Writing on the healthcare catastrophe that is the coronavirus outbreak – or Covid-19 – is no easy task. To perhaps synthesize some of the media overload for the past weeks, this is my attempt of giving some clarity of this modern crisis.
“If you look at the mortality of seasonal flu, the mortality is about 0.1%, but the mortality of Covid-19 is at least 1%. It can be easily spread,” says Dr. Anthony Fauci, the immunologist who is at the center of the News. ‘’It’s a respiratory illness that is transmitted by the respiratory route.’’
As Reuters reported on March 27, there have been 551,820 cases worldwide, with over 24,880 deaths. 202 countries and territories have reported cases, as tallied by Johns Hopkins University. These numbers only continue to rise.
“It’s much more transmissible than the flu, and more importantly, it’s significantly more serious,” continues Dr. Fauci. “So when people compare it [to the seasonal flu], there are some similarities but it’s really different to the degree of seriousness. What we are starting to see is that there are some younger people who are getting ill. It’s still a very small minority, but it doesn’t mean that young people are completely exempt from getting seriously ill.’’
Early on I felt the spread of the coronavirus virus might have been an act of bioterrorism, initiated by China or some state agent working on its behalf.
But why? Or how?
“I’m not sure I’m buying the theory,” Mariana Budjeryn, a research fellow at Harvard University’s Belfer Center Project on Managing the Atom, tells me. ‘’Viruses mutate and adapt. Most of the known ones have originated in domesticated animals and spread onto humans. Viruses might mutate because we disrupt bio-systems to which they are used.”
In recent days, the United States surged past Italy and China, and became the most infected nation in the world. Since the U.S. reported its first coronavirus on Jan. 20, more than 2,000 people in the country have died from the disease.
Italy, particularly in the region of Lombardy, in the city of Bergamo, has suffered tremendously by Covid-19. The cases and death totals, sadly, have only risen each day. 969 new deaths were reported on March 27, its highest figure in the outbreak thus far. Their doctors have performed heroically, however, in their faint hopes for saving any lives. Some of these very doctors also have died.
I contacted my friend and colleague Lorenzo Guelfi, a photographer who lives in Tuscany.
‘’We’ve got to hang in there,” he says before asking me whether the situation of where I am is “under control.’’
‘’Donald follows the advice of most of his experts, but admonishes some Governors, at the same time,’’ I tell him.
“The governors closed almost everything,” continues Lorenzo. “Just supermarkets for food, pharmacies, and little else, are open. We have to stay barricaded. We are truly scared about the economy in our country. Everything is going to be closed until May, and maybe more. Schools are closed, and most of the people do not work.”
Teleconferencing or Zoom for employees has become more and more common in recent days, as offices are largely closed in an effort to practice social distancing.
I ask Lorenzo if he believes Italian kids are more impatient or irritated that schools are still closed.
‘’Just impatient. We are not so scared of Covid-19; just for the consequences.”
Lorenzo lives in Chiesina Uzzanese, a small town with about five thousand people. Recently, Lorenzo was commissioned by the city’s mayor to make a photo in the newspaper of the city bell, in an effort ‘’to help the people to stay strong.’’
Seeking a better geopolitical understanding of this crisis, my journalist-colleague in Rome connects me with Professor Marco Clementi, an adjunct professor at the Department of Political Science in Consenza, Calabria.
Here is that exchange largely verbatim:
Jared Feldschreiber: The civil protection service chief Angelo Borrelli said, “The measures we took weeks ago are starting to have an effect.” Can you speak to this? What type of measures is he referring to, and do you think that’s correct?
Marco Clementi: He was talking about the lockdown of our cities. Since March 8, it has been forbidden to leave your house, but not for the basic reasons, such as going to work or to buy food. These [reasons were] marked on a sheet with indications of why you’d be on the street. Since that day, new orders [were issued] by the Prime Minister and the Presidents of the Regions, which increasingly have narrowed. [Soon after], everybody was forbidden to leave the municipality where they were located for two weeks, preventing even the return to their usual residence.
JF: So whom do you trust during this crisis?
MC: I trust what the scientists say, in particular the words of Professor Roberto Burioni, whom I know. He has been talking about lockdown for weeks and already at that time, in mid-January, he was visibly concerned. I think, however, that the measures should be less improvised and followed by an exit plan, which is currently lacking.
JF: What can the world learn from Italy with this pandemic outbreak, and its entire response?
MC: We have not been able to understand that we shouldn’t think according to prejudices, but to see what was happening. In January, I was in Egypt for research and had colleagues from Taiwan. There was talk of Covid-19, but it was still only felt far away as a problem that concerned only China. The same happened when it came to us in Italy.
[In those first] days, politicians said [things like] the Chinese “ate mice”, or that China “is the cancer of the world,’’ instead of understanding that we live in a global world, and the virus travels with people. For some Europeans, when [Italy] decided to have the lockdown, [they felt we] did not want to work and therefore had an excuse to stay at home.
Other countries should learn that any improvisation has a cost. Public health is a fundamental good, and that doctors and health personnel must not be left alone. We made a lot [of mistakes] unfortunately.
JF: How has this fully affected Italy’s society? How long did it take for shelters to be in place? How did Lombardy’s hospitals get so overrun with patients?
MC: The problem was that our public health was not ready for an emergency of this magnitude, and that the protocols were not adequate. The protective material for doctors and nurses was missing in this time of need. In Lombardy [the region most affected by the outbreak], we suddenly woke up from the dream of having the best public health in Europe. In reality, it is not like that. It is not bad, but it’s not the best. We were able to face the emergency only thanks to the sacrifice – sometimes extreme – by doctors and nurses, and [specifically] by the ability of an anesthesiologist, a woman, who found ‘’patient no. 1.’’ [This person was] saved after a month of care. In hospitals, the [medical staff] cannot do grueling shifts of 10-12 hours of intensive care. In these cases, protocols should be triggered that allow a change of staff after 6 hours of intense work. This was unfortunately missing.
I think we are normalizing the situation in our hospitals after 4 weeks of real wartime.
JF: Describe the “hunkering down” procedure that went into effect in Italy.
MC: The first phase began with the establishment of two red areas in Lombardy involving about 60,000 people. At the same time, the schools in the region were closed. That was on Feb. 23. Since then, there have been openings and closings. It was a mess.
JF: What is the role of public schools and universities during the crisis in Italy? How has virtual-education been made available to teachers now that the country has gone back to work, largely via the online classroom?
MC: The role of public schools and universities has been uneven. We moved as we could. There are schools – after a first moment of panic – that managed to organize real lessons for students at home, and others just gave homework day-by-day. For universities, it has been possible to restart online courses in [the next] two weeks.
In any case, each institution has followed its own path and there has not been coordination at the national level. The attempt, though, will be important, not only for continuity, but to offer moral support to students, and to make them feel the closeness of the teachers, even to those like me who live in areas affected dramatically by the pandemic.
The coronavirus story, sadly, is still being written, as is the role of governments in their handling of controlling their citizens. ‘’Governments straddle a delicate line when limiting the freedoms of their citizens for the purposes of public safety,” Budjeryn reminds me. “There’s always a fear of overreacting, hurting the economy, imposing limitations on their citizens. Security is always too much until it is not enough. In retrospect, ‘overreaction’ seems the least of problems. When a virus in densely populated areas reaches a critical mass, the rate of contagion is such that it will overwhelm the best of healthcare systems.’’
