
Italy is extending its coronavirus quarantine measures to the entire country - colinprince
https://www.bbc.com/news/world-europe-51810673
======
moultano
This is an account from one of the doctors in Italy.
[https://twitter.com/jasonvanschoor/status/123714289107769753...](https://twitter.com/jasonvanschoor/status/1237142891077697538?s=19)

Read the whole thing, but this passage in particular is just chilling.

"5/ Patients above 65 or younger with comorbidities are not even assessed by
ITU, I am not saying not tubed, I’m saying not assessed and no ITU staff
attends when they arrest. Staff are working as much as they can but they are
starting to get sick and are emotionally overwhelmed."

~~~
muyuan
I am a Chinese living in Bay Area. What's described by the Italian doctor was
exactly like the situation in Wuhan right after the lockdown for the first 2-3
weeks. Unfortunately, I think it will hit Italy harder this time, China locked
down Wuhan but every other provinces send in supplies and doctors to help,
just building new hospitals is not enough, and I don't see France/Germany
doing the same to Italy. The US response so far feels very much like what I
saw early Jan in China, the government kept assuring the public everything is
in control and risk is very low. One could argue it's either cover up or they
simply didn't know, I think it's a combination of both. But I really cannot
understand why US is handling it this way after seeing what happened in Wuhan
and now Italy, it almost feels like Trump has some secret weapons ready to
save the day. You would think that, since most of the leaders are in a high
risk demographic and spend large chunk of their time shaking hands with
strangers, they would be more vigilant

~~~
ALittleLight
I am extremely disappointed in the American government on this. We have had a
significant warning and we've seen the virus in multiple countries and the
response has been so lackluster.

Why should we wait 20 days for things to get terrible before going to
quarantines and lock down? Surely China and Italy have shown us our future.

I partly think the problem is political. If you quarantine and the virus is
controlled, then it looks like you panicked over nothing, because you took
this huge reaction and nothing much happened. However, if you wait till it's
sufficiently bad and then you quarantine everyone will understand what you
did, and later, you may get praised for your decisive leadership in a time of
struggle.

What I mostly wish is that citizens could throw some sort of flag now to say
"This crisis is being poorly handled. If this goes badly, let's have a review,
figure out why, and correct the problem once this is settled."

~~~
oefrha
> If you quarantine and the virus is controlled, then it looks like you
> panicked over nothing, because you took this huge reaction and nothing much
> happened.

Nails it. You could be so good at your job that people think your job isn’t
even necessary; or you could be putting out fires caused by your incompetence
all day every day and people think you’re a hero.

~~~
dd36
Trump isn’t looking like a hero.

~~~
vkou
He is to his base. For now.

His base is, however, going to be disproportionately impacted by this virus.

~~~
ferdbold
Why would you think that? The virus is going to hit way harder in dense cities
than in rural areas, and cities heavily lean towards the left

~~~
dd36
It's most deadly to older people.

------
CaciaraAsAServi
I was not very surprised that Italy turned out to be the (first?) major hit in
Europe. Considering the strong business connections, it had to be either us or
Germany.

We are, as much of the world, importers from China, but many enterprises here
are also, somewhat, strong exporters to China (I can see it from my dayjob as
industrial automation SI), and if you factor in the small average size of
Italian companies requiring many individual contacts (contrast with Germany
where companies on average are bigger), you can imagine that there is a strong
flow of people to and fro. Maybe the small size of companies requiring more
people to establish commercial links + population being more uniformly settled
across the country (no huge wildland or sparsely inhabited area left in Po
Valley, except maybe some parts of Piedmont?) + a certain cultural inclination
for useless quarreling hindering political action + inefficiencies in the
administration + an unsolved conflict of power between central gov't and
periphery possibly causing some waste of time in other quarreling + having to
keep the vast group of small business owners somewhat quiet has resulted in a
vast spreading of the virus.

The interesting thing is that, if you replace China with Germany in the
paragraph above (wrt. the possible German origin of the outbreak in Italy),
the consideration about business links would still apply.

Another interesting thing I have just noticed is that some journalists are now
openly praising the Chinese handling of the crisis. Maybe this may sound
strange to an American :D but there has been for some time a growing cross-
partisan movement calling for stronger links to China. In fact this movement
is somewhat present in European business community, so it is not so special to
Italy, but nonetheless it is interesting to see these comments of open praise.

~~~
soneil
> Another interesting thing I have just noticed is that some journalists are
> now openly praising the Chinese handling of the crisis.

I think this is a very interesting effect. China has a fantastic ability to
mobilize as one when needed. The vast majority of the time, the insane amount
of control this requires, is something we're simply not comfortable with
giving to governments. But sometimes, just sometimes, the results are worth
it.

The closest equivalence I could think of that'd be familiar to American ears,
would be the WW2 war effort. It's not how most of us would want a country run
day-to-day, but the ability to do so when needed is incredibly powerful.

Pumping a hospital out in a week or a battleship out in a month aren't
dissimilar in national focus. And they're both achievements. What makes China
feel alien to us is that this is their default stance.

(And that said, there's plenty to be critical of in the earlier days of
China's response. But in the interest of sharing data and research, we're
catching more flies with honey.)

~~~
Polylactic_acid
>What makes China feel alien to us is that this is their default stance.

Isn't having a massive military Americas default stance as well?

~~~
kelnos
Parent's comment had nothing to do with military, but with an authoritarian
executive's power to unilaterally get things done quickly, if they so desire.

The US was sometimes able to mobilize quickly in response to extraordinary
circumstances (WWII production being an example), but that isn't really our
default state, and requires consensus-building rather than orders from on
high. But sadly our ability to do so even in extraordinary circumstances has
atrophied.

~~~
dwohnitmok
It's perhaps worth noting that even in the U.S., these wartime mobilizations
have often been carried out by comparatively authoritarian governments
(especially in comparison to peacetime U.S. government), e.g. the suspension
of habeas corpus and mass arrests during the U.S. Civil War, German internment
and the Espionage and Sedition Acts of World War 1, and mass Japanese
internment camps and the Office of Censorship during World War 2.

------
fosk
Italy is a country of 60M+ people and the 8th largest economy in the world,
with a very high national debt and that significantly relies on tourism for
its economy. Above and beyond the Coronavirus, this can terribly affect the
long-term solvency of the country.

~~~
paganel
I hope (and suspect) that the ECB (and Europe as a whole) will financially
stand behind Italy, no questions asked (I'm a fellow European).

~~~
PeterStuer
You seem to forget that the ECB is there for the banks, not for the people or
their countries.

~~~
kspacewalk2
You seem to forget that [ insert deeply ideological sloganeering / extremely
arguable value judgment ].

~~~
andrei_says_
I wish everyone was addressing trolling face on, like you. Thank you.

------
llamataboot
The US really really /really/ needs to get out in front of this. We have the
lowest per-capita testing rate in the world, there are likely already
significant outbreaks in Seattle, Santa Clara co, NYC, and DC. Probably
elsewhere. We are literally like 12 days behind and can see into our future.

If this virus does indeed require such intense hospital resources (as in Wuhan
and now Northern Italy) letting it spike is just madness. Must put into place
heavy restrictions now.

We don't need travel lockdowns, but public events, movie theatres, etc should
be closed, and businesses should be highly urged to allow workers to WFH if
nec and/or try furloughs with public money (ha! good luck...)

In any case, just waiting until we see a spike in cases and then trying to get
behind it seems like so much madness.

Large sports events? Museums? _sigh_

~~~
tomohawk
We have the lowest testing rate because the CDC made some big mistakes early
on.

1) the CDC told all the other labs to stand down and wait for the CDC test kit

2) the CDC refused permission to test except under very narrow conditions

3) the CDC test kit was defective due to being over engineered, and delayed
availability during a very critical period

Now that we're behind the exponential growth curve, any measures that
politicians can take are going to be much less effective.

[https://www.nbcnews.com/health/health-news/after-missteps-
cd...](https://www.nbcnews.com/health/health-news/after-missteps-cdc-says-its-
coronavirus-test-kit-ready-primetime-n1145206)

~~~
bluGill
Which of those would you have cited if you didn't have the benefit of
hindsight?

~~~
tomohawk
KISS (keep it simple, stupid)

Why did CDC depart from this and make a 3 part test (1 part of which had
nothing to do with this virus) when there was already tests available they
could just copy?

During an emergency, you don't screw around and try to come up with the
perfect test. You don't exercise turf rights over other concerns.

------
DrNuke
Tocilizumab drug in Naples hospital seems promising: «The health of the
patient suffering from covid 19, who arrived in critical condition, intubated
and treated with the new drug therapy is recovering. Maybe we extubate him
because his conditions have improved a lot ». They also say they got
confirmation from Chinese colleagues who tested that earlier on 21 cases. The
drug is now undergoing trial at Roche.

[https://www.corriere.it/video-articoli/2020/03/09/dopo-
cina-...](https://www.corriere.it/video-articoli/2020/03/09/dopo-cina-anche-
italia-test-un-farmaco-casi-gravi-ecco-
risultati/9405aebc-622a-11ea-9897-5c6f48cf812d.shtml)

~~~
Someone1234
I'm incredibly ignorant, can someone explain why a drug used to treat
arthritis might work against a Coronavirus? I just don't understand the
connection/interaction, or why this was even tried originally?

Genuinely looking to learn.

~~~
autojoechen
One of the ways the virus kills the patient is causing a cytokine storm
[0][1]. And tocilizumab suppresses one of the cytokines in humans [2].

0: [https://www.nationalgeographic.com/science/2020/02/here-
is-w...](https://www.nationalgeographic.com/science/2020/02/here-is-what-
coronavirus-does-to-the-body/) 1:
[https://en.wikipedia.org/wiki/Cytokine_release_syndrome](https://en.wikipedia.org/wiki/Cytokine_release_syndrome)
2:
[https://en.wikipedia.org/wiki/Tocilizumab](https://en.wikipedia.org/wiki/Tocilizumab)

~~~
listsfrin
"It might be a cytokine storm".

------
jashkenas
The Italian Department of Civil Protection is now publishing detailed
confirmed case statistics on GitHub. I just finished throwing together a
little animated map of of how it's been spreading across provinces:

[https://observablehq.com/@jashkenas/italy-coronavirus-
daily-...](https://observablehq.com/@jashkenas/italy-coronavirus-daily-cases-
map-covid-19)

~~~
tomerico
Super interesting. For once it doesn’t look like a population density map.

~~~
digikata
I suspect if you laid transportation networks and commerce centers over the
data there would be some alignment.

------
bArray
Just spoken to an Italian friend, apparently they got a few hours notice
before this was enforced (much more kept under-wraps than the previous
quarantine of Northern Italy).

Expect other Western European Countries to follow this pattern as the number
of cases increase [1]. I would specifically be looking at France, Spain and
Germany as potential next candidates.

If people here haven't already, I would recommend not leaving your shopping to
the last minute and to stock up on a few extra supplies to help not exhaust
the local food-chain when people do start panic buying.

[1]
[https://www.worldometers.info/coronavirus/#countries](https://www.worldometers.info/coronavirus/#countries)

~~~
Nursie
People in the UK have already been panic buying, mostly pasta and toilet roll
AFAICT

~~~
usrusr
The toilet roll thing seems to be everywhere (Germany is full of "why toilet
paper!" outrage as well), but do people really panic buy so much? Toilet paper
is an item you buy once every few weeks or months, depending on household
size, it's very high volume per unit of money so shops stock just enough to
satisfy an even random distribution of individual buying times. Now if all of
a sudden, triggered by news, a considerable number of the people who would
otherwise be in the market for a fresh pack sometime in the next few weeks
decide to stock up a bit earlier there will inevitably be a brief but highly
visible local shortage everywhere. Stocking up a bit earlier is far from panic
buying, but due to the low price per volume of this specific product the
result (empty shelves) will easily give that impression. This might admittedly
trigger some second order panic buying effects, but that's not the effect of a
coming virus, is the effect of people setting empty shelves.

I believe that the world is mocking a phantom.

~~~
Laforet
Seeing the same thing happen across different cultures over very different
kinds of crises I came to the conclusion that this has to be a Freudian slip
of the fact that people subconsciously care more about being able to keep
their rear end tidy than eating.

~~~
mackrevinack
well the other reason is that if you bulk buy things like milk and bread it
will be gone off within a week

~~~
nieksand
The box milk you buy in Europe can keep about a year when unopened. That stems
from a combination of aseptic packaging and UHT pasteurization. I just peeked
at a few containers in my house and they have expiration dates around early
July.

------
lormayna
I am living in Italy (not in the zones where the virus starts spreading) and I
want to say that our healthcare system is still working even if it's
struggling. The big problem is that the number of places for critical care is
going to saturate; they are starting moving sick persons from Lombardia to
other regions in order to reduce pressure on the critical care hospitals
departments. The number of death is so high because they count person who had
other illness (cancer, heart disease, etc) and because we have lot of elder
persons (the probability of dying is higher for over 75).

I just hope that other government in Europe will take it seriously, because it
seems spreading fast over France, Germany, Spain and Netherlands.

~~~
BiteCode_dev
> The number of death is so high because they count person who had other
> illness (cancer, heart disease, etc) and because we have lot of elder
> persons (the probability of dying is higher for over 75).

I don't know how the count is made, but since the pressure will affect the
care for the other patients as well, it makes sense to at least take them in
consideration in the stats.

~~~
lormayna
Yes, it make sense. The strange value is the one from Germany with more than
1000 cases and only 2 died. I suspect that the criteria for counting the death
is not the same across different EU countries.

~~~
mister_hn
and information hiding (to preserve Economy or to avoid Panic) plays a role
here

------
labarilem
Official GitHub repository for COVID-19 data in Italy:
[https://github.com/pcm-dpc/COVID-19](https://github.com/pcm-dpc/COVID-19)

------
01100011
I'm curious, do we have good data on typical influenza infection rates per
month, and if so, are we seeing a sooner than expected drop in influenza
transmissions? I figure it would be a good gauge of how well people are
adopting safer hygiene protocols.

~~~
krrrh
This has been seen in Hong Kong already. It's been noted that residents there
were very receptive to social distancing measures due to their experience with
SARS in 2003.

 _Data provided by the government’s Centre for Health Protection show the
incidence of infection with influenza had fallen to less than 1 per cent by
the end of February, marking an end to the winter flu season, which normally
extends to the end of March or into April._

...

 _Ho Pak-leung, a leading microbiologist at the University of Hong Kong, said
data showed the flu season had shortened from an average of 98.7 days to 34
days this year._

[https://www.ft.com/content/ad7ae6b4-5eab-11ea-b0ab-339c2307b...](https://www.ft.com/content/ad7ae6b4-5eab-11ea-b0ab-339c2307bcd4)

* Twitter link to above to possibly bypass paywall: [https://twitter.com/Birdyword/status/1236491746541895685?s=2...](https://twitter.com/Birdyword/status/1236491746541895685?s=20)

~~~
perl4ever
"It's been noted that residents there were very receptive to social distancing
measures due to their experience with SARS in 2003"

It's going to be interesting how society changes as a result of this, for
those of us who live through it.

------
H8crilA
So this is awaiting all countries, in all likelihood? I mean what's the
difference between Italy and Switzerland? Or Germany? Or the United States?

~~~
missosoup
The united states is going to fare a lot worse. Their president is actively
contradicting his own experts and essentially encouraging people to go on
spreading the disease.

It's going to be a clusterfuck.

~~~
reaperducer
People in other countries put too much weight in what the president says,
Trump or otherwise, because they don't fully understand that there is an
entire system of government that can fully function with or without the
president.

I won't go so far as to say that the position of the president is a
figurehead, but it's been more than a little advisory for several generations.

I watch a lot of BBC, NHK, and DW, and see it all the time. I don't blame the
foreign journalists. If you're an overseas news organization working in
America, of course the president is going to be fully staffed. But few orgs go
much beyond that. Because of this, the European view of how America works is
very simplified.

~~~
akiselev
_> there is an entire system of government that can fully function with or
without the president._

Except when a major global catastrophe hits, like a pandemic, the response
requires massive coordination across local, state, and federal levels. What he
says now may not be so relevant but the president's lack of appoints to key
executive branch positions within the CDC and the rest of the healthcare
apparatus (including eliminating health related positions from the National
Security Council, one of the most important multi-agency coordination bodies)
has drastically hampered the COVID-19 response effort.

People from other countries more often tend to underestimate the sheer scale
and complexity created by a local-state-federal separation of powers weighed
down by over two hundred years of judicial baggage and thousands of miles of
geography. In a crisis like this, even figuring out who has legal jurisdiction
and authority is complicated. Doing it without an effective executive body,
whose job is to navigate and command that mess, is far more difficult.

~~~
SpicyLemonZest
Just look at the testing for an example. There's absolutely no reason we
couldn't be doing 10 times as many tests as we are; there's just nobody
sitting at the top insisting that test capacity _must_ be available and
demanding that everyone do what they can to make it happen.

------
alfyboy
For anybody living in quarantined areas of Italy. How much has your daily life
been affected?

~~~
J_cst
I have been reviewing the situation with a colleague of mine, and we have now
realized that the new measures are not enough. It makes no sense to allow
burger king or any bar to stay open util 6 p.m. And it makes no sense to allow
to go to work for any undeferrable (or also deferrable) reason. The only
effective measure seems logically to be quarantine, and for me and my family
(2+2), from tomorrow afternoon quarantine will be. The government will finally
arrive to the same conclusion, but a later stage. At the moment they seem to
be still trying to balance the counteracting of the epidemic and the economic
damage, but to us that's not the correct thing to do.

~~~
afiori
The problem with this is that a 14 day total economic halt will be
devastating. Even assuming all office workers work remote basic social
structure will be endangered. The hospitals need to stay open, people need to
keep operating water and electricity utilities, food distribution needs to
continue as many do not have 14 days of stock at home.

It is not about those dams politician that only care about reelection numbers,
it also about keeping the wheel of society turning.

To say nothing of how much total hysteria that would cause.

~~~
alisonatwork
In China we have been on economic halt since late January. The hospitals stay
open, utilities are running, food deliveries, all of that is still working.
There is no shortage of food or other daily products.

What has changed is that almost everything is being delivered from online
store or purchased from supermarket or pharmacy during restricted hours.
Anybody who worked a pink collar job before has no job now. Anybody who owned
a brick and mortar business before is hoping that the government grants will
cover the rent and allow it to reopen if/when things finally go back to
normal.

Lockdown like this is no doubt devastating to the economy. I don't think we've
seen the worst of it yet. But so far it hasn't affected supply of food,
clothing, shelter.

~~~
Laforet
Hospitals in China have been cancelling all elective surgeries and sending the
majority of their in-patient home. This was done partly due to the fears of
the virus but also because a large part of irregular staff (nurse assistants
contractors, medical students and registrars) were away and unable to work.
Bear in mind the outbreak happened in late winter when most hospitals would
run at near capacity anyway and there is no way to avoid the loss of life.

I agree that we have not fully realised the effect of the lockdown yet, but
from what I have gathered things are not very promising. It's unlikely that
people will ever go without food or shelter, however the economic progress
they worked hard to achieve in the past decade could very easily be undone.

------
Medicalidiot
All my medical colleagues kept saying this was bad. In the first cohorts of
patients, 10-20% needed ICU level care. I have privy to the latest peer
reviewed guidelines for medicine and had a double take when I read the initial
complications: 19.6% Acute Respiratory Distress Syndrome (ARDS). ARDS has a
supportive type of treatment, which means that we give you all the basics for
life and hope that you pull through. It's the last resort of care. It's only
~150 people, that statistics might be off. Then the cohort study came out that
was looking at 44k patients. It lined up with the first cohort so close you
could consider it a rounding error.

Folks, get mentally ready to know someone that will die because of this.
Luckily, almost everyone in this thread will be alive, but those that have
diabetes, cancer, coronary artery disease, and the elderly are the ones who
will have poor outcomes because of it.

>[http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9...](http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51)
>[https://pubmed.ncbi.nlm.nih.gov/32031570-clinical-
characteri...](https://pubmed.ncbi.nlm.nih.gov/32031570-clinical-
characteristics-of-138-hospitalized-patients-with-2019-novel-coronavirus-
infected-pneumonia-in-wuhan-china/?dopt=Abstract)
>[https://pubmed.ncbi.nlm.nih.gov/31986264-clinical-
features-o...](https://pubmed.ncbi.nlm.nih.gov/31986264-clinical-features-of-
patients-infected-with-2019-novel-coronavirus-in-wuhan-china/?dopt=Abstract)
>[https://pubmed.ncbi.nlm.nih.gov/32007143-epidemiological-
and...](https://pubmed.ncbi.nlm.nih.gov/32007143-epidemiological-and-clinical-
characteristics-of-99-cases-of-2019-novel-coronavirus-pneumonia-in-wuhan-
china-a-descriptive-study/?dopt=Abstract)

------
cleandreams
The fatality rate of Italy is scary high. I read the reason is that they have
such a high percentage of elderly.

~~~
bonzini
Yes, it's Simpson's paradox. Fatality rate is lower in Italy than in China for
all individual age ranges, but the overall rate is higher in Italy because of
the older population.

~~~
remarkEon
Visualization (one of my favorites):

[https://en.wikipedia.org/wiki/Simpson%27s_paradox](https://en.wikipedia.org/wiki/Simpson%27s_paradox)

------
giovan-ni
I think the sequence of choices is what matters most. First they ‘quarantined’
Lombardia and some surrounding provinces. This looked nonsensical, or worse,
as the contagion spread was nationwide already. Not two full days after, they
are extending the restrictive measures to the whole of Italy. The net result
is to have scared back home a lot of people working or studying in Lombardia,
thereby easing the potential burden on the collapsing regional health system.

The restrictive measures themselves are hardly enforceable, with some very
important exceptions, e.g. schools. Hopefully, they would induce some change
in habits.

I am from Milano, and my daily life has certainly been affected. I left the
city two weeks ago. It was easy for me, though, as I can distance teach and I
have a place in the mountains.

~~~
srg0
The new decree is probably a response to many potentially contagious people
fleeing to the south. As I see it, if the draft version of the previous decree
were not leaked, the final version would not cause so many people to run away.

Frankly, I expected that these measures will be extended to the entire country
not later than by the end of the week. We're still in the exponential growth
phase.

~~~
giovan-ni
You are right about the leakage. The final decree places no restrictions on
traveling back to residence, and even admits self-certification of other
reasons for traveling.

I am not sure you are right in assuming the leakage was unintended, though. If
they wanted people to run, the effective way was to force a choice under the
imminent and vague threat of being trapped in the ‘red zone’.

------
peter303
The US case growth and death growth curves are same as Italy ten days ago (Feb
28 & 29 respectively for March 9). I wonder if the US will take as drastic
actions, or perhaps individual US states.

------
Yetanfou
This is supposed to be a trasnscription of some Whatsapp calls between medical
personnel in the north and south of Italy where the northerners try to update
the southerners on the situation

[https://files.catbox.moe/3ns6c1.mp4](https://files.catbox.moe/3ns6c1.mp4)

This file is several weeks old by now, a search on the 'net finds a number of
pages where the link is mentioned (including one from the 21st of januari 2020
- according to Google that is - hoax alert? if so a prescient hoax in that
they knew it would start in the north of Italy).

This being the internet it it hard to ascertain the veracity of the thing. If
it is for real it sounds way worse than e.g. the situation on the cruise ship
'Diamond Princess' which saw 700+ infections but only a few deaths as far as I
know, nor does it tally with the situation in Korea. In the (supposed)
transcription they talk about a larger number of cases in younger people
without existing medical conditions, again something which goes counter the
current narrative. One of the possible explanations given for the higher
mortality in Italy (~4%) compared to Korea (~0.7%) is that Italy has a
generally older population (the oldest in Europe) but that does not explain
the mentioned incidence of cases among younger people. Of course the way
countries count 'cases' can also differ so there is another possible
explanation but this still does not explain those cases among younger people.

~~~
jfkebwjsbx
Facepalm.

Are you really still claiming this is not real?

~~~
Yetanfou
No, I am claiming that this specific sound file might not be real given that
there are references to it from the 21st of january (i.e. way before it hit
Italy) and given the stated incidence of cases in younger people while the
narrative is that the disease is mostly mild in those under 50. There is no
doubt that there is a pandemic going on, I can see it happen around me here in
Sweden.

~~~
jfkebwjsbx
My apologies then.

------
627467
I'm curious to how does these measures affect individuals ability to get help
and solve their problems they may have given the nation wide shutdown. I
understand that WHO questioning of China's decision to lockdown of many of
it's regions is now seen as helpful in buying the world time to deal with
covid19 spread (at the cost of individual freedom and access to help in those
lockdown regions).

But, don't lockdown also create massive barriers of people, including of those
who need access to life essential products/services?

~~~
alisonatwork
There has been no product shortages in China except for facemasks. Since the
first days of the lockdown till today, e-commerce is still working, deliveries
are still being made. Supermarkets and pharmacies are still open. There are
reduced hours and the vast majority of brick and mortar shops are closed, but
no one is struggling to find daily necessities.

One area that does seem to be lacking is gyms, beauty salons, barber shops
etc. But really those things are luxuries - people are able to go on without
it.

Lockdown really sucks but it doesn't suck because of a lack of goods. It sucks
because a massive number of people in pink collar/service roles are unable to
work. It sucks because the government, and other fearful people, have
essentially decided that face-to-face social interaction is not a prerequisite
for a functioning society. That might sound fine to someone who is introverted
and a homebody anyways, but when interactions have been forced onto the
internet or behind masks and checkpoints for months, I dunno... For me it's
really trying. I don't so much miss the products of life before coronavirus as
I miss the society we had.

------
dang
Related:
[https://news.ycombinator.com/item?id=22527796](https://news.ycombinator.com/item?id=22527796)

------
tome
If anyone wants to help out they might like to consider joining this volunteer
effort. There are people working on data analysis and visualisation,
communications and messaging, and other efforts.

[https://www.endcoronavirus.org/](https://www.endcoronavirus.org/)

------
mk89
I hope other countries follow the same example. China gave a great
demonstration that it's unfortunately the only way to stop such a thing from
spreading. People just don't give a f __*.

Here the cases country by country:
[https://www.worldometers.info/coronavirus/](https://www.worldometers.info/coronavirus/)

It's interesting to see that the growth is almost everywhere the same. In some
countries it just started earlier.

It took just 1 week (or 5 days min) to have cases from less than 100 to
roughly 1000. Same in Italy, same in S. Korea, same in Germany, etc.

------
joaomacp
This sounds authoritarian as fuck, you have to sign a document to say why
you're outside.

Some countries are following the chinese example of "authoritarian democracy",
particularly European countries with big commercial ties to China.

Then you have the reverse side of things: USA, where not even tests are being
done in obviously suspect cases. But people can still go to work, buy things,
live their life.

There's pros and cons to both approaches, but compared to how H1N1 was handled
I definitely see a turn to authoritarianism, at least in Italy.

------
LeanderK
Since the mortality for younger people seems to be quite low I wonder, given
the serious circumstances, whether it would be useful to give some (maybe
volunteers?) medical staff in endangered regions "controlled" exposures to
corona-virus so that the hospitals don't have a staffing problem due to sick
doctors/nurses if a serious outbreak happens.

------
bekseju
There is 'encouraging signs' in Korea's COVID-19 outbreak. I hope to Italy is
also going to get through it.

Here is KCDC's English daily reports about COVID-19.
[https://www.cdc.go.kr/board/board.es?mid=a30402000000&bid=00...](https://www.cdc.go.kr/board/board.es?mid=a30402000000&bid=0030)

------
duchenne
Is anyone here aware of some research trying to quantify the death toll of
such a large-scale quarantine?

For instance, closing universities could result many years later in ill-
trained doctors and then bad diagnostics.

The economic downfalls could result in an increase of poverty and
homelessness-related deaths and suicides.

~~~
llamataboot
What? I do think that doctors in training will be able to go back to school in
a few months. Have you missed the part about hospitals being on the edge of
being overwhelmed already?

------
maremmano
What surprises me is the number of deaths in relation to the number of
infections. Even higher than Iran where I would expect less effective patient
management than in northern Italy. What is your opinion on this?

~~~
anonuser123456
30% of the population is over 60.

Only 17% of the Chinese`population is over 60.

We should expect to see a devastating impact on Italy with a much higher CFR.

[https://www.populationpyramid.net/italy/2020/](https://www.populationpyramid.net/italy/2020/)

~~~
adventured
And yet Germany (median age 48, nearly the oldest in the world, slightly older
than Italy and similar to Japan) has seen only two deaths so far out of ~1,100
cases. I've yet to see a definitive explanation for the extreme difference
between what we're seeing in Italy vs South Korea vs Germany when it comes to
mortality rates. Italy has a developed-world, universal healthcare system.
Perhaps the cases in Germany are not far enough in yet to produce a higher
rate of death (seems unlikely, in many cases elsewhere older patients are
dying rapidly). The only explanation that seems plausible that I've seen, is
that their healthcare system (locally) was quickly overwhelmed and they're
leaving the worst cases to die, unable to tend to them.

~~~
Barrin92
another fairly obvious explanation would also be that the Italy's numbers are
underreported and there's significantly more sick people, which would also
explain the healthcare breakdown.

Because I have no real explanation how a few hundred people on ventilators are
supposed to bring the healthcare system down.

~~~
roywiggins
Here's an interview with another doctor in Milan.

[https://www.cbc.ca/radio/asithappens/as-it-happens-monday-
ed...](https://www.cbc.ca/radio/asithappens/as-it-happens-monday-
edition-1.5491009/italians-must-follow-rules-and-stay-home-to-stop-
coronavirus-disaster-says-doctor-1.5491013)

------
vishnuharidas
Three people travelled from Venice, Italy to Kerala on Feb 29th and skipped
the tests at the airport. Today Kerala has confirmed 12 cases of COVID-19 and
around 3000 people are under observation.

------
presiozo
This is how a global crisis begins. The virus is spread more than we know and
it's getting further

------
anotheryou
and i have to beg for home office here in germany...

~~~
a_imho
Would denying remote work (if applicable) open up companies to lawsuits?

------
swordsmith
Would make more sense for the elderly and vulnerable, and those that work/live
in close proximity with those to be self-quarantined. Makes little sense to
apply those measures to the young and healthy, for whom the effects (both
symptoms and mortality rate) are similar to contracting flu without vaccine.

------
paganel
Unreal, a month ago (February 7th) I was posting this news story [1] related
to the city of Shenzen which was about to be put into some form of lockdown,
it only received one upvote. A month from that event and we have an entire
European country (a G7 member to add) under lockdown. I guess the normalcy
bias [2] was too strong for too many people until reality hit us hard in the
face.

[1]
[https://www.epochtimes.com/gb/20/2/8/n11853273.htm](https://www.epochtimes.com/gb/20/2/8/n11853273.htm)

[2]
[https://en.wikipedia.org/wiki/Normalcy_bias](https://en.wikipedia.org/wiki/Normalcy_bias)

~~~
airstrike
I had a trip booked to Italy starting on March 20 so have been following the
news very closely since at least mid February... I Ask HN'd how people were
tracking the virus, and the answers I got were "I'm not tracking it in any
way, shape or form and I hope it reciprocates the courtesy."

Quite funny, but the stats don't lie[0]. The number of new cases in Italy has
grown at an exponential rate. This is a developed economy. Similar rates are
being seen in France, the UK and Switzerland. The same will happen in the US.
We're all going to get this, and most of us will be fine, but if you take the
midpoint of experts' forecast of 40-80% of people being infected and multiply
that for a conservative 1% death rate (the WHO has mentioned 3.4% and 2% is
also often thrown around), that yields

7.8 billion * 0.6 * 0.01 = 46.8 million dead

At an 80% infection rate and an 3.4% mortality rate (worst case scenario), you
get 212.2 million dead.

That's a once-in-a-century, catastrophic black swan event.

[0]
[https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_I...](https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_Italy#Statistics)
– see the chart below the table for the unbelievable exponential rate

~~~
igravious
People keep extrapolating that tens of millions will die, and I don't doubt
that tens of millions surely would _if_ there were no lock-downs! (The subject
of this article!)

The whole point of locking down Wuhan/Hubei and then northern Italy and now
the whole country and other places and cancelling large public gatherings and
events is that local, regional, and national authorities start seeing the
numbers soaring and initiate extreme mitigation strategies.

We don't know how successful these strategies will be
individually/collectively in the long run but if China is anything to go by it
can severely retard the spread of the virus.

To show I'm not spouting out of my derriere compare the logarithmic infection
and death rates of China[1] and Italy[2]

So you have to modify your formula: `7.8 billion * 0.6 * 0.03 *
mitigation_factor = ?` We just don't know what the mitigation_factor is yet
and because the spread is exponential any dent in the rate of spread brings
the fatality number tumbling down[3].

I happen to believe this virus is a _very_ serious global threat and I assure
you that I am not one given to alarmism. But I also have never seen
governments respond to the onset of an epidemic like this before and I'm
nearly fifty and my mother says she can't remember anything like this in her
lifetime. So yes, tens of millions absolutely _could_ die but I'm willing to
bet that between lock-downs and modern medicine tens of millions won't and I
pray to, you know, $deity I am not wrong.

[1]
[https://www.worldometers.info/coronavirus/country/china/](https://www.worldometers.info/coronavirus/country/china/)

[2]
[https://www.worldometers.info/coronavirus/country/italy/](https://www.worldometers.info/coronavirus/country/italy/)

[3]
[https://www.youtube.com/watch?v=Kas0tIxDvrg](https://www.youtube.com/watch?v=Kas0tIxDvrg)
[Exponential growth and epidemics]

~~~
adventured
There is cause for optimism in the numbers out of South Korea and China. Even
assuming China has lied about their numbers (population ratios with Italy and
South Korea vs China make that plainly clear, they lied to a large degree on
the numbers), if China has managed to bring it under control through their
extreme quarantine measures, then we can prevent it from killing tens of
millions. South Korea seems to have considerably slowed it there. Japan has
done a good job of limiting its spread.

China has 1.4 billion people, and they've had ~3,000 deaths (let's assume it's
several times higher in reality). But we'll see tens of millions dead
globally? No we will not. If you killed every person that has been infected in
China, and extrapolated that event globally, we would not see tens of millions
dead. So that premise is absurd, to an extreme.

I consider this to be a very serious situation, however, it's not very serious
as a great mass mortality threat (unless it mutates and becomes far more
deadly and we prove unable to slow it down or vaccinate against it). It's a
serious threat for massive disruption to our daily lives, including severely
harming the global economy. It's a serious threat to swamping our healthcare
systems due to ICU demands and diverting our resources to managing the ongoing
crisis (instead of routine, normal productive work).

Assuming this isn't going to burn out come Spring & Summer, the next step is
to rush to vaccine, at any cost. That will end this thing globally. Maybe
we'll need to vaccinate against it annually, maybe it won't come back after
this year, who knows of course.

Tens of millions will not die. Tens of thousands might die in the plausible
worst case scenario, before we get a vaccine ready. We can rush to vaccine at
greater patient risk and financial cost, as necessary.

~~~
greedo
I think this is far too optimistic.

1\. We don't know the actual reality of what's happening on the ground in
China. Hubei and Italy have approximately the same population, yet Italy is
suffering more proportionally. I think the obvious explanation is drastic
underreporting of cases and fatalities in China. When all is said and done I
think China probably has underreported by at least a magnitude if not double
that.

2\. Most Western countries won't impose the type of strategies that China
undertook; they simply can't. When things get too bad to impose draconian
quarantines, it'll be too late. Even Italy's efforts in quarantining the
nation are not enough.

3\. Most of the world doesn't have good healthcare. I'm talking about Africa,
Southwest Asia, South America. There simply aren't enough ICU beds and
ventilators to go around. Even in the US, I've read reports of only 100K
ventilators nationwide. If the pandemic keeps growing exponentially with a
doubling period of 4 days, the US alone will have 1M cases by mid-April.

4\. Simple math. World population outside of China is 6.5B. If 10% are
infected (very conservative imho) we're looking at 650M cases world wide. If
the CFR drops to 1%, then we're in the neighborhood of 6.5m fatalities. And
the survivors? Roughly 81% of those infected survive with no serious side
effects. The remainder have serious health issues even after the disease runs
its course. That's 117M casualties. This is world altering.

[https://ourworldindata.org/coronavirus](https://ourworldindata.org/coronavirus)

~~~
igravious
And I think your assessment is too pessimistic.

To address (1.) You and others are going to have to provide sources for why
you think that China "probably has under-reported by at least a magnitude if
not double that". I've seen the ill feeling and distrust towards China
increase on HN and elsewhere in the last 5 years and this fits the bill.

You can explain the differences between Hubei and Italy by the differences in
responses. As has been pointed out, China built two make-shift hospitals in ~
10 days and quarantined 100s of millions in cities. Have you not seen the
pictures coming out of China. Now that Italy is taking drastic steps we'll see
the outcome in a few weeks and it will tell us if it is an effective strategy.
If any of the reported numbers is suspect it is the total number of cases that
the USA is reporting:
[https://www.worldometers.info/coronavirus/](https://www.worldometers.info/coronavirus/)
It's completely out of whack with every other country. This implies the US has
been under-testing, something which we have lots of evidence for. On the other
hand we have no evidence China is under-reporting.

To address (2.) "Most Western countries won't impose the type of strategies
that China undertook; they simply can't." Why not? Why can't they?

To address (3.) "Most of the world doesn't have good healthcare." But most of
the world has soap, most of the world understands what it means to self-
isolate, most of the world can implement quarantining. "If the pandemic keeps
growing exponentially with a doubling period of 4 days," Looks like mitigation
strategies slow the doubling period to three weeks, why pick the worst case
scenario?

To address (4.) "Simple math." Yes! Times an unknown mitigation factor of ?
This outbreak is scary because it's exponential (highly lethal and highly
infectious), but the total fatalities is also highly susceptible to
interventions exactly for the same reason.

~~~
greedo
Chinese underreporting is currently underestimated by a factor of
20:([https://www.medrxiv.org/content/10.1101/2020.01.23.20018549v...](https://www.medrxiv.org/content/10.1101/2020.01.23.20018549v2))

I have no ill feeling towards China other than the fact that they have a
repressive, authoritarian government. Those types of government necessarily
try to control and spin the news to maintain their authority. If a country is
willing to censor Winnie the Pooh to make their leader feel better, than
they'll naturally minimize the effect of SARS-Cov2.

I also agree that the US is underreporting due to inadequate testing.
Estimates in the US should be closer to 9-10K. I think that we'll see a large
spike in cases as soon as testing approaches levels in other countries.

My inclination regarding quarantine controls in Western countries stems from
the willingness of these societies to restrict freedoms. Italy's quarantine is
very basic, a 1 on a 1-10 level. Compared to what China implemented, it's not
even close.

Soap isn't the ability to treat cases; it's a way of trying to mitigate the
spread.

------
justlexi93
The world is affected by Covid-19, most of the groceries have limited supplies
it it seems like a lot of people did hoard for food.

------
ouid
Why can't this be upvoted?

------
lend000
It seems like these actions taken by governments will ultimately be futile, so
the question is: can a vaccine or effective antiviral be developed fast enough
to be worth the ~2-4 months of "slow spread" that can be bought in exchange
for the economic and social slowdowns a country will sustain by creating
massive quarantines like this?

While an authoritarian government may be better suited to positively
addressing some very specific problems (such as a pandemic), I do not
personally consider the benefits to be worth the costs of infringing on
everyone's freedoms. A government built around liberty and individual rights
simply cannot enforce a sufficiently useful quarantine here to contain
something approximately as infectious as the flu.

Even China, which has severely curbed the spread of the coronavirus at
tremendous expense, is still dealing with an exponential decay of new cases,
at best. At the current rate (and assuming no incoming infections from
abroad), it could take China a full year to go 14 days with no new cases. And
if they let up restrictions sooner than that, perhaps they will lose ground to
the virus once more. It does not seem sustainable.

Also note that most cases are not being tested and reported. Anecdotally, I
have second degree connections who are mildly infected and being responsible
(although still probably exposing some people who live near them), but see no
point of getting tested because they don't need the hospital and it's just an
extra trip out in public. Other seemingly sick people are out and about in the
city in which I live, coughing without covering their mouths in busy areas,
etc. Perhaps I am just noticing it more, but I suspect the official case
numbers are still off by a factor of 10 or more, so considering roughly a
million people are likely infected throughout the world, containment is a
fantasy at this point.

~~~
caconym_
Assuming that survival grants some level of immunity, if you can flatten the
curve of the epidemic, you can make a limited supply of hospital beds,
supplies, and personnel go a lot further.

~~~
lend000
This is a good point, and I think it is reasonable to start with the immunity
assumption, since it is generally the case for respiratory viruses.

Still, I wonder what the math looks like. It has indeed been shown that flu
outbreaks in ideal conditions are more intense, but conversely, the flu
seasons are shorter [0]. If medical attention makes a significant difference
in patient outcome, then the longer virus season is presumably preferable.
However, the significance of medical attention needs to somehow be weighed
against the total number of people who end up being infected and the costs of
shutting down pieces of the global economy for longer periods of time (not to
mention limiting individual rights.)

Consider that less vulnerable people may be more likely to become infected in
their daily lives since they are more active and likely come into contact with
more people. In this case, a faster outbreak with many mild cases may actually
result in faster herd immunity, and therefore fewer total infections in
vulnerable populations. Perhaps a partial quarantine of at-risk populations is
the best solution.

[0] [https://www.citylab.com/environment/2018/10/big-cities-
have-...](https://www.citylab.com/environment/2018/10/big-cities-have-longer-
flu-seasons-while-small-cities-have-more-intense-ones/572161/)

------
vkou
For anyone claiming that this is just a flu:

I've never heard of an entire country being shut down because of the flu.

~~~
dpcan
I've never heard of 14 people dying in a 120-bed nursing home of the seasonal
flu in a 3 week time span either, but the Coronavirus is making that happen in
Kirkland, WA right now. Actually, about 30 people have died, but since they
don't have enough tests, they can't say that it was Coronavirus.

My wife is an administrator at a Nursing facility that is much larger, and
this many people DYING so quickly is terrifying.

~~~
hef19898
Do you have any numbers or is it just anecdotal? Because when worked in a
nursing home back the day, the seasonal flus was already bad enough, so...

~~~
ThisIsTheWay
I'm not OP, but it's a quick search. "Nineteen of those who died in King
County were residents of Life Care Center, a nursing home in Kirkland,
according to Public Health - Seattle & King County. Researchers say the virus
may have been circulating undetected for weeks."[0]

[0] - [https://www.kiro7.com/news/local/coronavirus-number-
confirme...](https://www.kiro7.com/news/local/coronavirus-number-confirmed-
cases-more-than-100-virus-moves-more-counties/XIDPHMLVOJAAREQ5YCL75367PU/)

~~~
hef19898
I was referring to the fact that nobody died fothe flu the last time it was
around. usually, at least over here, you don't conduct that level of testing.

Which indicates one really big issue. People are, for a large degree, scared
by numbers now. Not because the nmbers look black death level bad, but rather
because there are no numbers on stuf like, say, the flu or some other disease
out there to compare them against. Not blaming people for it, that's just how
numbers work, not just for diseases.

bad thing is, nobody is addressing this, or anything else related to testing,
numbers and so on, in the public. Which includes TV, internet, papers...
Instead we have fake news spreading. This fake news is then erroding trust in
official information. And as a reult you have to sides, one that believes the
virus is at most a flu and the other one believing it will at least be the
spanish flu if not the black death. Both are wrong, but the true facts are not
getting through. Also the official information is badly presented.

------
mlang23
The voting system on HN is being used to punish those that try to stay calm
and put things into perspective. Frankly, this actually surprises me. Either I
always have had a distored view of the hacker culture, or some large scale
manipulation is going on. Since I am not inclined to believe in conspiracy
theories, I guess I was always wrong about the hacker culture and its people.

And now, let the donwvotes come. I am pretty done with this site anyway. BTW,
why doesn't HN allow me to delete my account? This seems worse then FaceBook.
Even Twitter lets you delete your account and your posts. I smell bigotry, and
that is why I want to run away.

------
fulvioterzapi
The government is calling to unity, and the situation is tragic enough that
no-one can ignore the call.

However the left wing (and the current ruling coalition) has some serious
responsibilities here, and I hope they are held accountable once this mess is
over. A few weeks ago we were told that 'the only virus there is, is racism',
implying that people worried about the virus spreading were doing so because
of an anti-Chinese sentiment. The other popular talking point was that there
are more flu deaths every year, so one shouldn't worry.

I see a link between this attitude and the current disaster.

The situation is bad, though. I was particularly shocked by an ICU medic from
Lombardia declaring that in his hospital they cannot treat all the patients,
and that they have to select those that appear to have the highest survival
chances, something you do in times of war.

(throwaway since my coworkers know my username here, and they wouldn't like my
political opinions, I hope this is allowed, otherwise please remove.)

~~~
egeozcan
Left or right, all governments seem to be doing less than stellar job fighting
this, to say the least. I don't understand why it is relevant.

~~~
tim333
Some are doing a good job eg Taiwan
[https://www.aljazeera.com/news/2020/03/taiwan-reins-
spread-c...](https://www.aljazeera.com/news/2020/03/taiwan-reins-spread-
coronavirus-countries-stumble-200307034353325.html)

