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Italy’s Elderly Suffer Heavy Toll as Coronavirus Spreads Italy’s Elderly Suffer Heavy Toll as Coronavirus Spreads
(2 months later)
MILAN — A table of old men were shooting the breeze next to the bocce ball courts in a Milan recreation center on Wednesday, talking, like seemingly everyone else in northern Italy, about the coronavirus outbreak that had shut down towns, closed all of Italy’s schools and claimed the lives of more than 100 people, almost all of them elderly.MILAN — A table of old men were shooting the breeze next to the bocce ball courts in a Milan recreation center on Wednesday, talking, like seemingly everyone else in northern Italy, about the coronavirus outbreak that had shut down towns, closed all of Italy’s schools and claimed the lives of more than 100 people, almost all of them elderly.
The men, mostly in their 70s and 80s, joked that their wives gave them a hard time for leaving the house (“not even the coronavirus can keep this guy home”), that life’s finish line was too close to get worked up about a contagion, that they had faith in northern Italy’s vaunted health care system.The men, mostly in their 70s and 80s, joked that their wives gave them a hard time for leaving the house (“not even the coronavirus can keep this guy home”), that life’s finish line was too close to get worked up about a contagion, that they had faith in northern Italy’s vaunted health care system.
But the bravado also disguised real concern.But the bravado also disguised real concern.
“It’s normal that I’m a little worried,” Antonio Di Furia, the club’s owner, 67, said. “I have heart problems.”“It’s normal that I’m a little worried,” Antonio Di Furia, the club’s owner, 67, said. “I have heart problems.”
Italy’s mortality rate in the outbreak, about 3.5 percent, is not much above the global average of 3.4 percent reported by the World Health Organization. But the virus is taking a disproportionate toll on the elderly in Italy, which has the oldest population in Europe, and the second-oldest in the world after Japan.Italy’s mortality rate in the outbreak, about 3.5 percent, is not much above the global average of 3.4 percent reported by the World Health Organization. But the virus is taking a disproportionate toll on the elderly in Italy, which has the oldest population in Europe, and the second-oldest in the world after Japan.
The number of coronavirus cases and deaths spiked again on Wednesday in Italy, which has reported 3,089 people infected and 107 deaths over all. Daily jumps have become the new normal.The number of coronavirus cases and deaths spiked again on Wednesday in Italy, which has reported 3,089 people infected and 107 deaths over all. Daily jumps have become the new normal.
The increases reflect what is known about the contagion, in which each person is thought to infect about two others. That means that even as Italy locks down towns — two more were added on Wednesday, bringing the total to 13 — the virus continues to spread.The increases reflect what is known about the contagion, in which each person is thought to infect about two others. That means that even as Italy locks down towns — two more were added on Wednesday, bringing the total to 13 — the virus continues to spread.
Italy’s measures have slowed the spread, but not enough to allay concerns about the burdens the virus is placing on the health care system and the threat it poses, especially to older people.Italy’s measures have slowed the spread, but not enough to allay concerns about the burdens the virus is placing on the health care system and the threat it poses, especially to older people.
“The measures introduced in these days have the aim of avoiding a large epidemic wave,” Italy’s National Health Institute said in a statement explaining its stiffening guidelines, which recommend personal separation as schools closed nationwide until at least March 15.“The measures introduced in these days have the aim of avoiding a large epidemic wave,” Italy’s National Health Institute said in a statement explaining its stiffening guidelines, which recommend personal separation as schools closed nationwide until at least March 15.
“In the case of the coronavirus we must take into account, moreover, that Italy has an elderly population, actually much older than the Chinese, and needs to be protected from the contagious,” it said.“In the case of the coronavirus we must take into account, moreover, that Italy has an elderly population, actually much older than the Chinese, and needs to be protected from the contagious,” it said.
About 23 percent of Italy’s population is 65 or older. The median age is 47.3, compared to 38.3 in the United States, according to the United Nations.About 23 percent of Italy’s population is 65 or older. The median age is 47.3, compared to 38.3 in the United States, according to the United Nations.
Many of those who have died in Italy already suffered from serious illnesses that put them in grave danger, then the virus “destabilized them,” said Walter Ricciardi, an official at the World Health Organization who is advising the Italian health ministry.Many of those who have died in Italy already suffered from serious illnesses that put them in grave danger, then the virus “destabilized them,” said Walter Ricciardi, an official at the World Health Organization who is advising the Italian health ministry.
The array of pre-existing conditions suffered by some victims, including cancer, diabetes and heart disease, has complicated efforts to assess the lethality of the virus.The array of pre-existing conditions suffered by some victims, including cancer, diabetes and heart disease, has complicated efforts to assess the lethality of the virus.
Angelo Borrelli, the head of Italy’s Civil Protection Agency who is coordinating the country’s response to the crisis, said Tuesday that of the people who died, “Most were over 70, and some had pre-existing conditions.’’Angelo Borrelli, the head of Italy’s Civil Protection Agency who is coordinating the country’s response to the crisis, said Tuesday that of the people who died, “Most were over 70, and some had pre-existing conditions.’’
‘‘But for the others,’’ he said, ‘‘we still aren’t sure.”‘‘But for the others,’’ he said, ‘‘we still aren’t sure.”
Lombardy’s president, Attilio Fontana, made a similar point in an interview last week. “All the deaths we’ve had are either very old people or very sick people,” he said.Lombardy’s president, Attilio Fontana, made a similar point in an interview last week. “All the deaths we’ve had are either very old people or very sick people,” he said.
The World Health Organization said that the case-fatality ratio was highly fluid and likely to change. Infections have probably been underreported, it said, given that many are asymptomatic or very mild.The World Health Organization said that the case-fatality ratio was highly fluid and likely to change. Infections have probably been underreported, it said, given that many are asymptomatic or very mild.
Some experts argued that the aggressive response by Italy’s northern regions had not only slowed the spread of the virus but had also brought down the death rate.Some experts argued that the aggressive response by Italy’s northern regions had not only slowed the spread of the virus but had also brought down the death rate.
“There was a huge expansion of the intensive care units,” said Fausto Baldanti, a virologist at the San Matteo Hospital in Pavia. “That can make the difference.”“There was a huge expansion of the intensive care units,” said Fausto Baldanti, a virologist at the San Matteo Hospital in Pavia. “That can make the difference.”
But the intense focus on the coronavirus in Italy is exacting a cost.But the intense focus on the coronavirus in Italy is exacting a cost.
Last week, an old man lost his balance and fell on a sidewalk in Casalpusterlengo, one of the northern towns quarantined to prevent the spread of the coronavirus. A neighbor, Noemi Carelli, called an ambulance, but said the usual emergency hotline automatically diverted to a recorded message about the outbreak.Last week, an old man lost his balance and fell on a sidewalk in Casalpusterlengo, one of the northern towns quarantined to prevent the spread of the coronavirus. A neighbor, Noemi Carelli, called an ambulance, but said the usual emergency hotline automatically diverted to a recorded message about the outbreak.
As the old man bled from his face on the street, she kept trying and finally reached the police, who dispatched an ambulance from a town miles away. “We have to hope that nothing else happens to us besides the coronavirus,” said Ms. Carelli, 45.As the old man bled from his face on the street, she kept trying and finally reached the police, who dispatched an ambulance from a town miles away. “We have to hope that nothing else happens to us besides the coronavirus,” said Ms. Carelli, 45.
The spread of the virus and the abundance of elderly patients have worried experts, many of whom are concerned that the outbreak threatens to monopolize the attention and resources of Italy’s public health system.The spread of the virus and the abundance of elderly patients have worried experts, many of whom are concerned that the outbreak threatens to monopolize the attention and resources of Italy’s public health system.
In the north, many hospitals have suspended all but the most urgent surgeries in order to free medical beds and other resources for acute coronavirus cases. Staff have canceled vacations and put in overtime.In the north, many hospitals have suspended all but the most urgent surgeries in order to free medical beds and other resources for acute coronavirus cases. Staff have canceled vacations and put in overtime.
Lombardy’s president, Attilio Fontana, said that the region is asking retired doctors and nurses to return to work. In Padova, the hospital pitched tents outside in preparation for an influx of cases. And on Wednesday, Italy’s government set aside a space for patients with the virus inside a military hospital.Lombardy’s president, Attilio Fontana, said that the region is asking retired doctors and nurses to return to work. In Padova, the hospital pitched tents outside in preparation for an influx of cases. And on Wednesday, Italy’s government set aside a space for patients with the virus inside a military hospital.
Raffaele Bruno, director of the infectious disease unit at San Matteo, said that a sudden burst in the number of cases would put an unsustainable strain on operations in the north. “If I have to admit 10 percent of them in the hospital and 2 percent goes to intensive care, I don’t have any more spots to take care of other patients who have other illnesses,” he said.Raffaele Bruno, director of the infectious disease unit at San Matteo, said that a sudden burst in the number of cases would put an unsustainable strain on operations in the north. “If I have to admit 10 percent of them in the hospital and 2 percent goes to intensive care, I don’t have any more spots to take care of other patients who have other illnesses,” he said.
Updated May 28, 2020
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
There is an uptick in people reporting symptoms of chilblains, which are painful red or purple lesions that typically appear in the winter on fingers or toes. The lesions are emerging as yet another symptom of infection with the new coronavirus. Chilblains are caused by inflammation in small blood vessels in reaction to cold or damp conditions, but they are usually common in the coldest winter months. Federal health officials do not include toe lesions in the list of coronavirus symptoms, but some dermatologists are pushing for a change, saying so-called Covid toe should be sufficient grounds for testing.
Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.
Speaking on Radio1, Alessandro Vergallo, the president of the national association of anesthetists, said that in Lombardy, “we can count the free spots in the hospitals on the fingers of two hands.” The health system can’t long survive under such conditions, he said.Speaking on Radio1, Alessandro Vergallo, the president of the national association of anesthetists, said that in Lombardy, “we can count the free spots in the hospitals on the fingers of two hands.” The health system can’t long survive under such conditions, he said.
Around Lombardy, elderly Italians expressed a mix of caution, fatalism and nonchalance.Around Lombardy, elderly Italians expressed a mix of caution, fatalism and nonchalance.
While the men in the bocce club shrugged off the threat, they did so next to empty courts and empty tables. Most of their friends had stayed away.While the men in the bocce club shrugged off the threat, they did so next to empty courts and empty tables. Most of their friends had stayed away.
“I think they’re scared,” said Annalisa Canato, 67, who sat by the bar. “For good reason.”“I think they’re scared,” said Annalisa Canato, 67, who sat by the bar. “For good reason.”
In Secugnago, a few hundred yards outside a checkpoint blocking the entrance to one of Italy’s locked-down towns, old men shrugged off the threat and said they often drank with friends who slipped out of the quarantined towns via country roads.In Secugnago, a few hundred yards outside a checkpoint blocking the entrance to one of Italy’s locked-down towns, old men shrugged off the threat and said they often drank with friends who slipped out of the quarantined towns via country roads.
“If it comes here and gets me, it gets me,” said Domenico Coppini, 79, as he stood outside the Liberty Bar in Secugnago. “Italy is old. And the virus is getting old people.”“If it comes here and gets me, it gets me,” said Domenico Coppini, 79, as he stood outside the Liberty Bar in Secugnago. “Italy is old. And the virus is getting old people.”
In Milan, others were more cautious.In Milan, others were more cautious.
Lucia Franceschini, 84, shopped for vegetables at a market and said it was important not to be “excessively worried” but to keep up normal routines and good hygiene and to maintain “the appropriate distance” when talking to people.Lucia Franceschini, 84, shopped for vegetables at a market and said it was important not to be “excessively worried” but to keep up normal routines and good hygiene and to maintain “the appropriate distance” when talking to people.
Still, she had not failed to notice that the vast majority of Italians who died were elderly.Still, she had not failed to notice that the vast majority of Italians who died were elderly.
“You become fragile,” she said, and lamented that Italy was “maybe more vulnerable.”“You become fragile,” she said, and lamented that Italy was “maybe more vulnerable.”
“We’re all little old people now,” she said.“We’re all little old people now,” she said.
Emma Bubola contributed reporting from Milan.Emma Bubola contributed reporting from Milan.