Over 2,000 Italian health workers infected | Hacker News Reader

Over 2,000 Italian health workers infected

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63 pointspmoriarty54 comments

I'm infected. As are many more than any official number out there. I infected my SO, of course. She's having a worse time than me, with a nasty cough that goes right through my soul.

We haven't bothered with getting tested since we'll probably be OK and can sit this one out from home.

I'm a healthy 34 year male without any further conditions. I couldn't find anything about the duration or livecycle of the disease so for those wondering: For me, it started as getting a regular 'flu'. A tingle down my spine, a little light headed, a little hotter. No actual fever. No coughing (for me). No sneezing. And now, day 5, my lungs are acting up. Difficulty breathing. Feeling like I've just ran up the stairs. Last night I woke up out of breath with light pain in my chest.

There are so little accounts of people describing how bad it is going to get or how long it is going to take... I wish more people would share.

I can, however still do remote development work. Besides the breathing issues, my head is clear and sitting still (and typing) is the only thing I feel like doing. Really.

[Edit] thanks everybody for your concern. These are scary times for everybody. Our country policy is "sit it out unless you have fever". I don't have a fever but can assure you I'm taking my temperature hourly and will check myself in when it hits 38°C.

You should really contact a doctor, if there is availability. Breathing issues are not to be ignored.

If you're feeling out of breath you absolutely need to get help. This is a serious symptom and if left untreated it can be deadly.

I agree, he said himself he's only 5 days in too

As I mentioned in another comment. I've heard it will last 5 to 7 days for most, but around 12% will have more serious illness starting around day 5.

Whatever the case, it is becoming increasingly important that people know not only the first symptoms but how the disease is likely to progress.

Please get tested, if you are developing pneumonia you could need hospitalization asap. Call your doctor or the emergency number now.

CDC suggests to seek medical attention as soon as you have difficulty breathing. [ https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/st... ]

I'm French, right now they're going to quarantine the whole country because young people are starting to get it and suffer grave consequences including death. Search for "cytokin storm" if you want to understand why a supposedly good immune system is not a warranty against it.

Don't think it's nothing, get checked now.

In the best case you're looking at being weak for 4 to 6 months.

After thinking about it this week-end I decided to self quarantine at home even though I don't have any symptoms. I sent an email to my boss this morning to tell him that I was taking at least 2 weeks vacation time. He didn't even bother to answer.

Merde ! (we don't say good luck in France ;-)

There have been healthy people your age and younger who have died from this disease. Even survivors can suffer extensive lung damage.

Please talk to your doctor as soon as possible.

As others have said, please go to a hospital. You are 34, so will probably recover fine without medical help, but there have been many cases in their 30s that have taken a sharp downturn for the worse and needed oxygen support, etc. For example, see case history of the U.S. first detected case, a 35 year old man in Washington: https://www.nejm.org/doi/full/10.1056/NEJMoa2001191

He should call ahead first. That gives the hospital a chance to prepare to isolate him safely and prevent infecting medical staff and other patients, which is what could easily happen if he just walks in to the hospital unannounced.

Also, in some countries if you're sick with a suspected case of COVID-19, you don't have to go anywhere. A doctor will come to you.

https://youtu.be/BYTFk34nhoI

Between the 10 and 12 minute mark in this video the doctor describes how most people have illness for 5 days, and a few begin having complications around day 5 (and he gives a name as his source, if you want to research further).

I think you are not OK yet and should seek medical advice.

Similar here (also untested because my government has a policy of not testing non-hospitalised cases, but none of the symptoms [or absence of symptoms] feels like other respiratory infections I've had before)

Symptoms somewhat similar to yours; I'm also the same age. No proper fever [some of my sleep is the slightly fitful sleep I'd associate with fighting off mild infections, but my temperature is normal or very close], I've coughed only a literal handful of times and not painfully, so clearly sufficiently mild to miss those characteristic responses, no headache and only occasional feelings of fatigue and a bit more sleep than usual. Just inflamed lungs which are more uncomfortable than painful. Back when I felt completely healthy last Wednesday and went for a 3k outdoor run (no more uncomfortable or slower than I'd have expected considering I haven't run much this year) I obviously felt like I was breathing a bit too shallowly and breathing deoxygenated air. This is basically that same feeling coming back the following day, except with a normal breathing rate [and heart rate]. I can still take a deeper breath whenever I want and I'm far from worrying I'm about to run out of oxygen, but just feels uncomfortable and I can imagine how it can cause much more serious problems for people with more severe symptoms, pre-existing lung conditions or immune system issues. It's been steady for most of this period.

I appear to be one of the lucky ones. Expect to make a full recovery, able to work from home and if the run helped accelerate symptoms showing then I'm quite glad it saved me from passing it on to other people.

Thanks for sharing. May I ask what day you are on?

Uncertain. Four days have elapsed since I first showed symptoms, but unclear how long I had it before then since it normally has a long incubation period and I doubt I actually caught it whilst running round a park in the evening on Weds which was the only time I crossed the threshold that day

Best guess is I caught it last Monday (train ride through London). Would prefer that to earlier since I was travelling back from seeing my parents and my brother's young family in a lower risk area then...

Also possible I caught it from a coworker the previous week when actually in the office: she is self isolating but exhibiting very different symptoms.

The data is so strange. Malaysia has had an outbreak since well before Italy, with zero deaths so far. Vietnam and Thailand are similar. I'm beginning to suspect that sunshine/vitamin D is a good proxy for how hard-hit different regions are and the huge discrepancy. It's an awfully optimistic theory, since it suggests things will start to get better in the northern hemisphere regardless of intervention and since everyone can individually supplement with Vitamin D immediately.

Some data collected here, I welcome any additions or good counterexamples, but we won't have much more for a few weeks when we can better observe countries that are "behind" Italy, like Spain: https://simonsarris.com/sunlight

Is Italian population deficient in vitamin D compared to those other countries you mentioned?

Did you look at the sunshine data? Bergamo has low sunshine in Feb and March comparatively.

Places hard hit:

* Wuhan: 100 (In Feb)

* Paris: 79-129 (Feb-March, North France harder it by # of cases, cannot find death info)

* Bergamo Italy: 100-150 (Feb-March average)

* Seattle WA: 100-150 (Feb-March)

* Iran sunshine varies a lot by locale. But some places like Rasht, its very low light: 90, 78, 71, 113 for Jan, Feb, Mar, April

Places less hard hit:

* Bangkok 250-275 (Feb-March)

* Kuala Lumpur 185, 192, 208 (Jan Feb March)

* Ho Chi Minh City, 272 (March)

* Seoul: 175-200 (Feb-March) South Korea contained it of course, but their lethality numbers are also lower, and its the lethality that I find odd in all this.

Thank you for clarification. Yeah, the numbers look interesting.

Following this pattern we should see similar numbers all over Europe, heck significantly more in the nordic countries but that's not the case.

The Nord countries are "days behind" Italy. So far we can only study countries which are days ahead, which is why Malaysia, Thailand, and Vietnam are compelling.

In the coming month we can observe the Nordic countries, but as April approaches their sunshine gets better.

Also: Latitude is not enough to determine sunshine, you have to go look up the monthly data. For Rasht in Iran for example, its very low light: 90, 78, 71, 113 for Jan, Feb, Mar, April.

This city is south of say, Lisbon, but Lisbon has far more sunshine hours.

heck significantly more in the nordic countries

I think some of them instituted programs to fix vitamin D deficiency a while ago:

https://www.nutraingredients.com/Article/2015/05/28/Sweden-t...

Damn, one would think in our data-crazy world stats like vitamin D deficiency by country would be one search away. But in reality, it's pretty hard to find and even harder to verify.

Possible explanations for the discrepancies:

1 - A difference in the amount or quality of testing. If you don't test enough, you won't really know how many cases you have. If the tests that are performed are unreliable, that can also lead you to a false sense of security.

2 - Deaths from the disease could be miscategorised as deaths from pneumonia, the flu, or some other illness. This goes hand-in-hand with lack of testing.

3 - There is some difference in the location that might impact the disease. For instance, China has a lot of air pollution, which could impact lung function, and may in turn increase the severity of COVID-19 symptoms, which primarily impact breathing by damaging the lungs. Hot and humid climates also seem to be inhospitable to the virus, though it is hot in Iran now and they're very hard hit. Widespread use of air conditioning might negate the effects of outside temperature and humidity, however.

4 - There could be population differences. This has not been studied yet, but in theory some people may be less susceptible to the disease because of genetic factors.

5 - Behavioral differences could impact this disease. Doing lots of testing, tracking down all the contacts of each infected individual and isolating them, having the population self-isolate and avoid gatherings can make a huge difference. Conversely, a population and government which ignore this outbreak or pretend it's not serious, and continue going on with their life as usual is a recipe for disaster.

6 - Medical preparedness: having a lot of excess ICU capacity, ventilators, personal protection equipment, and trained (and healthy, and not overworked) medical staff in hospitals.

And currently there are about 20 new infections per day in all of China. How is this even plausible? What are we doing totally wrong in Europe that China has done right? Or is there something fundamentally wrong with the numbers?

Sorry for me spamming this but this is extraordinary times:

For people who are curious what living in China feels like now (video uploaded Mar 14th), from a Japanese director living in Nanjing, China: https://www.youtube.com/watch?v=YfsdJGj3-jM

Things are getting back to normal, with tons of precautions.

There are a few other youtube channels run by westerners vlogging on the current situation in China. e.g. https://www.youtube.com/channel/UC1XG7bJnYqta_ezr12WZp7w

Also, from someone lived in Wuhan: https://www.thetimes.co.uk/article/more-likely-to-get-sick-i...

I will recommend everyone to watch the Nanjing video. That is an insane amount of precautions. Keep in mind that it is about Nanjing, which was nowhere near Wuhan numbers. Some examples:

1. Every place is taking temperature of people. Every place

2. You have to register your presence everywhere. Boarding the metro train you have to scan a QR

3. Takeout is totally touchless, and contains the names of the employees involved in making it.

4. Cabs have a plastic seal between driver and passenger sides.

5. Restaurants have physical barriers between seats, so even if you go together with someone, you can't eat the food while looking at each other.

There are just some examples, the video shows many more.

To top it all, everyone is wearing masks. Everyone.

You posted this simultaneously with my comment just above, and it provides some helpful information related to my questions. Thank you.

Just to update as this changes from day to day as things get relaxed (in Nanjing)

> 1. Every place is taking temperature of people. Every place

Not every places anymore. Most shops, supermarkets or malls no longer have dedicated temperature staff. However entrances to living areas (neighbourhoods) and official infrastructure would have

> 2. You have to register your presence everywhere. Boarding the metro train you have to scan a QR

Not everywhere, like shops etc. However some cafes and restaurants required you to scan in to let you sit down. Additionally the app checked your face with your ID so you cant just share your qr code.

> Takeout is touchless

Also deliveries to your door are not back yet. Deliveries get dropped in a designated area where you go to pick them up.

> 4. Cabs have a plastic seal between driver and passenger sides.

However their version of "Uber" has no seals and is normal.

> 5. Restaurants have physical barriers between seats, so even if you go together with someone, you can't eat the food while looking at each other.

No longer the case as a rule. Most restaurants are not open for seating it seems currently, but those that do you can sit next to or opposite people now. However originally it was one person per seat when they first re-opened.

Rules are being relaxed daily. In Nanjing there hasnt been a case of the virus for 2 weeks.

This may seem redundant, but can you confirm that the video from the Japanese resident of Nanjing is a fairly accurate representation of what it was like in Nanjing before the restrictions were loosened? Also, you didn't say it, but I assume you actually live in Nanjing currently?

I have read countless comments online asking how can it be possible for China's case numbers to be nearly non-existent at this point and the Nanjing video paints the picture completely for me, an average American.

Another comment in this thread talks about symptoms and what it's like actually having the virus.

If a series of videos existed that showed a) what it's like having the disease (I haven't seen any videos showing that but the top comment on this thread as of now is a good first-person explanation of a "mild" case) and b) the lockdown response necessary to keep the numbers down or eliminate them altogether I feel like more people would be able to take this seriously here.

Of course I also watch that Nanjing video and realize that I don't see how it's possible that Americans would ever go for such extreme measures, which makes one think that the UK "let them get sick to get herd immunity" starts to make more sense.

Plz keep in mind that with all those measures employed in China, we don't know exactly which ones are effective and how effective they are. Also S.K. Taiwan, and Singapore has a different set of measures that seems to work. What I wanted from posting that video is to show the virus is containable once everyone is onboard.

And as a Chinese I know everyone is onboard on day 1. Tons of volunteers. Tons of volunteering health workers from day 1. The people keep temperature readings from many communities and neighbourhoods are volunteers. Many elderly volunteered to do that. Everyone is onboard to contain the virus on day 1 by themselves, not forced. Ask any Chinese you know, I guarantee you no one thinks it's just a flu. I would bet that people from S.K. Taiwan, Hong Kong, Singapore all share the same attitude.

In startup world we say people would achieve wonders once the vision is clear and everyone is onboard. It's the same with this pandemic.

Yes, the situation on the video is accurate from when it was filmed. Just that the situation is also rapidly loosening up and variable from place to place. Also it was much more strict a couple of weeks ago. I think people want to return to normality as quickly as possible. I've seen a few people walking around in their living areas with no masks now.

One update would be that some deliveries (possibly postal or parcels) are able to come into the living areas - but again this is just this week. Some other delivery companies are not allowed in just yet though.

I've a contact living in the north of Nanjing in a residential area.

It could be that keeping 900M in house arrest is working,

Or that the Chinese authorities are fibbing.

Or, of course, a combination.

Exactly. People have no idea how vast and strong the measures were. China locked down hard, Europe is going middle of the road with some lockdowns but nothing is really strongly enforced so far.

Which organizations are monitoring how many China is truly testing? These numbers are more plausible if they just reduced testing.

China's numbers continued to rise for some time after the lockdowns. If Italy's works, it won't necessarily be apparent yet.

China was more aggressive about their locking down, so expect Italy's numbers to peak higher than theirs did.

China has a far more aggressive containment approach.

I don't want to go too far into it, because China is a sensitive topic on HN. But here's a little snippet of how they handle people who violate self-isolation.

https://www.youtube.com/watch?v=rKek0Y30Ctw

Not saying it's right or it's wrong. This is a serious threat. I know that even in the West right now, particularly in Italy, a lot of people would applaud this. Scofflaws can really hamper a society's recovery. Just trying to give people some context so they can better evaluate the difference in response protocols between East and West for themselves.

Also: South Korea.

They seem to have essentially stopped the spread of coronavirus with <0.02% of their population infected.

People frequently cite extensive testing as the key to Korea's success, but it's not like they've been testing everybody; they've tested about one-half of one percent of the population. And they didn't even take steps nearly as drastic as China did in terms of quarantines and the like.

I wish someone could provide good reasons for why they've been so successful at containing this virus.

I obviously don't know much about infectious diseases, but it strikes me as really odd that there is a consensus among scientists that this virus will inevitably infect 20% to 70% of the US and the world, when it seems to be pretty well contained at less than 0.02% in China and South Korea.

If this virus is so inexorably contagious, shouldn't it at least infect, I don't know, 5% of China/SK? Or at least one percent?

I have been looking for answers to this puzzle and have found little or nothing to explain it.

I think it's a matter of time everywhere it goes. Some East Asian countries have similar experiences in the past and people still remember.

Everywhere else, including the EU, Some people don't take is seriously yet. Specially younger people don't understand not being at health risk doesn't mean that you aren't responsible to slow down the spread and keep elderly safe.

My neighbor had birthday party last night. His house was full of people. Definitely not what I would call social distance.

Ralph Baric, an epidemiologist from the University of North Carolina Chapel Hill, had this to say on episode 591 of This Week in Virology[1] a couple of days ago:

"I heard recently that the Chinese aren't planning on doing serology on their population, which tells me that there's probably significantly more infections than the 80+ thousand that are reported and they don't want the actual number to be reported."[2]

also:

"The Chinese are primarily reporting cases in their quarantine zones, which involve a hundred million people and that the Chinese in rural communities are not being picked up by their surveillance systems."[3]

[1] - http://www.microbe.tv/twiv/twiv-591/

[2] - about 12 minutes in to the program

[3] - about 19 minutes in to the program

It's a campaign called "zero out", since Chinese officials only report to their superiors, you can imagine this urge to report zero or at little as possible to ensure their bright political career, this also explains basically any thing in China.

There are anecdotes about communitiy cases listed on community notices but not reported in official data.

Sad. This number has exceeded China's.

And it's after what had happened in China.

I just hope other countries do not repeat what happens here, and be more decisive in their measures.

My question is, why all the numbers look so different in Italy and South Korea? The countries are roughly the same size. They both have modern, socialized medical systems AFAIK. But the stats are completely different. We're not talking about percentages. We're talking about order of magnitude difference in everything, including relative stats.

Is this difference due to some property of population (e.g. average age, smoking rates) or the response?

Could be an age problem, in Italy atm the median age of the death patients is 80yo.

[ https://tg24.sky.it/salute-e-benessere/2020/03/16/morti-coro... ]

They managed to quickly break the exponential evolution probably with a very rapid and strong response. Could be that Latin people are less disciplined when it comes to adhere to restrictions. See https://twitter.com/PrieurJulien/status/1239227017549283330?...

I've also been thinking about this. From what I can tell, a big part of it is the most of South Korea's cases so far were skewed young and female (both demographics less likely to die). Stats for ages in SK cases here: https://en.wikipedia.org/wiki/Template:2019%E2%80%9320_coron...

Additionally, it seems SK has picked up cases much earlier in their progression than Italy (and most other countries except perhaps Singapore). This means we'll likely see more deaths as those cases resolve (and deaths/cases in SK has been increasing, was 0.6% a week ago, now 0.9%).

Another factor is it seems SK picked up a majority of their cases, mild and serious, due to extensive testing, while Italy has likely not detected many mild cases.

Finally, death rates are much higher in places where health systems are overwhelmed, such as northern Italy.

Difference in sampling basically as they test people who are sick in Italy versus allow anyone to test in SK.

You should estimate the levels based on the sampling. For example last week the UK Govt said they estimate there was 10,000 infected in the UK based (in part) the number of positive people in the hundreds. You should be able to make better predictions using geo-demographics and population density etc.

For south korea, do we know the number of people who are in hospital with the virus being treated? Then you can compare Italy and South Korea.

South Korea has been doing extensive testing, not just of people presenting symptoms but also tracking their movements to find those they've been in contact with. https://www.france24.com/en/20200311-coronavirus-can-s-korea...

Does every article about a canceled event, or some new infections need to be posted?

https://news.ycombinator.com/newsguidelines.html

> If they'd cover it on TV news, it's probably off-topic.

Historically, in practice, this guideline never applied to events that directly threaten livelihoods and lives of many of us and our families.

That's more than North America has tested for infected. How fucked is North America then? Italy is skinny as hell. The states suffers from an obesity epidemic.

The US has tested more than 2k people each day since March 8th. This is just wrong and misinformation at a time like this is really really dangerous. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/test...

My bad if I wasn't clear - I meant daily. My point is America's obesity rate will just make things worse than what we are seeing in Italy.

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