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Coronavirus skyrockets in Italy; cases surge from 3 to more than 200 in a few days Surprised by coronavirus, Italy locks down — for now
(32 minutes later)
ROME — In an unnerving four-day span, the coronavirus has arrived with force in Italy, with case numbers spiking almost hourly and the virus jumping from one region to the next across the country's north. ROME — Checkpoints block entry to a dozen towns across northern Italy. Milan's landmark cathedral and opera house lie empty. Venice's Carnival is ordered closed two days early. Schools are shuttered, soccer matches called off.
And for a nation racing to piece together how it happened and how to contain further spread, even the most basic questions give a sense of the challenge: Officials still are not sure how the virus arrived in the country. For much of the past month, the fight to contain the coronavirus has depended largely on China, whose authoritarian communist government has relied on high-tech surveillance and tight restrictions on the movements of hundreds of millions of people.
“Looking for [patient zero] makes less sense by the day,” said Giulio Gallera, health chief of the Lombardy region, where the majority of Italy’s cases are located. But as the virus jumps to other parts of the world, the fight is entering a new phase, testing the extent to which democracies are able or willing to curtail freedoms and impose sustained restrictions of their own.
Italy’s experience — with more than 200 confirmed cases as of Monday and six deaths — shows how the virus can slip onto a new continent undetected, only to then erupt as a sudden crisis, while bringing with it the interruptions and fears that once seemed far away. Italy, where confirmed cases jumped from a few to more than 200 in a matter of days and six people have died, has responded aggressively. Checkpoints outside hotspot towns are allowing only those with special permission to enter or leave.
Four days ago, Italy had only three confirmed cases of the virus. Now, it has the largest known outbreak outside Asia, pushing the world closer to a pandemic, in which epidemics spread across multiple countries and continents at the same time. South Korea has avoided China-style bans on movement — asking, not ordering, residents of the hard-hit city of Daegu to stay indoors.
And although China has tried to restrict the virus’s spread with forceful controls in Hubei province, its arrival in Italy brings new complications, testing whether a democratic government is willing to impose its own prolonged restrictions. A sustained outbreak also was expected to deal a blow to the Italian economy, which is the fourth-largest in Europe but weakened by two decades of stagnation. But hanging over such tactics is the question of how the people will respond if the measures persist for weeks or longer — particularly in Italy, where the fractious government is subject to constant second-guessing and the economy was teetering on recession before the virus erupted.
Containing the virus in northern Italy is no given: Milan, the city closest to the outbreak, has Italy’s second-busiest airport and rail connections in all directions, including dozens of daily high-speed trains to Rome. “I don’t think it is wise to stop the whole of Italy for two or three months and put the economy on its knees for a problem that is big but not so big,” said Andrea Braga, 55, who owns a bar in Casalpusterlengo, a sealed-off town outside Milan.
If the virus expands across Italy, neighboring European countries will face pressure to back away from this continent’s open-border ideals in the name of security. Or the coronavirus will pop up elsewhere across the continent as it did in Italy: without much warning. Some infectious-disease experts have speculated that the virus was already in Italy for weeks, carried by one or more people with negligible symptoms, before it was detected. When the threat of the virus felt remote, democratic countries including the United States imposed controls on people returning from China. Italy went a step further, banning flights to and from the country. But now that the virus has gained a foothold in Europe the focus has turned to the normally permeable borders within the continent, and authorities across the bloc are scrambling to prepare.
In recent days, Italy has scrambled to close off a cluster of small towns south of Milan, some of the primary hot spots. Police have set up checkpoints outside those areas, and only people with special permission can enter or exit. Video from inside those towns shows largely deserted town centers, except for the occasional person walking a dog or searching for a mini market to buy groceries. One church, where a funeral was scheduled, allowed only family members inside. If the virus expands across Italy, neighboring governments could face public pressure to back away from the continent’s open-border ideals in the name of security. European officials in Brussels on Monday emphasized there was no plan to close borders.
“All the things you used to see in films that are far from us, now you see them here,” said Carlo Benuzzi, 56, a shop owner in the sealed-off hot spot town Codogno who is friends with one of the first Italians to contract the virus. The coronavirus could pop up elsewhere as it did in Italy: without much warning. Some infectious disease analysts have speculated the virus was in Italy for weeks, carried by one or more people with negligible symptoms, before it was detected.
At a closed church in Codogno, priests have been holding Mass by themselves. The diocese has ordered the closure to continue for at least two weeks, so Fabrizio Senneca, a church caretaker, dumped the holy water into a flower bed. German officials said this month they had contained a cluster of cases. But Health Minister Jens Spahn said Monday the country was now bracing for more infections.
“The atmosphere is pretty eerie,” Senneca said. “We are trying not to let psychosis take hold. I have very little to do.” The coronavirus has “arrived as an epidemic in Europe,” Spahn said. “So we must expect it to spread to Germany.”
Elsewhere across the north, most major gatherings have been called off, from soccer matches to school, and it is unclear for how long the closures will last. Milan’s landmark cathedral and opera house both shut down, and Venice’s Carnival was suspended two days before its planned conclusion. He said developments in Italy, where the chain of infection could no longer be traced, had changed his ministry’s assessments.
On Monday morning, Italy’s stock index opened down 3.5 percent, as traders worried about sustained interruptions in the country’s economic and industrial heartland. As people prepared to hunker down, grocery stores were picked dry in Milan, and people raced to scoop up masks and hand sanitizer. Germany, has recorded 16 coronavirus infections, 14 of them linked to employees of a car parts manufacturer in the southern region of Bavaria. No new infections have been detected for more than two weeks.
“Half of Italy in quarantine,” a headline in one of the country’s major newspapers, La Repubblica, said Monday. Lothar Wieler, president of the German government agency responsible for disease control, said he expected the virus to spread.
In the capital of Rome, which is three hours by train from Milan, life continued as normal, and only a few people wore masks. “When it comes to Germany, it will not go through Germany like a hurricane within two weeks,” he said. “It will hit different regions in succession.”
But some regions in the south mandated that people visiting from northern areas report to authorities or submit to a 14-day quarantine. Other countries were on guard as well. On Sunday night, trains heading through Austria to Italy were briefly halted while two passengers were screened for the coronavirus and tested negative. Monday, an Alitalia plane was held up in the island nation of Mauritius as authorities there requested that all passengers from Lombardy and Veneto either return home or be subject to quarantine. In Italy, the outbreak has come into view in a matter of days, with case numbers spiking almost hourly and the virus jumping from one northern region to the next. Most of the cases have been contained in Lombardy, in towns to the south of Milan, the country’s economic hub. The neighboring region of Veneto has a smaller cluster of its own.
For Italians, part of what has made the virus’s spread so vexing is the sense of uncertainty about how to stay safe. Authorities have talked about cases popping up that have no obvious connection to people coming from China or to people already infected. Officials have described closing towns as a short-term “sacrifice.” In a briefing Monday, Angelo Borrelli, Italy’s head of civil protection, referenced the trope that Italians can be “undisciplined,” but said they can be “very orderly” for the sake of a health crisis.
At first, Italian authorities had theorized that the infection was started by an Italian businessman returning from China, who in turn met with people in the hot spot towns south of Milan. But testing subsequently indicated that he had never carried the virus. Italians trapped in the hotspots have voiced little opposition. Videos from inside those towns show largely deserted town centers, except for the occasional person walking a dog or venturing to a mini market for groceries. One church, where a funeral was scheduled, allowed only family members inside.
Even without identifying how the virus started, Italian officials have managed to draw a partial picture of how it may have furtively spread before exploding into view. One of the first detected cases came from a 38-year-old who lives in Codogno, about 40 miles southeast of Milan. It is unclear when the man might have contracted the virus, but according to Italian officials and media accounts, he was active and social before a fever hit, meeting with people at bars and participating in running events, including a half-marathon, while visiting nearby towns that are now sealed off. “The atmosphere is pretty eerie,” said Fabrizio Senneca, a church employee in Codogno. “We are trying not to let psychosis take hold. I have very little to do.”
In turn, the virus was spread to his pregnant wife and to a fellow runner. A handful of health workers at the hospital where the 38-year-old was treated also tested positive. It was a sense of foreboding that made people willing to hunker down. Authorities say cases have popped up with no obvious connection to travelers from China or people already infected.
“The initial suspected patient zero was not the real patient zero,” said Carlo Torti, a professor of infectious diseases at Magna Graecia University in Catanzaro, in the southern region of Calabria. “The infection came from other people, and we don’t know — maybe a person coming from China. I think the more reliable explanation is that a person coming from the endemic countries was not detected and spread the infection.” “As always in Italy, individual behaviors are hard to govern,” said Giovanni Orsina, the director of the school of government at LUISS Guido Carli University in Rome. “But it feels to me like there is a willingness to compromise on freedom in the name of protection.”
Countries neighboring China have faced their own questions about how to safeguard themselves.
Japan is still debating the confinement of more than 3,700 people on board a cruise ship for two weeks in an attempt to contain the spread of the virus.
It was an attempt that critics say was unsuccessful — more than 700 people on the Diamond Princess ended up becoming infected anyway — and unnecessary: The virus was already spreading invisibly around Japan.
It was also dangerous, because it risked the lives of the many hundreds of elderly passengers, and, critics say, morally questionable, because crew members’ lives were put at risk by forcing them to continue working without isolation from each other.
Three passengers in their 80s have died, and at least 129 crew members have contracted the virus.
“Quarantine means, in other words, restrictions of human rights for some period — in this case, 14 days,” said Norio Ohmagari, the head of the National Center for Global Health and Medicine Disease Control & Prevention and a government adviser on the crisis. “I’m sure not all the Japanese people or the international community will agree with that, in terms of the consideration of human rights and human dignity.”
Shigeru Omi, head of the Japan Community Healthcare Organization and a senior government adviser on the crisis, said officials were “of course” sympathetic to the human rights of the crew. But he said they had to remain on board to serve the passengers.
Human rights also played a part in the decision to allow Japanese passengers to return home after their 14-day quarantine, Omi said.
While the United States and other countries have imposed an additional 14-day quarantine on people evacuated from the ship, Japan allowed its passengers to return to their homes if they tested negative for the virus. Authorities asked them not to leave their homes “unless absolutely necessary,” and to wear masks if going out.
“We strike the balance — on the one hand, we have to respect the human right of the movement of people, et cetera,” Omi said. “But also, we have to give focus to the public interest.”
Loveday Morris and Luisa Beck in Berlin, and Steve Hendrix, in Jerusalem, contributed to this report.
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