Print this post.DISPATCHES FROM MOON OF ALABAMA, BY "B"
This article is part of an ongoing series of dispatches from Moon of Alabama
Italy in lockdown mode: Even Rome seems semi-deserted.
While the U.S. president continues to blame China there are more signs that the outbreak started elsewhere:
Some question why Italy was caught off guard when the virus outbreak was revealed on Feb. 21.
Remuzzi says he is now hearing information about it from general practitioners. "They remember having seen very strange pneumonia, very severe, particularly in old people in December and even November," he says. "This means that the virus was circulating, at least in [the northern region of] Lombardy and before we were aware of this outbreak occurring in China."
The sudden appearance of a new type of coronavirus against which no one had any immunity led to a sudden rise of cases with severe respiratory difficulties. These require up to three weeks of ventilator support and intensive care.
Our healthcare systems are not capable of working under such an onslaught. If they get overwhelmed other cases which require intensive care will fall by the wayside. The number of unnecessary deaths will then start to explode.
The only possible way to avoid such an outcome is to minimize contacts between humans to stop the mass infection wave.
When the first wave exploded in Wuhan city the authorities ordered a complete lockdown of the city and of Hubei province. That happened on January 23. Twelve days later, on February 4, the number of new cases in Wuhan started to decline. The Lombardy region in Italy ordered a lockdown on March 9. Twelve days later Italy reported its first decline of new cases.
While the hospitals in Wuhan as well as in Lombardy were for a while overwhelmed the further outbreak has been slowed if not stopped.
(Wuhan is notorious for air pollution but Lombardy is not. The theory that air pollution has contributed to the high number of severe cases in both regions is thus not confirmed.)
Lockdowns have been ordered in several European nations and in several U.S. states. Boeing and other companies have shut down their production facilities in Washington state. Many people are now unemployed. The situations in various states look dire.
But the lockdowns work and they will limit the rise of the current wave.
The question is now when to lift a lockdown. While twelve days are sufficient to stop an explosive rise in new cases they are likely not sufficient to stop the wave. Another two weeks of lockdown is probably required. After that the restrictions will have to be lifted in several steps to keep the number of new cases manageable.
It may well be necessary to prevent mass events from happening for several more months. Some travel restrictions are also likely to be kept in place. People will be able to get back to work but large meetings should be avoided. Using masks should become a social requirement (see below).
Instead of locking down whole populations one will have to find and lock down clusters.
The health care system needs a new branch that can take care of Covid-19 cases without the danger of infecting other patients. China established local fever clinics where people with flu or Covid symptoms can get tested. Those who have Covid must then be isolated for two weeks to prevent further infections. Their contacts must be actively traced. People who have come into near contact with an acute infected person are part of the cluster and must also be tested and isolated. Those who are put into isolation must be paid. Otherwise some will avoid it and will continue to spread the virus and disease.
These measures can be intensified or relaxed as needed. Their purpose is to keep the number of severe cases manageable. If the system works well we might even be able to eradicate the virus.
We now have tests for the antibodies people develop while they have the disease. Mass production has started. These tests will allow us to identify those who are no longer in danger when they handle a Covid patient.
There are signs that children often have carried the disease but were little affected by it. The antibody tests will show how many of them are already immune. The larger their number the better for the rest of us. Mass testing also seems to show that there are a quite a large number of asymptomatic cases among grownups who nonetheless infect others. We should find some measures to prevent that.
A current paper published in Lancet argues that everyone should wear a mask:
Evidence that face masks can provide effective protection against respiratory infections in the community is scarce, as acknowledged in recommendations from the UK and Germany.
However, face masks are widely used by medical workers as part of droplet precautions when caring for patients with respiratory infections. It would be reasonable to suggest vulnerable individuals avoid crowded areas and use surgical face masks rationally when exposed to high-risk areas. As evidence suggests COVID-19 could be transmitted before symptom onset, community transmission might be reduced if everyone, including people who have been infected but are asymptomatic and contagious, wear face masks.
Wearing a mask helps with protecting oneself but even more importantly helps to protect others. One might be carrying and spreading the disease without knowing it. We all release fine droplets when we speak, sneeze or cough. Masks prevent one's droplets from spreading out.
The viruses are quite small and could slip through the pores of a mask. But the droplets they are carried with are larger and are less likely to come through. There are also suggestions that one virus alone is less likely to do harm and that a significant load of viruses is required to start the disease.
There are some cultural consideration that support the call for everyone to wear a mask:
The contrast between face mask use as hygienic practice (ie, in many Asian countries) or as something only people who are unwell do (ie, in European and North American countries) has induced stigmatisation and racial aggravations, for which further public education is needed. One advantage of universal use of face masks is that it prevents discrimination of individuals who wear masks when unwell because everybody is wearing a mask.
There is currently a shortage of professional masks and those that are still available are needed in our hospitals.
But one can also use a scarf, sew oneself a mask or make one's own masks from household items. None will be as good as a professional masks but all will help to keep the number of cases down.
Viruses do not like heat. Soap breaks them apart. One can clean a mask by heating it in an oven at 70°C (160°F) or by washing it with soap.
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Previous Moon of Alabama posts on the issue:
- The Coronavirus - No Need To Panic - Jan 25 2020
- Novel Coronavirus Defies Conspiracy Theories As Data Shows Its Coming Decline - Feb 1 2020
- The Epidemic Recedes - Number Of New Coronavirus Cases In Decline - Feb 8 2020
- Coronavirus - Statistical Change Causes Confusion - New Case Count Continues To Decline - Feb 13 2020
- Coronavirus - The Decline Of New Cases Continues - Economic Ripples Begin To Emerge - Feb 21 2020
- As Virus Spreads Over The Planet Governments Are Slow To React - Feb 27 2020
- Coronavirus - Its Time To Press Your Government To React Faster - Feb 29 2020
- Coronavirus - Bad Preparation And Propaganda Increase The Onsetting Panic - Mar 6 2020
- Why Is The Coronavirus More Dangerous Than The Flu? - Mar 9 2020
- Coronavirus - The Hidden Cases - Why We Must Shut Everything Down And Do It Now - Mar 11 2020
- News-Nugget About The Coronavirus Pandemic - Mar 13 2020
- The Pandemic Will Cause A Global Depression - We Need Demand Side Measures To Counter It - Mar 16 2020
- Coronavirus - A Lockdown Is Not Enough - Mar 17 2020
- False Claims About The Novel Coronavirus And How To Debunk Them - Mar 19 2020
- Congress Grifters Profit From Crisis - Mar 20 2020
- Coronavirus - On Western Government Failures And Possible Therapies - Mar 21 2020
- Coronavirus - How To Lift Lockdowns And Why We Should All Wear Masks - Mar 23 2020
Posted by b on March 23, 2020 at 18:00 UTC | Permalink
COMMENTS SAMPLER
I hate to contradict you, but northern Italy (which definitely includes Milan/Lombardy) has some of the worst air pollution in Europe. The only similarly polluted zone is the coal region of southern Poland.
Posted by: Sam | Mar 23 2020 18:09 utc | 2
Proof of northern Italy's air pollution:
https://www.thelocal.it/20190228/po-valley-air-pollution-italy
Posted by: Sam | Mar 23 2020 18:10 utc | 3
The focus on air pollution seems wrong to me. It is a hypothesis, more than one actually. Short term pollution, medium term or long term? The question i would ask first is , what if in some regions the virus is effectvely much less dangerous. As in 30 times less.
Posted by: tuyzentfloot | Mar 23 2020 18:16 utc | 5
One very interesting question for me is:
Is there a correlation between the positive test result and people who already had in their life an operation where a respiratory ventilation machine was used?
I personally know just one Person...Rand Paul!
That's how a respiratory therapist described his work with the "new" epidemic.
"Holy shit"
"your risk of mortality increases every day that you spend on a ventilator. The high pressures from high vent settings is pushing air into the lung and can overinflate those little balloons. They can pop. It can destroy the alveoli. Even if you survive ARDS, although some damage can heal, it can also do long-lasting damage to the lungs. They can get filled up with scar tissue".
Well, this is exactly also what DR. Owen Tsang in Hong Kong detected.
He described the "scar tissue" found on patients who whent through this nightmare but survived, as "pulmonary fibrosis".
The lung function on those people who survied still is 20-30 % reduced and those people get easily breathlessness and may have a relapse.
This totally bolsters also my theory that all this people who got tested covid 19 positive start to have a fear created by the believe to have a deadly virus in the lungs. In absence of any intelligent breathing technique which could master this situation they get a panic and after a while they cannot open their lungs anymore because of the overloaded static energy contraction in the lung tissue.
After that they get the respiratory ventilation treatment....with the above described problematic. Especially for old and prestressed people this is the end.
I see this as proof that the death of all this people who where tested positive is not caused by the virus!
And for this evil virus scam the whole world is forced to shoot down their economy to hunt a harmless virus for which many people all over the world already have the antibodies!
Posted by: Hempus | Mar 23 2020 18:17 utc | 6
Here's a report on the best scientific study so far on the virus. Important report, written in plain English
Posted by: Pundita | Mar 23 2020 18:19 utc | 7
There are theories that the Italian Covid-19 is a more virulent strain. That is important to investigate. Are there any genome analyses of the Wuhan vs Italian viruses?
If they are different strains and if the Italian cases began first, this would upend the bat to humans via pangolins theory.
Given China now reports the first 13 cases in Wuhan had no contact with the food markets in question - the whole origin of Covid-19 becomes more mysterious.
I realise this is Thought Crime because it raises the question of human deliberation if two strains appear or are released nearly simultaneously on opposite sides of the planet.
Then there’s the added early appearance in what seems like the Iranian parliament.
Confirming when those early cases occurred in Italy and whether the RNA of the Italian virus is different and if so in what way, is of vital interest.
Posted by: PJB | Mar 23 2020 18:20 utc | 8
Perhaps one should be careful with the "strange pneumonia" bit because the same argument has been used to link the coronavirus to the vaping illness.
Posted by: Jonathan W | Mar 23 2020 18:24 utc | 9
Nobody reads old threads, so my reply is here ....
@abierno | Mar 20 2020 21:49 utc | 412
Concerns are being raised regarding bankrupting a substantial portion of the population for a death rate far,far below that of the current flu virus, especially regarding children and the fragile, at risk population. Why is this happening?
We are concerned because far more people could die from Covid-19 than from all the flus combined this year. This would be true even if the Covid death rate proves much lower than the flu (and that is not established yet).
A paradox? No. Covid could have lower death rates but more people could still die of it. And that is because many times more people will be infected. Covid-19 is "novel", new to humans: few have much immunity to it.
According to the CDC, 160 million to 214 million Americans will be infected. Even the most optimistic assessment (160 million) means the novel coronavirus will infect more people in the US than will all the flus combined. Thus many more will die from Covid-19 than from all the flus combined: from 200,000 to 1.7 million Americans, according to the CDC.
Posted by: Cyril | Mar 23 2020 18:26 utc | 10
There is a bit more encouraging news tonight. the numbers for Italy have come down just a little bit more.
Restrictions on the other hand have got even tighter, now only people who do essential work are allowed out of their homes. As I mentioned yesterday in a post that got swallowed by the ether, Italy is going through some hard times financially. some self inflicted by governments spending more than the took in to stay in power and some because the banks refused to take a haircut. Many small businesses are just barely survive and a couple of months without income is going to really hurt.
Posted by: dan of steele | Mar 23 2020 18:31 utc | 11
No, China didn’t cover up the Covid-19 outbreak: An analysis
https://asia-review.com/2020/03/20/no-china-didnt-cover-up-the-covid-19-outbreak/
The above article is a concise and clear summary of the Wuhan timeline that debunks the idea that the Chinese govt initially covered up the outbreak. That disinformation is propagated by the NYT and US media.
Posted by: occupatio | Mar 23 2020 18:33 utc | 12
In the case of "Brave New World", the establishment knows how to cure pretty much any conventional disease. Then if you're in approved society you die around age 60 because of everything that's kept you alive and looking like 40.
I just read the book last month for the first time in 30+ years. It does belong on that diagram. And "1984" doesn't either, since it really doesn't deal with anything like infectious diseases--reread that about 2 years ago.
I've not read the other 2 outer books ever, but the movie of "Fahrenheit 451", which I just watched and Bradbury certainly had a hand in writing, has nothing to do with infectious disease.
There might be something in Camus' "The Plague" though. Haven't read that since the 1980s.
There aren't food shortages so not sure about the "Soylent Green" reference, yet at least. "Long's Run" is about killing people off at age 35, which I guess overlaps with "kill 80% of the poor workers", something the likes of Charles Koch certainly supports. So indirectly there could be a "Logan's Run" connection.
Gattica is just about favored people with the right genes, so an update of "Brave New World", without the highly literate "savage" as the main character.
I don't see how "The Matrix" relates, that's more about the material world's completeness being an illusion.
"Clockwork Orange?" A thug suppressed with mind control?
Haven't read "Lord of the Flies", but don't the kids worship a god of the island, and justify the horrors they commit based on that conception of god or a god?
Posted by: Jay | Mar 23 2020 18:34 utc | 14
@abierno | Mar 20 2020 21:49 utc | 412
regarding bankrupting a substantial portion of the population
I forgot to address this, so I will do it now.
Bankruptcy doesn't have to happen. Even a tiny fraction of the $trillions going to the 1% in the next few weeks will greatly help the 99%. The 99% will be helped, because the US is a democracy, right? Right?
Posted by: Cyril | Mar 23 2020 18:39 utc | 18
"Those who are put into isolation must be paid" is key factor.also if nothing else presence of mask can keep wearer cognizant of not touching face.
Posted by: kiawi | Mar 23 2020 18:43 utc | 19
@4
If you can, get one of these, and there are 110 volt UVC lamps also.
Posted by: Taffyboy | Mar 23 2020 18:51 utc | 21
Just a status report from my corner of the world, Evanston immediately north of Chicago.
Testing remains absolutely unavailable. Nursing homes are flatly denied testing. Nursing homes where outbreak is identified because residents have had healthcare elsewhere are flatly denied testing. Testing is for celebrities and those sick enough to be admitted to hospital.
Masks are completely unavailable. Not talking about N95. Any type of mask at all cannot be had. Basic dust masks are way better than nothing. Hardware store told me they won’t order any more because either the employees steal them or they are stolen first while in transit. And yet no masks at all are seen on the street. Hoarders have all of them.
Lots of people seen doing something Americans never do. Walking. With all entertainment venues closed nothing left to do but walk. Pretty clear that many do not know how, they are re-learning as if children. Everyone maintains the six foot distance when passing other pedestrians. Wear a mask (simple homemade) and people cross the street to avoid you. Catcalls telling the mask-wearer to stay home.
Posted by: oldhippie | Mar 23 2020 18:52 utc | 23
@dan... i would be feeling a bit anxious in that environment as well..
Posted by: james | Mar 23 2020 18:53 utc | 24
Cyril 10,
I would be sceptical of anything published by politically compromised US institutions. They are not reliable. If the US could corrupt the OPCW, image how easily they could corrupt their own institutions if it was to their benefit. And we know that they are using this "crisis" to "bail out" their major corporations and banks - again. The virus may be real, but so are the sharks causing the excessive panic. Face it. The US is a cesspool of lies and corruption from Boeing to Pompeo.
Posted by: Blue Dotterel | Mar 23 2020 18:56 utc | 25
^5000The arch-hypocritical corporate media are our worst enemies.
They shamelessly block truth, peace, equality, and true democracy.
They are shills for those who murder the environment with impunity.
It's time you embrace YOUR media, the citizens' press.
Be sure to support the Greanville Post. If not you, who will?
"b" is Moon of Alabama's founding (and chief) editor. This site's purpose is to discuss politics, economics, philosophy and blogger Billmon's Whiskey Bar writings. Moon Of Alabama was opened as an independent, open forum for members of the Whiskey Bar community. Bernhard )"b") started and still runs the site. Once in a while you will also find posts and art from regular commentators. You can reach the current administrator of this site by emailing Bernhard at MoonofA@aol.com. 
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
A mask could easily become a form of good manners. Unless you're a superhero
Posted by: tuyzentfloot | Mar 23 2020 18:06 utc | 1