders, I might drive across a few just to reinforce the fact that such measures are unconstitutional and anti-American. This is all starting to feel like mass hysteria, considering how much reports vary from country to country and the whiplash speed at which the overton window is moving. How long until Congress passes the Pandemic-triot act to suspend the 1st amendment in the same way that the Patriot act suspended the 4th and 5th?
This happens every 5 years or so; SARS, swine flu, and H1N1 were all more severe, and we didn't destroy our societies over them. We just have more access to information and mediums of emotional contagion nowadays. I understand that most people disagree with me on this, but that's what happens with mass hysteria and emotional contagion. Know that not everyone buys into it, and if you are keeping calm you are not alone :)
Personally, I'm thinking of visiting Venice in a few weeks once the planes and trains are operating again. This seems like a great opportunity to avoid the crowds and get a good deal on seeing the city before it is submerged for good.
China shut down it's entire industry for two months. Knowing full well the risk of losing global business permanently. Perhaps it is time for drastic measures.
I think we need to acknowledge that the worst-cast predictions are laughably inaccurate, and a little bit of fear of the unknown is not worth losing our civil rights over.
Now do you honestly think China would shut down it's entire economy for 2 months over the flu? Have you actually read any published literature on the virus, or are you just watching people around you prepare and laughing at them? 8% of the Iranian parliament was infected last week - two were dead by Friday.
Because this is all unfolding slowly, we still don't even know if any of the following speculation is true:
1. Multiple Chinese sources report reinfection after recover
2. Multiple sources report positive tests after recovery
3. Hot weather may not stop the virus (see Singapore)
This is not SARS. This is not just another flu outbreak. Global markets are crashing because they see what's happened in 6+ countries now. It's time to get your head out of the sand.
Do you know that fucking Mecca is deserted right now? I don't think that's ever happened before.
The markets crashing is overdue IMO; things have been overheated for a long time now and a correction has been expected for awhile. It had may as well come as a result of herd behavior rather than market fundamentals, and I say let it ride. Like the old adage goes: be greedy when people are fearful, and fearful when people are greedy.
Also, the Hajj isn't until July this year; it's not surprising that Mecca is not crowded, and closing it for most business at this point in time is not beyond the pale in a global sense.
Coronavirus has begun exponential growth in the rest of the world. The rest of the world already has more cases than China did when exponential growth inflected.
As of today, it's not showing any signs of inflection. On February 26th, Trump said we had 15 cases in the US, and would be close to zero within a few days. 11 days later, we have 607 cases, 22 deaths, and 8 recoveries. That's a growth rate of 40% per day, and holding steady.
The scary number isn't 607. And it isn't even 22. Nor is it 22/607 or 22/(8+22). (which, tbh, is pretty scary)
The scary number is 40%.
Sure, it's "just" old people with a high probability of dying. But I have several elderly relatives. I'm not enthusiastic about losing any of them.
See how China scientifically tracked spreading: https://news.ycombinator.com/item?id=22528245
> China shut down it's entire industry for two months
and kept everybody at home (and if you violate those restrictions, go to jail), and had masks for everybody... It's safer to be in China than EU now.
Just wait a week or so.
"Just wait a week" is the refrain of everyone who is panicking right now, as it has been for the past few weeks.
Because that's how the exponential function works. Italy started earlier so its numbers are still growing by thousands every day.
But the numbers for France and Germany are almost exactly the same as the numbers that Italy had 10 days earlier, and Switzerland trails Italy by only 5 days once you correct for the smaller population.
https://en.wikipedia.org/wiki/Timeline_of_the_2019%E2%80%932...
So I ask again, if this is such a super-pandemic, why are Germany and France fine despite having looser quarantine measures and earlier outbreaks than Italy? And why do you expect them to get dramatically worse over the next week?
Is this what you want in your community?
https://www.npr.org/sections/goatsandsoda/2020/03/03/8099657...
If that's your definition of "fine", then when you wrote this:
> why are Germany and France fine despite having looser quarantine measures ...
were you actually saying:
"why are Germany and France having looser quarantine measures despite having looser quarantine measures?"
/shakes head
"Why are Germany and France not worse off than Italy despite having looser quarantine measures and an earlier start to their outbreaks?"
And I still haven't heard an answer which comes close to justifying Italy suspending its citizens' rights. But that's fine; it won't matter in a few months, and we're approaching an easy opportunity to make money and travel smart as the herds follow their predictable migrations.
I just wish that people were less eager to give our fundamental rights away over this; history shows that they are unlikely to come back once they are surrendered. I'm already tired of the CBP shutting down entire 80mph interstates to search every vehicle passing through; where does this end?
Anyways, arguing about it is just something to do while everything is shut down, eh? :)
Looking back at the January data, however, there were already more cases of pneumonia than usual in that same area and many of those that survived now have antibodies. And in fact, the strain that is hitting Italy was actually already present in Germany in January based on genome analysis; for whatever reason the real outbreak started a bit later in Germany than in Italy, but that's expected because the initial phases of the epidemic are random.
You're wrong. The constitution explicitly carves out allowances for quarantines.
A "nobody is allowed to leave their homes starting now" type order would obviously be practically impossible to enforce, but that's a different matter.
Where? I could be missing something, but I don't see that:
The closest I could find was the part that grants Congress the power to pass any law that it wants, but I don't think that the executive arm could unilaterally lock down interstate travel. It also says:
>The Citizens of each State shall be entitled to all Privileges and Immunities of Citizens in the several States.
We are citizens of the United States, not of one state in particular. We pull together, or we fall apart.
Well, at least she didn't claim that it was her constitutional rights to barge into random hospitals carrying virus. Cultural differences, I guess.
Short answer: we don't know.
My hypothesis: Italy was the first G7 nation to join China's Belt & Road Initiative [1]. Its populist government also bet heavily on integration with Russia and China. That caused it, alongside Germany, to get hit early. Its sclerotic state then let it fester.
[1] https://en.wikipedia.org/wiki/Belt_and_Road_Initiative#Italy
- lot of heavy smokers
- the typical european old people attitude (and i'm saying that as a european too): "you don't take me anywhere". My grandparents passed away long ago but they never went to doctor only in the very last minute all the time. It's a kind of mentality and you can see that in the Italy cases. When they take people to the hospital and they die the next day it means they had a heavy fever for a week or more already. They have been sick for a long time but no, we don't go to the hospital. That's why what South Korea does is important, 20k tests daily, and they have done 200k already.
There is no real evidence that smokers or older people more easily get the virus, and of course if they stayed put at home they did not contribute to the spreading (they had no or however less contacts).
I've never been to the US but I don't think kiss on the cheek is that common there.
Thanks for fixing.
On 16 February, as the 38-year-old man's condition worsened, he went to Codogno Hospital, reporting respiratory problems.[20] Initially, there was no suspicion of COVID-19, so no additional precautionary measures were taken, and the virus was able to infect other patients and health workers.[21] Later, the patient, his pregnant wife, and a friend tested positive.[20] Three more cases were confirmed on the same day, after the patients reported symptoms of pneumonia.[22] Thereafter, extensive screenings and checks were performed on everyone that had possibly been in contact or near the infected subjects.[23]
The 38-year-old man was asymptomatic for weeks, reportedly led an active social life, and potentially interacted with dozens of people before spreading the virus at Codogno Hospital.[20][21] Afterwards, he was transferred to Policlinico San Matteo in Pavia,[24] and his wife to Sacco Hospital in Milan.[25][26] " [1]
[1] https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_I...
Total speculation on my part, but you can imagine a dozen similar scenarios that are just bad luck. Heck, in Germany, there was a cross-training event at an auto manufacturer, with Chinese workers visiting plant in Germany. Imagine: "Ok, let's all take turns at the controls of this metal press..." Boom.
The same thing has no doubt happened in the USA, we just don't know about it yet. I just looked at an annual event that I go to most Aprils, and.... not cancelled yet. I sure am not going this year -- I can't believe the organizers are not cancelling out -- knowing them, I suspect greed.
Edit: Typo's and grammo's.
Most other European countries are now at 20-40 cases per million inhabitants, where Italy was 5-10 days ago[1]. They will be in our situation or worse in a week, since Italy had already started putting (mild) containment measures in place in the last week of February.
[1] https://twitter.com/fagiolinux/status/1237059898304847874/ph...
We created systems for like-minded individuals who were previously geographically separated to find each other and cross-communicate easily, asynchronously, peer-to-peer, and globally. What you're seeing that looks like organized planning by a central office is more the effect of these people all reading (and posting on) the same news sources and message boards regardless of country of origin.
As for number of deaths in Italy - they are already in warlike conditions where patients are going through selection and some are simply left to die.
> Since there is, unfortunately, a disproportion between hospital resources, resuscitation beds and critically ill patients, not everyone can be intubated,” Salaroli said. “We decide based on age and state of health,” he added. [1]
[1 https://www.brusselstimes.com/all-news/belgium-all-news/heal...]
> Italian health officials are making another change in their testing protocols that may slow the growth of new case numbers. The country expects to limit coronavirus testing to at-risk people showing symptoms of COVID-19, said Giuseppe Ippolito, scientific director at Italy’s National Institute for Infectious Diseases.
> Previously, Italy was testing anyone who visited certain towns in northern Italy or came into contact with someone infected with the virus but not necessarily showing symptoms.
> Ippolito said the shift corresponds with updated recommendations from the European Centre for Disease Prevention and Control,.
[0] https://abcnews.go.com/Health/wireStory/italy-virus-count-me...
..."According to data published by the Italian Ministry of Labor and Social Policies, 309,110 Chinese people were officially living in the country in 2018, comprising 155,305 men and 153,805 women with an average age of 31 years. Lombardy and Tuscany emerged as the two regions that received the largest number. Specifically, several businesses producing or selling clothes, supermarkets, and technological-device stores have been concentrated in the city of Milan, boosting a vibrant multicultural environment in Lombardy."...
https://asiatimes.com/2020/03/on-being-a-chinese-in-italy-du...
Currently people are, in part, still going to work even at non-essential jobs, non-essential shops are still open and enforcement is very limited.
I support the lock down in Italy because I am convinced of the threat of the virus. However, I can imagine an alternative scenario in which a viral threat is exaggerated and a lock down is used to consolidate political power.
People look for strong leadership in times of panic and fear. Sometimes to their detriment. But I would be surprised if a majority is not for stronger measures when they think of their loved ones, and themselves.
Be it cancer or COVID-19, the US default attitude to healthcare in general is very "Whatever happens to a person, happens. Can't control it." One could even, uncharitably, point to the origins of the country and suggest that there's a critical mass of people who look at health crises, shrug, and go "God's will."
> People will just get sick and die
People may get COVID-19, but in general I would anticipate the rate of severe outcomes to be lower than we've seen given both the physical distance between people in the US versus more dense areas and the higher distribution of healthcare - we just have a lot more hospitals per person than China does.
> Hospitals will experience shortages and we'll try to back-stop those shortages via capitalistic solutions
That may happen, but Hospitals are also free to invest heavily in having their own supplies and we've already seen companies start shipping supplies in bulk. We are better positioned to address shortages than most other nations.
> I wouldn't rule out the possibility of even stories of straight-up bribery for hospital access to come up some years after this is all over.
That is far fetched and not tied to reality.
> we won't try to contain it beyond perfunctory measures
It would be surprising to see a formal quarantine. It is more likely some areas will have recommended quarantines and in general social distancing will be heavily encouraged.
What are the costs of this testing?
There’s been no evidence so far that our social distancing measures have done anything to slow this down, and at the rate it’s growing we will absolutely run out of hospital capacity at some point (and that’s just regular beds, not to mention oxygen, masks and PPE for the hospital staff, or ICU beds for the critically ill).
A formal quarantine is just a matter of time.
And it's not just beds. It's personnel too. CDC is preparing for 96MM cases. 5% hospitalization is already 4.8MM beds spread out over a couple months.
Not to mention if you don't quarantine the cases in the hospital already sick people are going to get the virus and likely die. This is a logistical nightmare.
I don't think this is true, do you have evidence to back this up?
Hospital beds per 1000 people is probably a better comparison though: China 4.05, US 2.77 [0]
[0]: https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hosp...
The US's concept of individual liberty is unusual and, in some cases, self-destructive.
Well, aside from the government shouldering the costs of the tests approved by the FDA.[0] But, since getting tested would involve going to the doctor (not free), and potentially being forbidden from working for two weeks, there are a lot of people in the margins who will simply not voluntarily get tested, even if they have the symptoms. [1]
[0] https://news.ycombinator.com/item?id=22493046 [1] https://news.ycombinator.com/item?id=22519125
Americans will have less sympathy for the victims of the virus but not because of gods will blaming but because they’ll blame that person for touching their face or not taking precautions. We blame people for failing not god.
The flip-side of the "your success is due to your own efforts" coin is a kind of collective defeatism: if you get sick, it's not because you drew a short statistical straw, it's because you made bad choices. And coupled with that predestination meme, the thought extends to "And you deserve what you're getting because God wills you make bad choices."
It's a meme cocktail that can make it hard to get people moving on collective action that could benefit the average person.
Cus without that, I just won't get an ICU bed and may actually die
I don't think it's apocalypse levels where money stops mattering and it's only about material goods. I'm gonna be enjoying my Yacht in two years when a vaccine is finally out because the USD will remain strong relative to competitor currencies.
Thoughts and prayers?
What? Even with the modern capitalist system the vast majority of people will be better off than they would have been 40 years ago. Our poor in the US live better lives than billions of people across the globe. Your opinion lacks perspective.