(Note: While this report is not up-to-date, it includes certain basic information that should be useful as the spread of the coronavirus in Italy (and elsewhere) proceeds.  The town where Andrew lives is now in the “red zone.”)

By Nancy Spannaus

March 5, 2020—The nation of Italy represents the major hot spot for the outbreak of COVID-19 epidemic in Europe, and thus the situation there should be of considerable interest to citizens worldwide. I am fortunate to be able to provide a short firsthand report from a highly qualified observer on how the crisis is being dealt with there. (For a broader perspective on this outbreak, please see my recent post.)

The Virus in Italy: A Firsthand Report
Testing for the coronavirus in Italy.

The following interview was done with my son Andrew Spannaus, who lives in a town outside Milan which is not under lock-down but is about 30 miles away from the epicenter. Andrew is a journalist, political analyst, and commentator, and the president of the Milan Foreign Press Association. (For a fuller biography, see his newsletter TransAtlantico.)

My questions were sent on March 1, and the answers were updated as of today.

  • Would you please specify for us Americans the scope of the emergency in Italy? I understand that about 100,000 people in several towns in regions east of Milan are under lock-down. How big is the area, actually, and what are its characteristics? What measures are being taken to control the spread? Are there additional measures being taken nationally?

There are currently 11 small towns under forced quarantine, affecting about 50,000 people. The main area is only about 40 miles southeast of Milan, but has a much lower population density, with agriculture and small businesses being the main economic activities. There is also a smaller area under lock-down in the Veneto region, again outside of any large cities.

The ordinance issued by the Lombardy Region, and now coordinated with the national government, divides the country into three zones: red, yellow, and green. In the red zone, almost everything is shut down: schools, most stores, public transportation, and entry and exit from the area is restricted.

The City of Milan is not shut down. Here, its famous Piazza del Duomo

In the yellow zone, which includes the metropolis of Milan and many other medium-size cities, schools have been closed for two weeks now and most public events are prohibited. People are free to go where they want, but encouraged to avoid social events, and even bars and restaurants must ensure people are seated at a distance, rather than standing close to each other.

In the second week of the crisis, Lombardy, Veneto, and Emilia-Romagna, three northern regions, are all under the yellow zone rules. The rest of the country has only sporadic cases, and ordinary public health procedures are being followed.

The numbers are still growing, with over 3,000 people infected, and over 100 deaths attributed to the virus. The federal government has now decided to close all schools in Italy until mid-March, and is considering expanding the red zone, although only to include a few more small towns, no larger urban areas.

  • What is the situation in terms of medical resources – beds, personnel, and protective gear?

The hospitals in the red zone are severely taxed. The problem is that close to 10% of Coronavirus patients are in intensive care in Italy, which is overburdening the system. There are plenty of hospitals in the surrounding area which can help out, but when intensive care beds are occupied, that means that regular hospital traffic, such as heart attack victims, for example, end up being sent farther away.

Masks are in short supply, as a lot of people ran out to buy them as soon as the crisis arose, while a more serious problem is the insufficient number of hospital personnel. The government is moving to hire and train new people immediately, but that takes time and creates risks as well.

  • Here in the United States the extent of testing has been extremely narrow up until now. Do you know how extensive it’s been in Italy?

Wide-scale testing began only when the number of cases began to rise about 10 days ago. The testing is mostly in the red zone, and among people who have gone to those areas or had contact with others who are infected. The more testing, the more confirmed cases, of course, which has led to some public debate on what strategy to follow. The WHO suggests only testing those with symptoms, which is now the approach being taken.

  • Is there a known source for bringing the coronavirus to Italy from China?

Originally, it was thought that the virus was brought here by a businessman returning from a trip to China. He was dubbed “patient 0,” after some of his friends who went to dinner with him got sick. Yet he then tested negative. So it’s not known how the virus got here, and given that thousands of people go between China and Europe regularly, and it can take weeks before symptoms start, it’s very hard to trace.

One of many makeshift hospitals set up for the 1918 Spanish flu
  • Here in the U.S. some commentators are harking back to major pandemics, such as the 1918 Spanish flu, which swept an unprepared world and killed an estimated 50 million people or more. Indeed, the mortality rate from that flu was also in the range of 2 to 3%. Could you give us an on-the-ground picture of the popular reaction to this crisis in Italy?

There have been two types of reactions: a certain amount of panic emerged at the beginning, with people hoarding food from supermarkets and buying out stocks of masks and hand sanitizer at pharmacies. Things calmed down after a few days, and now many people in the Milan area are itching to get back to normal, although they are generally following the instructions from public authorities.

On the other hand, many people initially took a cavalier attitude towards the crisis, suggesting that it was all a big overreaction to something which is “just a bad flu” that mostly affects the elderly. Even some health professionals have contributed to this narrative.

The ironic thing is that this attitude has been expressed even by politicians who are usually supportive of the institutions and promote a technocratic approach to government; while on the other hand, populist political parties were demanding stronger measures from the start. So, we saw a partial reversal of roles, with establishment figures downplaying the warnings from science professionals, and populists being more “responsible.”

As the numbers have gotten worse, this attitude is receding, but it showed a worrying tendency to underestimate the danger of the Coronavirus. Two percent may not sound like much to some, but when applied to large numbers, it can be catastrophic.

           * Thank you, Andrew




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