The virus stop in Italy came too late. What’s going on now?

0
64


In the weeks that have passed since all of Italy was ordered inside – no football games, no cafe or bar visits, no religious services – the country has slowly progressed to contain its serious epidemic of coronavirus.

There are signs of hope: as the number of cases increases, the rate of infection has started to slow as a result of nationwide isolation. But Italy continues to answer for mistakes made before it entered into force.

More than 124,000 people in Italy have tested positive for Covid-19, the disease caused by the new coronavirus, since the start of its epidemic. The country, which has recorded more than 15,000 deaths, now has the highest number of coronavirus deaths in the world – and it continues to rise.

Some scientists say the Italian authorities did not act decisively to stop the virus early, underestimating its danger and its speed of spread. “We realized that the virus had arrived too late,” said Roberto Burioni, one of Italy’s top virologists. “It was already spreading. “

Any decision to drop now and ease traffic restrictions, public health officials have warned, would risk a new wave of infections. “We have not reached the summit and we have not passed it,” said Silvio Brusaferro, director of the Italian National Institute of Health, at a recent press conference.

Number of new cases of coronavirus in Italy seems to be decreasing…

… But it takes longer for the number of new deaths fall.

Source: Italian Department of Civil Protection

Realizing the continuing gravity of the crisis, Italy extended its lockout until at least mid-April, with most government and public health officials recommending that the measures remain in place for even longer.

“If we had started to relax the measures, all our efforts so far would have been in vain,” Prime Minister Giuseppe Conte said on Wednesday at a press conference. “We would pay a very high price. We ask everyone to continue to comply with the measures. “

Read more: Return to work in Italy may depend on having the right antibodies

This message may be difficult to hear for the 60 million people who spent the past month confined to their homes and whose patience is becoming weaker. But public health experts point out that Italy’s safe release from the lockdown will require not only more certainty that the spread of the infection has slowed considerably, but also assurances that the country can prevent another immediate epidemic.

“There has to be a solid test, tracing and quarantine system in place before you can start unblocking these measures,” said Thomas Hale, professor of public policy at the University of Oxford, who tracks the responses from the coronavirus government worldwide. “In Japan, we saw a country that thought it was under control, but may have to go into a severe lockout now. “

Fortunately, Italy has evidence that the “flattening of the curve” of new infections is possible within its own borders. Northern provinces such as Lodi and Padua, which have responded to the epidemic faster than their neighbors, are already experiencing a sustained decline in new infections. They offer clues to how the country as a whole could break out of its lockdown.

Locked and waiting

On March 8, the government ordered most parts of northern Italy to close schools and ban sporting events and large rallies. A curfew closed the bars at 6 p.m.

The national lockdown that went into effect on March 10 went further, prohibiting non-essential movement and requiring permission to travel for work, health or “other necessities”, such as groceries. Checkpoints were set up all over the country and those who were arrested had to fill out official forms explaining their movements.

These extreme measures seem to have worked: people have stopped moving.

Reduced locks how far people have traveled compared to travel before the epidemic.

After the start of a partial lockdown on February 23, residents of Lodi Province traveled only 30 percent as far as before.

the national lock which started on March 10 halted the movement of most people in Italy.

Italians reduced travel by more than 50% after extension of lock to cover most of northern Italy.

After the start of a partial lockdown on February 23, residents of Lodi Province traveled only 30 percent as far as before.

Italians reduced travel by more than 50% after extension of lock to cover most of northern Italy.

the national lock which started on March 10 halted the movement of most people in Italy.

the national lock which started on March 10 halted the movement of most people in Italy.

After the start of a partial lockdown on February 23, residents of Lodi Province traveled only 30 percent as far as before.

Italians reduced travel by more than 50% after extension of lock to cover most of northern Italy.

After the start of a partial lockdown on February 23, residents of Lodi Province traveled only 30 percent as far as before.

Italians reduced travel by more than 50% after extension of lock to cover most of northern Italy.

the national lock which started on March 10 halted the movement of most people in Italy.

After the start of a partial lockdown on February 23, residents of Lodi Province traveled only 30 percent as far as before.

Italians reduced travel by more than 50% after extension of lock to cover most of northern Italy.

the national lock which started on March 10 halted the movement of most people in Italy.

Note: To calculate the travel reductions, the researchers drew a circle around all the points visited by the individuals in each period. The reductions in each province reflect the change in the median distance per person traveled.·Source: Data compiled for the New York Times based on an article by Pepe et al.

Researchers who studied anonymized smartphone data revealed that Italians stayed much closer to home after the locks were imposed. In the week after the national lockout, they walked 20% of the distance they used to travel, on average. (The middle person traveled even less: just one-tenth of their usual distance.)

But by that time, the virus had already had ample time to spread. And almost a month after the national foreclosure, Italy was adding another 2,500 new cases a day.

Plans: Monitoring the global coronavirus epidemic

Scientists say the trajectory is expected. Since the virus has an incubation period of up to two weeks, the new cases reflect infections that may have occurred days or weeks earlier. This means that even the most stringent blockages will not give immediate results.

“It’s the frustrating thing,” said Dr. Burioni. “You have to wait 15 days to see if there is an effect. In the meantime, you just have to hold your breath. “

Lombardy, the northern region where the outbreak was first detected, was the hardest hit: the region accounts for around 40% of the country’s confirmed cases and more than 50% of its deaths. But Lombardy may also be the first region in Italy to see the positive effects of the foreclosure.

Local blockages seem to have contributed to slowing the spread of the virus, even in Lombardy. Provinces that took steps to limit mobility earlier were able to reduce the infection rate earlier.

The growth of new cases of coronavirus varied between the provinces of Lombardy.

Note: Official data on government cases begin on February 24, although cases existed before this date. Source: Italian Department of Civil Protection.

Lodi, the province just south of Milan that saw the initial cluster of cases, moved to lock out several cities as early as February 24. The neighboring provinces of Bergamo and Milan did not restrict movement until the national government imposed a foreclosure on most of the north two weeks later.

Lodi managed to flatten its curve, while some of the other provinces of Lombardy still saw an increasing number of new cases per day until the end of March. Giovanni Sebastiani, a mathematician at the Italian National Research Council, said that Lodi’s experience showed “that we would probably have reduced the spread of the epidemic if the blockages had taken place earlier elsewhere”.

Lift the lock

Countries around the world will be monitoring Italy to see if it relaxes the restrictions later this month and what happens if and when it happens.

Mr. Brusaferro, the head of the country’s health agency, told reporters that Italy was not in an unenviable position to be the first in the West: first to see a serious epidemic, d ‘first to lock up its citizens and first to decide what to do next.

“We must avoid any measure that would turn the curve upside down,” he said at a press conference on Tuesday. “There is no study or literature on this. We are looking at scenarios that have never been taken before by countries that look like Italy. Other countries see us as a pilot program. “

There is no ideal timeframe for a lockout, say public health experts. The growing international consensus considers that once an area experiences a sustained decline in case growth – ideally close to zero new cases per day – it can begin to ease the restrictions. Italy could start by reopening schools or businesses in certain regions or relaxing the rules on social distancing.

The other major consideration is to what extent Italy can continue to test people for the virus and find their contacts to avoid a second epidemic.

In South Korea, widespread testing has allowed health officials to detect infections early and quarantine the sick, even among those who had no symptoms. Public health officials then traced anyone with whom an infected person may have been in contact, slowly eliminating the spread of the virus.

In Italy, the Veneto region, an area of ​​around five million people in the north, is already far ahead of the tests. The regional government plans to run 20,000 tests a day this month.

Veneto leads Italy in number of tests per 100,000 people.

2000 tests per 100,000 inhabitants

2000 tests per 100,000 inhabitants

Source: Italian Department of Civil Protection

However, scaling up testing is difficult, given the limited availability of testing and the ability of laboratories to take samples. And the most difficult part comes next: finding the contacts of those who tested positive for the virus and urging those who are in contact with an infected person to isolate themselves and to be tested.

Rosalind Eggo, infectious disease modeller at the London School of Hygiene and Tropical Medicine, estimates that for each infected person, public health officials should rush to seek between 20 and 100 contacts each, depending on the activity of an individual before being positive. Efforts are underway to continue the search for digital contacts on a larger scale, but they are still under development.

For now, keeping the lock in place – even longer than strictly necessary – is the safest way for Italy to ensure that the virus does not continue to spread.

“If we relax, is it better to relax in schools, workplaces or social interactions?” Asked Dr. Eggo. “Which of these interventions are the ones we can relax? This is a very big question that we are trying to answer. We have never been in this situation. It’s unprecedented. “

LEAVE A REPLY

Please enter your comment!
Please enter your name here