Italy's Coronavirus Lockdown Tests the Limits of Democracy(bloomberg.com)
bloomberg.com
Italy's Coronavirus Lockdown Tests the Limits of Democracy
https://www.bloomberg.com/opinion/articles/2020-03-09/italy-s-coronavirus-lockdown-tests-the-limits-of-democracy
104 comments
I've been trying to find a source to clarify and have come up empty: what happened in Italy that they were hit so disproportionately hard relative to other countries?
They did extensive testing and were finding cases other countries weren't. They changed this a bit over a week ago [0] to be more in line with other countries, so the numbers wouldn't increase quite as quickly.
> 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...
> 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...
Textile workers from Wuhan
https://www.bbc.com/news/business-21350013
and
..."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...
..."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...
Older population?
Correct. The average age of deceased in Italy from COVID-19 is 81.4. Which is mental and puts the current crisis in perspective.
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)
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)
that's actually a very good answer.
Nothing. They're just one of the early hot spots.
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.
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.
Where have you read that it spreads during the incubation time? So far Swedish epidemiologs have not seen any evidence of that fact.
I've heard 1-14 days with an average of 3 days, but I'd have to dig up sources. But even if the long incubation periods are rare, they'll still have an outsized impact.
>average of 3 days
That should be 'mean'
That should be 'mean'
Mean is a type of average. And for communicating to the public, unless there's a strong reason otherwise, statistical jargon should absolutely be avoided in favor of more universally understood terminology.
Even worse, this is a total blunder, I meant 'median'.
Also, what would the mechanism be? Coughing is the ‘normal’ mechanism to move viruses out of your lungs.
If it spreads before the coughing starts, i.e. during normal breathing, doesn’t it get out of your body too easily?
If it spreads before the coughing starts, i.e. during normal breathing, doesn’t it get out of your body too easily?
The virus accumulates in digestive organs and sheds in fecal matter. Gastrointestinal (fecal-oral) infection route seems likely.
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...
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...
I've grown tired of pulling up sources on mobile but publications claim the virus accumulates in nasal passaged during incubation. Also thought to play a role in the high false negative rates for testing.
This is also true - digestive and respiratory organs appear to accumulate the virus most. Also heart and liver, which explains the high co-morbidity for people with damage to those organs.
See http://www.chinaxiv.org/abs/202002.00082
See http://www.chinaxiv.org/abs/202002.00082
Looks like any organ with ACE2 receptors.
Lots of reports of this, for example: http://www.chinaxiv.org/abs/202002.00078
South Korea's timeline is very likely to be atypical, because a majority of the cases in the country are linked with one particular religious group.
Then why are countries like Germany, which were exposed earlier, not experiencing similar problems and lockdowns? I am deeply troubled by this sort of isolated authoritarian overreach and the eagerness with which people accept it.
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.
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.
Of course every country has its own share of idiots. According to the latest Korean news, some elderly lady moved from Daegu to her daughter's home at Seoul, had a flu-like symptom, went to one of the biggest hospitals in Seoul and lied five times that she wasn't from Daegu. Now they have to quarantine the hospital.
Well, at least she didn't claim that it was her constitutional rights to barge into random hospitals carrying virus. Cultural differences, I guess.
Well, at least she didn't claim that it was her constitutional rights to barge into random hospitals carrying virus. Cultural differences, I guess.
> Then why are countries like Germany, which were exposed earlier, not experiencing similar problems and lockdowns?
Just wait a week or so.
Just wait a week or so.
Why would it be taking much longer for the virus to spread in Germany than it is in Italy, when Italy is implementing much stricter quarantine measures than Germany?
"Just wait a week" is the refrain of everyone who is panicking right now, as it has been for the past few weeks.
"Just wait a week" is the refrain of everyone who is panicking right now, as it has been for the past few weeks.
> Why would it be taking much longer for the virus to spread in Germany than it is in Italy
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.
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.
But Italy did not start earlier; France and Germany did. Here's an animated map:
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?
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?
For the exponential phase of the epidemic to kick in, you need a cluster that goes undetected for a week or so. For example it can be a young local person that just shrugs it off as a bad cold and meets a lot of people while he's sick---which is exactly what happened in Italy. Italy found out after someone that "shouldn't have gotten sick" ended up in the ICU with pneumonia and a clever doctor decided to test him for COVID-19. That was in mid February, one week before 10 municipalities were the first to be locked down.
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.
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.
Germany and France now have 1,151 and 1,209 patients, with latest daily increase of 31% and 27%, respectively. What do you mean they are "fine"?
I mean that they have not felt the need to take the extremely aggressive step of suspending their citizens' civil liberties for an arbitrary period of time, and rightly so.
Is this what you want in your community?
https://www.npr.org/sections/goatsandsoda/2020/03/03/8099657...
Is this what you want in your community?
https://www.npr.org/sections/goatsandsoda/2020/03/03/8099657...
> ... they have not felt the need to take the extremely aggressive step of suspending their citizens' civil liberties ...
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
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
I understand your point of view, but I would phrase it more like:
"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? :)
"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? :)
> that such measures are unconstitutional and anti-American
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.
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.
>The constitution explicitly carves out allowances for quarantines.
Where? I could be missing something, but I don't see that:
https://constitutionus.com/
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.
Where? I could be missing something, but I don't see that:
https://constitutionus.com/
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.
Gibbons v Ogden (1824) — states may pass quarantine laws under the interstate commerce clause.
That sounds like it involves the legislature passing a law, not an executive decision.
... but roving armed police cruisers are, obviously, a good start to such enforcement, and most American towns already know how to do that.
Normally I lean heavily libertarian and I agree with your concerns, but all of the literature out of China on lancet, pubmed, etc are demonstrating that this is far worse than SARS or anything else that's hit. At the very least the rate of spread is .25-4 times higher than the Spanish flu and lethality is comparable.
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.
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.
> At the very least the rate of spread is .25-4 times higher
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.
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.
I don't understand how people can keep saying this with a straight face. It's been months since the infections started in Wuhan, people keep predicting imminent doom within the next week, and it keeps not happening.
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.
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.
The thing that stopped the spread of coronavirus in Hubei after ~50k infections is the lockdown. The lockdowns began January 22-23rd, affecting about 59m people. Nobody is leaving their homes except a few essential personnel, to include medical personnel and food delivery. That works in China but it probably won't fly in most liberal democracies. At the time, less than 2k people were confirmed infected. Exponential growth continued for two more weeks, until hitting its inflection point. That's with the lockdown.
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.
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.
You are misinformed. This is literally starting now. Jesus man open your eyes. Multiple states have declared states of emergency. At the very least that means the virus is here.
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.
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.
Sure I believe that the virus is here and that it is serious. I wouldn't be surprised if my neighbors had it, and I might have had it a week ago judging from symptoms, but so what? I'm staying away from at-risk groups like the elderly and immune-compromised, I have enough food and water to last a few weeks, and I'm not running out to social gatherings. But I also believe that it is not an excuse to suspend the Constitution. Jesus man open your eyes, a lot of people died for those rights and it's insane to throw them away over a momentary panic.
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.
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.
> what happened in Italy that they were hit so disproportionately hard relative to other countries?
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
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
eecc(1)
- Older population
- 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.
- 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.
All three may account for higher number of fatalities, but not for the speed of the virus spreading.
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).
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).
As bryanrasmussen pointed out physical contact is also more common on meeting, especially kiss on the cheek. Like that's how you greet everyone and the best way to spread viruses
I've never been to the US but I don't think kiss on the cheek is that common there.
I've never been to the US but I don't think kiss on the cheek is that common there.
I see a kiss on the cheek as a greeting in the US about once a year, usually between two visiting Europeans.
physical contact, kiss on the cheeks common.
"The Lombardy outbreak came to light when a 38-year-old Italian tested positive in Codogno, a comune in the province of Lodi. According to his wife, he had met an Italian friend who had returned from China on 21 January, who subsequently tested negative.[20] On 14 February, he felt unwell and went to a doctor in Castiglione d'Adda. He was prescribed treatments for influenza.[20]
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...
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...
Heard it went through some winter sports locations. If you've ever been in such a place you know that you will at times be transported in jam-packed cable cars and buses. I can imagine one person can infect the whole car/bus, and they all leave in a few days (most people stay <10 days) and bring the virus to new lands.
Bad luck. Ski season? All it takes is one person coming home from 6 weeks trying to ramp manufacturing in China taking a week's break to ski and unwind. Boom.
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.
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.
All European countries are growing at the same rate. Italy just started first
You're not used to the exponential nature of the spread, which makes the numbers look disproportionate, but we aren't being hit much harder. We were only hit earlier, and not that much earlier even.
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...
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...
How was the sentiment in the public before it hit the fan? Do you have politicians or celebrities who peddle the "It's only a flu" argument?
The "it's only a flu" sentiment never died and nor has "it only kills elders", albeit more people are taking it seriously because hospitals may soon begin to select who has access to ICU. It feels like "I have nothing to hide" you know, or "if you have something to hide then you are a criminal"; some things are never taken seriously.
We did during the first week, i.e. 10 days ago approximately, including the opposition pandering to their base about how the government was incompetent. They have since backtracked, and the opposition leader (Salvini) has never been so silent.
It feels as if all these people were trained in a secret CIA guerilla training camp and spread across the world to champion the same bullshit. I find it creepy.
It wasn't a secret CIA camp; it was the Internet.
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.
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.
Germany or France are only 4-5 days behind Italy in number of infected. (Germany 1100 : Italy 7300).
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...]
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...]
Wait until we make attempts to control the spread in the US. Things are about to get really interesting. Based on timelines from other countries, we're probably 1-6, closer to 1-3 weeks away from full outbreak and severe containment measures.
The likeliest scenario in the US is that (at the federal level at least) we won't try to contain it beyond perfunctory measures. People will just get sick and die. Hospitals will experience shortages and we'll try to back-stop those shortages via capitalistic solutions. 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.
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."
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."
The core belief of Americans and the defining belief in my opinion is you can rise to any level of success or failure based off your own efforts alone. I’m not arguing the validity of belief but I am arguing against whatever idea you have of gods will and America’s founding.
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.
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.
Where it gets tricky is one particular breed of religious refugee that settled the US in the European colonial period (and who's philosophical thinking is deeply encoded into American culture) was particularly interested in predestination. For some Americans (perhaps a critical mass), God's will and success based on your own efforts are one and the same---they succeed because God chose them for success.
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.
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.
My entire reason for investing heavily in the market right now is that if the economy collapses, I can use my earnings from puts to literally bribe doctors for an ICU bed.
Cus without that, I just won't get an ICU bed and may actually die
Cus without that, I just won't get an ICU bed and may actually die
If the market collapses you're exceedingly unlikely to have any earnings...
I invest in things that print money during a market collapse. Sure, you can argue that the USD will become worthless, but every country is being hit by this and if all currency is worthless than the best currency out of the lot is worth it.
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.
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.
> Can't control it.
Thoughts and prayers?
Thoughts and prayers?
Right now the US in a relatively short span of time has gone from having no testing (due almost exclusively to government regulation) to having broad testing availability (thanks to free markets).
> 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.
> 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.
We do not have more hospital beds than China does. China is at 4.3 hospital beds per 1,000 people. In the US we are at 2.7. Italy is at 3.18.
https://en.m.wikipedia.org/wiki/List_of_OECD_countries_by_ho...
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.
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.
Comparing quantity of hospital beds is a bit of a red herring. Having been in hospital beds in three countries on three continents (US, Brazil and China), I'd take the US hospital beds over the other two every single time. Much better beds, much better equipment, much better training, much better practices, processes and protocols.
It doesn't really matter how good the bed is if there isn't one left for you.
We don't have the surge capacity necessary to handle this outbreak. That's the bottom line and will be the trigger for shutting down everything else in an attempt to lessen the load on overburdened hospitals.
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.
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.
> having broad testing availability (thanks to free markets).
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
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
Regarding formal quarantine: you don't have to look far in this thread to see people saying if it's attempted, they'll try to break it on purpose just to prove the government doesn't have the right to enforce it.
The US's concept of individual liberty is unusual and, in some cases, self-destructive.
The US's concept of individual liberty is unusual and, in some cases, self-destructive.
> we just have a lot more hospitals per person than China does.
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...
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...
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> to having broad testing availability
What are the costs of this testing?
What are the costs of this testing?
More like 5-10 days. There will be a massive spike on Wednesday when test results from Quest start coming in.
Yep. And the poor in the US will not be tested because they cannot afford the test ($2000 if negative or false negative, and ? if positive or false positive) and told by their bosses that they still have to work. In the past, say 40+ years ago, anyone who was suspected of having a pandemic disease would be tested for free. This is vulture, gotcha capitalism profiteering off a disaster and assisted by the executive branch. When the POTUS gets sick from a pile of McDonald's cheeseburgers, that's karma.
>In the past, say 40+ years ago, anyone who was suspected of having a pandemic disease would be tested for free.
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.
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.
You should try telling that to a poor person in this country. Your experience “lacks perspective”. This is the wealthiest and most powerful country on earth. How we treat our poor and sick says a lot about us as a country.
According to the data, it's closer to 1 week in the US. The pandemic curve latency is roughly 45 days between China and the first cases in the US. Also, the US is large and the pandemic will take more time to accelerate (or not at all) in far-off places than urban areas... it won't spread uniformly or coherently.
Hopefully the sprawl will work in our favor.
>Italy’s steps are less limiting than one might have anticipated. The government is letting people move around the affected areas, and even to leave them, for work- or health-related reasons. Rome says it will fine or arrest those who break the rules, but it will be difficult to patrol such a vast area. Individuals will only need a written statement to prove that they’re traveling for work — a system that’s open to abuse.
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.
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.
More like politicians need to look like they are doing something.
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.
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.
Yes, absolutely. I wasn't trying to suggest the actual motive, just note a possibly beneficial side effect.
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.
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.
I know of at least one person that has been fined in Milan.
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).
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).
It does not.
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.
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.
Watch LegalEagle's video. Quarantining people is completely legal in the US.
I think they are not enough, and that instead everyone should be forced to stay home and only go out if it's essential for their own or for other people's survival (e.g. buying food, working at jobs related to medicine, food, utilities, etc.); furthermore all non-essential travel (i.e. pretty much everything except delivering supplies) should also be blocked.
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.
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 agree this would be a good policy in this case, but in my opinion the real issue is "what should our general policy be for empowering leaders to make this decision, and on what basis."
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.
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.
A transmissible disease that has already overwhelmed hospitals in another country and is spreading uncontrollably in yours seems a good criteria.
Yes, and we would need to either clearly, objectively define "overwhelmed" and "uncontrollably" or designate people authorized to make this categorization. (Or both).
Working from Milan, the last tests of the day are running in the terminal below this browser.
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.
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.
May Gods grace be with you, your city, and your people. LOVE
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.