by Rachana Raizada for The Saker Blog

A few days ago, I walked down the street to the supermarket to buy food past glittering skyscrapers, the seat of Lombardy’s regional government. According to an interview in the New York Times [1] with the region’s President Attilio Fontana, on the sixth floor, “two dozen epidemiologists and public health experts form the nerve center of the effort to contain a coronavirus outbreak in Italy…They track those whom infected people might have had contact with.” Really? A telephone prevents illness? Of course, contract tracing is extremely important. But once you find infected people, what preparations have you made to deal with them? Fontana forgets to mention this minor detail to the NYT.

A man sitting on a bench grumbled: “Why is everything closed?” he demanded angrily. “Do you know anyone who is ill?” Three passersby shook their heads. As we stood (one metre from each other), we agreed that we don’t know anyone who is ill, nor does anyone we know know anyone who is ill with Covid-19 (the disease) or who’s tested positive for SARS-CoV-2 (the pathogen). Of course, this charming vignette is no longer possible. Now I can only go out for necessities: food, medicines, work (although all non-essential consumer-facing businesses are shut)…or cigarettes. Before I can go out, I have to download a form, copy it out (because I am not a prepper who stockpiled printer toner), provide proof etc. Just finished listening to a long legal audio explaining what to do if stopped by police. But Italian police are generally friendly. I digress.

Wait! Wasn’t it China who’s authoritarian? I’ve been stuck at home since Feb 23 with rules changing at dizzying speed and getting more draconian by the minute and red zones (now “security zones”) extending from 11 tiny towns nobody had heard of, to Lombardy and Veneto, to the whole country.

So what is the problem? Why is Italy shut down?

March 11, 2020: Italy: 827 deaths; 12,462 positive cases. 75% of deaths are in Lombardy, one of the richest regions in the world, with one of the best healthcare systems in the world: Italy’s healthcare systems are managed regionally; in Lombardy by the right wing Lega government led by Attilio Fontana. Lombardy has 16% of Italy’s population. The deaths and intensive cases are concentrated (for now), not in Milan but in a handful of hospitals in the provinces of Lodi and Bergamo. Sadly, among the hospitals which have the most intensive care beds in all of Italy. On March 8, only Lombardy and Veneto were shut down, but by March 12 all of Italy was shut down based on the fear of what could happen if the epidemics broke out in less well equipped Southern regions.

In his 2am press conference of March 9, 2020, Italy’s exhausted PM Giuseppe Conte explained the harsh measures by reminding Italians the constitution guarantees the right to healthcare for anyone on the territory. So that’s why a whole country has been shut down (at a minimum cost of €25,000,000,000 minus interest) to limit social contact among people outside hospitals so people don’t end up inside hospitals.

But! Let’s look at deaths which brought Italy to crisis point: The average age of the deceased was 81, the average number of pathologies observed in this population was 3.4 (median 3, standard deviation 2.1). The most common comorbidities for these patients included hypertension, diabetes, etc. [2] Doctors have emphasized in media interviews that while the deceased tested positive for the coronavirus before or after death; it cannot always be ascertained they died because of it.

Where did all these elderly ill patients in Italy catch the coronavirus?

“In China, human-to-human transmission of the COVID-19 virus is largely occurring in families. The Joint Mission received detailed information from the investigation of clusters and some household transmission studies, which are ongoing in a number of Provinces. Among 344 clusters involving 1308 cases (of a total of 1836 cases reported) in Guangdong Province and Sichuan Province, most clusters (78%-85%) have occurred in families,” says WHO.[3]

Wait! Didn’t Fontana say that he’s tracing contacts? Have these elderly patients with diabetes been out enjoying the nightlife? Did they catch the virus from their Filippina caretakers (in Milan, “Filippina” is an occupation, not a nationality) or from family members? Interestingly, l’Istituto Superiore di Sanità (ISS) appears clueless. After making a vague statement about a person from Iran who is not connected to anything, the Institute claims (in translation): currently it is not possible to reconstruct for all patients the chain of transmission for all patients. The majority of the cases in Italy have an epidemiological connection to the clusters observed in Lombardy, Veneto and Emilia Romagna (i.e. they are not connected epidemiologically to the first three cases treated in Rome involving persons who had travelled to China.

OK. But is it rocket science to exclude the closest contacts of the deceased who were elderly and/or deceased? Surely they must have been tested? Where do elderly, ill people spend a lot of time?

When Fontana gave his interview to the New York Times, it had been over a month since the Wuhan lockdown was announced on January 23. We saw the frightening images splashed by corporate media throughout the world. The media tell me: China lies. Ok. But do we remember what happened in 2009 with H1N1? By the time a virus is identified, the cat’s out of the bag. It’s not about open or closed borders. Venice was a global trading centre long before Columbus “discovered” the Americas.

WHO declared the outbreak a Public Health Emergency of International Concern on 30 January 2020, having issued testing guidelines on January 27, 2020: “A patient with severe acute respiratory infection (fever and at least one sign/symptom of respiratory disease (e.g., cough, shortness breath) AND requiring hospitalization AND with no other aetiology that fully explains the clinical presentation.”

So what emergency procedures did Lega prepare for Lombardy since the end of January? Attilio Fontana forgets to mention this minor detail to the New York Times. (Yes, I know already said this).

The initially (but no longer) presumed “patient zero” presented himself at a hospital in Codogno in mid-February for fever and respiratory issues. He’s a 38 year old soccer playing, marathon runner who can’t battle what seems like a regular flu. But with headlines screaming about coronavirus, not only is he not tested, he is put into an ICU…tragic events followed. Conte wanted to investigate the hospital, Fontana refused and the overworked doctors and nurses in the field got infected, the crisis exploded.

But not only in Codogno. Even as La Repubblica reported on February 28 [5] that oops, doctors had been noticing anomalous pneumonia cases since the middle of January 2020, the same sad story was now replicating in Bergamo in tragic and epic proportions with large numbers of medical operatives among the infected. [6]

Since January, the Lega’s Matteo Salvini has been one of the most vocal critics of China even going so far as to link African migrants to the virus. But the “China connection” proved to be a wild goose chase that allowed the virus to spread. A paper published by Rome’s Spallanzani Institute tested 126 patients primarily those with connections to “Asia” and suspicion of a viral aetiology.[7] Only three were confirmed to be infected with SARS-CoV-2 while 53.2% of the patients resulted positive for other respiratory pathogen(s).

Let’s recheck our timeline: Dec 26, 2019, Jixian Zhang notices a cluster of 4 anomalous cases of pneumonia, 3 within the same family and reports them to the local CDC the next day. By December 31, 2019 WHO reports this to the world. By January 7 China had identified the virus, by January 12 the first 2019-nCov (later renamed to SARS-CoV-2) and by January 13, the first test kits were available.

But screaming media headlines didn’t mention any of this, and for doctors in Lodi and Bergamo didn’t do anything special about the strange cases they had noticed since the middle of January. To be clear: I am not blaming overworked medical staff on the ground; I am talking about the preparedness of the regional health authority of Lombardy, especially since medical staff have tested positive for the virus because they have been working without proper equipment”

While the Italian media snickered (with a touch of envy) at China’s temporary “hospitals” built in 10 days, Wuhan implemented this system: you go to special testing clinics; wait 4 hours for results. If positive you either go a) hospitals for people over 65 and/or with other complications; or b) to these temp isolation structures intended as a caring space for those who live alone but need hot soup brought to them and for those who don’t want to infect their families. They were built in 10 days because they were intended to be destroyed afterwards. Today’s Corriere reports that Italy is following the “Wuhan Model” in its famous trade centre, Milan’s Fiera. Which, presumably is not going to be destroyed afterwards.

While the national government has been firefighting a serious health crisis non-stop, Lega has been ferociously witch-hunting: demanding the quarantine of schoolchildren returning from China and wasting resources on hunting down “patient -1” a non-existent hypothetical figure with connections to China who infected our marathon man in Codogno.

It’s not a crime if an epidemic broke out in hospitals with overworked staff. It is a crime to refuse an investigation. To try and distract attention from the epidemics inside the hospitals by demanding that effectively, martial law be declared in Lombardy and parts of Veneto, Lega’s dream of Padania. By relentlessly attacking Conte’s government every day while the tragedy unfolds in Lombardy.

The New York Times noted, “Mr. Fontana is a leading member of the League party, led by the nationalist Matteo Salvini, who has not been shy about leveraging the crisis to pursue his aim of bringing down Mr. Conte’s government.” While discussions were ongoing on March 7 on how to create a delineated zone to limit social contacts without imposing on civil liberties, CNN published a leaked draft of a decree stating it came from Fontana’s office. The Region of Lombardy denied it.

Woohoo, a choice between believing CNN or the League / Lega. While the Lega was busy creating panic and chaos in Lombardy, Salvini was running around giving international interviews to the likes of El Pais to complain about the Italian government.

When this is all over, it will be Conte’s signature on all the decrees and there will billion dollar debts to be repaid. The finger pointing and blame game will start in earnest. But every cloud has a silver lining. The ever calm and rational Foreign Minister of Italy, Luigi di Maio of the Five Star Movement has been quietly working diplomatic channels in the background even as Matteo Salvini slams China in the global media. Last night, a team of medics arrived from China with 31 tons of medical equipment. Ultimately it is China, with its gift of 1,000 respirators to Italy which will allow the residents of Padana to breathe. Literally. The irony. But then again, doesn’t Venice have an airport named after Marco Polo who is connected to some Chinese noodle stories?

We are one species, our most dangerous enemies, apart from diseases and pollution, are those who live amongst us and would exploit a crisis while we battle a common threat.

The Lega Nord got their Padania for one day on March 8, 2020 and it was an absolute disaster.

About Rachana Raizada: I enjoy my day job, dancing, cycling, football, lectures on architecture, lots of things…. I was motivated to air my private views on politics in public only because I am seriously worried about how the media reports and does not report the news. I have no political affiliation.

References:

[1] “Italy, Mired in Politics Over Virus, Asks How Much Testing Is Too Much”, Jason Horowitz, February, 2020, New York Times.
[2] https://www.iss.it/en/comunicati-stampa/-/asset_publisher/fjTKmjJgSgdK/content/id/5286166
[3] https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf
[4] https://www.epicentro.iss.it/coronavirus/bollettino/Bollettino-sorveglianza-integrata-COVID-19_09-marzo-2020.pdf
[5] https://www.repubblica.it/cronaca/2020/02/28/news/_polmoniti_anomale_a_meta_gennaio_cosi_e_nato_il_focolaio_di_codogno_-249759796/?refresh_ce
[6] https://bergamo.corriere.it/notizie/cronaca/20_marzo_12/coronavirus-focolaio-bergamo-camere-mortuarie-strapiene-sottovalutato-contagio-val-seriana-ora-ci-sono-142-morti-550a66fe-6454-11ea-90f7-c3419f46e6a5.shtml
[7] Differential diagnosis of illness in patients under investigation for the novel coronavirus (SARS-CoV-2), Italy, February 2020, Licia Bordi¹ , Emanuele Nicastri¹ , Laura Scorzolini¹ , Antonino Di Caro¹ , Maria Rosaria Capobianchi¹ , Concetta Castilletti¹ Eleonora Lalle¹ , on behalf of INMI COVID-19 study group and Collaborating Centers2 1. National Institute for Infectious Diseases ‘Lazzaro Spallanzani’ IRCCS, Rome, Italy and 2. The participating members of INMI COVID-19 study group and Collaborating Centers

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