#15,069
Less than 72 hours ago (Mar 7th) - when Italy's official COVID-19 case count sat at 5884 cases and 233 deaths - the Italian government ordered Exceptional Measures be undertaken in Lombardy and 14 Northern provinces in an attempt to slow the spread of the virus.
Some of those measures included:
- Ban on travel to outside of Red Zone
- Enforced Home Quarantines
- Halting sporting events and competitions
- Closing cinemas, theaters, pubs, discos, bingo halls
- Schools and universities closed
- Ceremonies and funerals suspended
- Ordinary leave suspended for health personnel
- Closed shops in shopping malls and markets on festive and pre-holiday days
Essentially locking down 16 million people living in the hardest hit areas for the next month. It is worth noting that Italy went from having just `3 known cases' to nearly 6,000 in just a little over 2 weeks.
Late yesterday - barely 48 hours later - we saw the number of COVID-19 cases had jumped by more than 3,000, and the number of deaths had nearly doubled to 463, prompting the Italian government to extend all of the emergency measures to the Italy's entire (60 million) population.
Coronavirus, new decree "#iorestoacasa" extends the most affected areas to all Italy
Stop moving, schools closed until April 3, blocking of any sporting event, including football leagues. "From today there will be Italy a protected area, the measures already foreseen by the Dpcm of last March 8 will be valid on the whole national territory". The new provision was announced by Prime Minister Giuseppe Conte at a press conference on the evening of 9 March.
The text, after the signature of the President of the Conte Council, will be published in the Official Journal and the new measures will be operational as early as 10 March.
"We are aware of how difficult it is to change our habits. But unfortunately there is no time. The numbers tell us of an important growth in infections, hospitalizations in intensive care and deaths. The closeness of all Italians goes to their loved ones Our habits must be changed now. We must all give up something for the good of Italy, and we must do it immediately. We will take stronger measures to contain the advance of the coronavirus as much as possible and to protect the health of all citizens " , explained the premier.
"I am about to sign a measure that I could define as follows: #iorestoacasa. There will no longer be" red zone "or" zone 1 and zone 2 ", there will only be Italy protected area. Therefore, movements throughout the national territory will be avoided unless they are motivated by reasons of work, necessity or health. We will extend all the measures already provided for by the Prime Ministerial Decree of last March 8 throughout the national territory. Furthermore - concluded Conte - we also add a ban on gatherings both outdoors and in closed rooms. I am forced to take decisive action to protect everyone's health and in particular that of the most fragile ".
Watch the video of the press conference
The stealth component of COVID-19, caused by its relatively long incubation period and slow onset of symptoms, makes it possible for community spread to be well underway before the first wave of severely ill patients hit the hospital door.
Proactive communities - like Hong Kong and Singapore, which implemented strict social distancing very early - have managed to limit community spread, and still have fewer than 200 cases each after more than 6 weeks.Other countries - like Italy, Iran, and South Korea - which all initially adopted a more relaxed and reactive approach, are now dealing with incapacitating epidemics. Many other countries around the world appear to be on similar paths, as they continue to wait for substantial community outbreaks before acting decisively.
The economic and societal `pain' caused by proactively shuttering schools, halting public events, and even closing or restricting some businesses is a `hard sell' to countries where the virus hasn't yet caused major disruptions.
And so many governments gamble, waiting for clear signs of community spread before launching a concerted, and often painful, response.To be fair, until China showed it was possible to shut down COVID-19 transmission by invoking draconian measures, it was thought impossible - or at least impractical - by most public health officials.
While China is being touted as a `success' story in their fight against the virus, we really don't know - and may never know - the true cost (in terms of lives, and the economy) of their interventions. I suspect there was far more collateral damage than we've heard.But we can see what happens when the virus is allowed to spread unchecked - even if only for a few weeks - and so it is hard to argue against early, and decisive, community mitigation.
Whatever hardship Hong Kong has gone through due to their preemptive measures will likely pale in comparison to what Italy will have to contend with in the weeks to come.
The irony here is that despite their best efforts, Hong Kong is still at risk of seeing a major epidemic, due to the lack of decisiveness on the part of other countries around the globe.Exactly what the `right' balance is between imposing strict community mitigations and promoting `business as usual' - and when to pivot - is something the rest of the world is going to have to figure out through trial and error.
If it is true that we learn best from our mistakes, we should be a lot smarter about respiratory pandemics - and how to successfully prepare for and manage them - a year from now.Hopefully the learning curve won't be too steep.
