People are reaching out to me multiple times a day concerned about me here in Italy. So I just need to say, I’m fine. It’s not anything like the media has been describing. Though it might become that way soon; that’s actually changing while I’m writing this, so I’ll tack that on the end.
Italy is doing a pretty damn good job, IMO. There is honestly no other country I would rather be living in during this.
Tuesday all of Italy entered a “Lockdown” — as multiple English language headlines called it. A misleading term to say the least. It implies we’re all quarantined, and in fact Colbert and others started calling it a nation-wide quarantine shortly after. This is not the case, though as I mentioned, a new law today might change that.
As of yesterday, we’re just supposed to stay in our “community” and be able to justify travel between regions. Work is a justification, for example. Additionally, some “common sense” rules. School closures have been extended. Clubs are closed. Businesses are to minimize crowds.
For a while here the virus has been a major topic of conversation. Not panicked, just everyone was very aware. Though we were also still saying goodbye with a kiss on each cheek at the end of those conversations.
Now everyone is actually making adjustments to their lives. But I have to say– it’s not that bad! These “inconveniences” are things I would put up with if they even saved one life. At this point all we can do is slow the spread; doing so will save lives.
Businesses minimizing crowds
This means people wait outside the grocery store so it’s not crowded inside. Quite the visual, but then you don’t wait at the cashier, so it’s not that bad. And appointment businesses are to stagger appointments to avoid crowds in waiting rooms.
Yesterday (Wednesday) I was at the dentist. I was the only one there (plus the dentist and hygienist). Normally there are a few people in the large waiting room. Tomorrow I had a chiropractor appointment at 9. He moved me to 10:30 for the new staggered schedule. Frankly, he is always running very behind so this is a positive for me, haha. I also have a consultation Friday; that one looks like it will move to Skype. I had my nails done Tuesday. Most people’s arms are not long enough to keep the recommended 2 meters apart. So they gave everyone a mask at the door and no one inside ever lowered or removed their mask.
Still imagining me locked in my apartment? We also went on a picnic Monday. We are not under quarantine. But I’ve still never been within 2 meters of any human outside my family without them wearing a mask (I can hardly wear a mask myself at the dentist).
School closures
The change that affects me most (by a mile) is the schools being closed. I now have two small children to entertain all day. And I have to feed them all their meals! Che palle! I miss the hours I could expect them to be under their teachers care and plan non-mom tasks. And I miss knowing they were eating healthy 4-course lunches that I didn’t have to cook. I miss how much easier they were to entertain at home when they hadn’t already been home all day (for days in a row).
Still, as my kids are 1 and 4, this just puts me on level with every American mom who is stuck with their little angels until they can go to kindergarten at age 5.
Corona virus in Italy
My husband, an ICU nurse, has been following every minute update for months. He’s normally not one to be particularly glued to his phone, but he is these days. As such, I’m about as informed as any non-virologist out there. He’ll tell me about new studies published the day before over breakfast. Then I see the same thing on Twitter that night. I. Am. Informed. If information is more that 24hrs old, don’t bother sending it to me, I’ve seen it.
A summary of the outbreak in Italy
In January, we had 3 cases. A couple from China on a bus tour and one of the passengers on the government flight evacuating Italian Nationals from China. Later an additional single case on a second evacuation flight. The evacuees are not interesting because they got it in China and were quarantined the second they set foot back in Italy.
The bus tour couple was cared for here in Rome. The rest of the bus was quarantined in an out-of-use hospital that was converted for them; no others got sick; they’re all home now. The couple are still recovering here but doing well.
Yes, it takes that long. If you think it would be better to get it now before the peak, you’re wrong. Get it now and you will still be sick at the peak.
Back to the history summary. We went a month with just that one couple. During that time anyone who even sneezed and had any connection to them (e.g. was in the same hotel, even a different floor) was tested. Anyone with cold symptoms and an Asian face was tested. Anyone with cold symptoms that could claim any connection to Asia was tested.
Then everything changed the weekend of February 22. In a day we went from 4 to 11 cases. By Monday, 124.
These were all in small towns in the north. One town at the center of the outbreak is Vo’ Euganeo, a small town of 3k people in Veneto near Venice. The other is Codogno in Lombardia near Milan. These new cases didn’t have any connection to China. In Vo’ Euganeo none of the 3k residents had any connection to China. It was obvious the virus had been circulating and was estimated to be the 3rd or so generation.
The government reacted quickly. Venice carnevale (a big deal, possibly the most famous carnevale celebration after Rio) was cancelled. Fat Tuesday was February 25, so we’re talking very short notice. Schools all over the north closed — including for my poor pregnant sister in-law with her not-one-to-sit-still-at-home toddler.
Experts continue to try to track infection for the sake of understanding this new virus. For example, in that little town of 3k people they tested every soul to understand it better (89 were positive, that number has stayed stable). But now the focus has shifted from following the chain to slowing the spread.
Since that carnevale weekend, things have basically been growing at the expected exponential rate. Anyone who is calls Italy a “failure” is not particularly informed. Here you can see a table of cases in Italy compared to Germany, offset by 8 days. The missing numbers for Germany since that table was made are: March 9: 1224, March 10: 1565, March 11: 1966. They are exactly following our numbers.
Someone also made it a chart and included more countries. You can see every western country is basically doing the same.
Source image: https://pbs.twimg.com/media/ES31or1UYAEY3Ih.jpg
Note, the growth is exponential while the lines are straight because the y-axis of that chart is on a logarithmic scale. That means it is increasing by a multiple (in this case 10) rather than a number. The bottom of the chart is 100, halfway is 1,000, the top is 10,000. If your rusty on logarithmic and exponential growth and how they graph, this video is a nice refresher. And even if you’re not rusty, it’s a lovely visualization that makes a satisfying watch.
https://kottke.org/20/03/exponential-growth-and-epidemics
Back to the summary of what has been happening in Italy.
For a while the outbreak kept itself largely to the north. And the situation sounds much more dire there. We had a few cases here in Rome. On March 4th the city announced that all schools would be closed starting March 5th until at least the 15th.
Then Tuesday (March 10th), the so-called “Lockdown” went into effect nation wide. It was partially leaked and there was some panicking Monday night from people who thought it was going to be an actual quarantine.
There have also been prison riots. I confess I have not been following those stories. I believe the first ones were protesting limits to visits. I assume now it’s the opposite, that the prisoners are afraid they are primed for an outbreak and won’t get access to care.
Wednesday (between me starting this and uploading it) a new law went into effect which is much closer to a nation-wide quarantine. We’re really supposed to stay home now — except for work, medical reasons, or to buy necessities. Businesses are closed except those selling said necessities: supermarkets, pharmacies, Tabacchi, and some others. And only one person from the household is supposed to do that shopping. There are various restrictions on cars designed to limit travel.
I just got my nails done in the nick of time! My chiropractor appointment was cancelled. We’re not supposed to go outside for non necessities. It’s not clear if airing out children qualifies. We’re going to keep bringing them outside once a day at least to the building courtyard or roof or linger for a bit on the way to their Nonni. Places where there isn’t another soul anywhere near.
For our family, I believe our biggest risk factor is the same as it was before: getting it from Daniele. At the start, about 10% of infected in Italy were healthcare workers. Now it’s 13%. Maybe that number is inflated because it’s more clear when they’ve been exposed and they are tested. But either way.
As for us infecting other people… The vast majority of people that the girls and I interact with are from school. For them, their classmates. For us, their teachers or the other parents for a coffee after drop off. So that’s stopped. I stoped going to my co-working space a little while back. I normally would see my chiropractor twice a month, my manicurist once a month, and most weeks some other appointment (dentist, electrician, etc) — that’s all on pause and (stiff neck aside) I won’t miss those. Daniele normally does the shopping and I mostly keep in touch with friends on Slack, WhatsApp, Skype, and Hangouts for years now. I don’t interact with a lot of people in my normal life, and these small changes have effectively made it 0 outside Daniele, the girls, and Daniele’s parents. The x-factor here is my in-laws who could more-or-less be considered part of our nuclear family. I believe they are being more careful now for the sake of the girls, but I don’t know everything they do.
These changes from yesterday are pretty “drastic”. But it’s still not that big a deal. It’s not that different from when we keep the kids home for a cold normally. Frankly, its easier than being snowed in after a blizzard (we have power, we can go to the store). And it’s much easier than the extended power outages and fuel shortages in NJ after Sandy (what I time for me to go home for a visit!).
The Italian health care system
Switching gears back to Italy. Italy has a very good health care system. I’ve been living here 10 years — through surgeries and baby deliveries and plenty of preventative care. I get better care here than I did back in California with my fancy Adobe health insurance that even paid for massages in full (if done at my chiropractor’s office).
When people say Italy has one of the best health care systems in the world, it’s actually true. The best jobs in Italy are government jobs. And the best position for a doctor (or nurse) is a contract with the public healthcare system. So by having the best doctors, the public system keeps from being a system for the poor. There is a parallel private system. We sometimes use it because it’s not that expensive and the experience is what I imagine celebrities get in the US. Some public hospital doctors keep a private office one day a week (my gynecologist does this). But if the richest man in Italy needed bypass surgery, he’s having it done at a hospital (every hospital is public even the Catholic ones).
The situation in Italy
I’m pretty aware of the situation in Rome because of Daniele. For what’s happening in the North, I only have the same news and doctor Facebook posts that everyone else does.
Rome is nothing like what the doctors are describing up North. Just like NJ is not like Seattle (yet). Every US news story that describes the situation “in Italy” based on the doctors up north are misrepresenting us, IMO.
How is it possible to be fine here and a “war” up there?
Supplies are owned by the regions. I’m in Lazio (central Italy), Tuscany is directly north of here (where Florence is). Lombardi (Milan) and Veneto (Venice) are way up North. So while we’re sharing… Rome’s not about to give them everything just like the rest of the US isn’t offering everything to Seattle.
Couldn’t we at least move them to our empty hospitals? Nope. The pneumonia you get from corona is serious enough that patients can not be moved 5hrs away.
The response in Rome
Here in Rome the plan is to dedicate entire hospitals as either corona hospitals or clean hospitals. The first corona dedicated hospital has already been completely evacuated and has about 100 corona virus patients. This is almost all of Lazio’s infected; a few can not be transported. The second corona hospital is currently in the process of completely evacuating the normal patients.
Daniele works in the ICU of Ospedale San Giovanni, which for now is dedicated clean. There is a plan for converting more clean hospitals as needed.
If you come to the San Giovanni ER as a potential corona patient, you are sent to a temporary structure that’s tented and all the staff are in full gear. There you will be screened (temperature, chest x-ray, etc) and probably tested. If you’re in critical condition, you’ll be treated in an isolated area.
For non critical patients, the tests can take a day to come back. If you are not in critical condition and you live alone, you’ll optionally be sent home on quarantine. They add your info to an app where you check in every day. You can stay home using the app while “healthy” even after testing positive. If that’s not practical for you, you get a bed in that temporary structure. If positive, you’ll go to a dedicated corona hospital.
If you come to San Giovanni with something like a broken leg, you are sent to the regular old ER. The staff here are still in full protective gear. You’re screened just the same. Assuming no fever or anything, you proceed through the process as normal (just getting you temperature taken more). If you need surgery, there will be more screening than normal, specifically a CT scan.
Staff outside the ER like Daniele, who works in a sub-department of the ICU for post-surgery patients, wear more protective hear than they used to (masks and goggles) but not the whole suit that the ER wears.
That’s where we are now.
However, exponential growth means things aren’t just changing quickly, the rate of change itself is increasing. Before February 22, our only cases were still just that one Chinese couple. Our schools closed March 5th. The first official nation-wide restrictions were put into law March 10. Then March 12 every non-essential business was closed.
There is nothing unique about Italy. There has been no particular failure of the government here. Granted, that’s cheeky of me to say when people have died. But I think there would have been riots if they had tried to close everything down sooner (or it would have just been ignored).
So to reiterate, we have actually had to make some drastic changes in the past few days. But other than getting less kid-free time, my life has not actually changed much.
