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For Italians, Dodging Coronavirus Has Become a Game of Chance For Italians, Dodging Coronavirus Has Become a Game of Chance
(32 minutes later)
PAVIA, Italy — As his glasses fogged up from the mask he wore over his mouth and nose, Riccardo Rosso, a historian of mathematics, scribbled on a blackboard the possible outcomes of a dice game, substituting the chances of getting the coronavirus.PAVIA, Italy — As his glasses fogged up from the mask he wore over his mouth and nose, Riccardo Rosso, a historian of mathematics, scribbled on a blackboard the possible outcomes of a dice game, substituting the chances of getting the coronavirus.
“The concept is the same,” he said. “It is still probability.” But he noted that many variables in the current health emergency were still unknown. So personal interactions — increasing the potential to come in contact with the virus — were probably a bad bet.“The concept is the same,” he said. “It is still probability.” But he noted that many variables in the current health emergency were still unknown. So personal interactions — increasing the potential to come in contact with the virus — were probably a bad bet.
“The probability of these encounters can be minimized obviously by reducing one’s social life,” he said.“The probability of these encounters can be minimized obviously by reducing one’s social life,” he said.
That is precisely Italy’s strategy, on a grand scale. Having expanded an initial lockdown of 11 towns first to a northern region of 16 million people, and then to the entire nation — ordering the closure of all businesses except pharmacies and supermarkets on Wednesday — Italy is trying to reduce the chances that its coronavirus epidemic, already the worst in Europe, will spread further.That is precisely Italy’s strategy, on a grand scale. Having expanded an initial lockdown of 11 towns first to a northern region of 16 million people, and then to the entire nation — ordering the closure of all businesses except pharmacies and supermarkets on Wednesday — Italy is trying to reduce the chances that its coronavirus epidemic, already the worst in Europe, will spread further.
As it does, caution is mixing with hysteria, paranoia and fear. The question on almost everyone’s mind: What are my chances of getting infected?As it does, caution is mixing with hysteria, paranoia and fear. The question on almost everyone’s mind: What are my chances of getting infected?
[Read: My life on Italy’s coronavirus frontlines, and in quarantine.][Read: My life on Italy’s coronavirus frontlines, and in quarantine.]
In Italy, at least, there is no better place to assess those odds than Pavia. The handsome town of about 75,000 sits south of Milan, in the middle of the hard hit Lombardy region, and is known as the Las Vegas of Italy for its abundance of slot and lotto machines.In Italy, at least, there is no better place to assess those odds than Pavia. The handsome town of about 75,000 sits south of Milan, in the middle of the hard hit Lombardy region, and is known as the Las Vegas of Italy for its abundance of slot and lotto machines.
More than that, Pavia is famed as the home of Gerolamo Cardano, a 16th-century mathematician and doctor. His father was an associate of Leonardo da Vinci, his siblings succumbed to the plague, and his terrible luck at gambling inspired him to try to divine whether the dictates of fate could be predicted and calculated.More than that, Pavia is famed as the home of Gerolamo Cardano, a 16th-century mathematician and doctor. His father was an associate of Leonardo da Vinci, his siblings succumbed to the plague, and his terrible luck at gambling inspired him to try to divine whether the dictates of fate could be predicted and calculated.
His landmark treatise made him a father of probability theory, something the modern world seemingly takes for granted — until something terrifyingly random, like the ravages of an invisible viral predator, vaults it to the forefront of our consciousness.His landmark treatise made him a father of probability theory, something the modern world seemingly takes for granted — until something terrifyingly random, like the ravages of an invisible viral predator, vaults it to the forefront of our consciousness.
In the intensive care unit of a Pavia hospital, doctors are treating a person known as Patient One, a previously healthy 38-year-old runner who is believed to have helped spread the virus around the Lombardy region.In the intensive care unit of a Pavia hospital, doctors are treating a person known as Patient One, a previously healthy 38-year-old runner who is believed to have helped spread the virus around the Lombardy region.
[Update: Trump’s unilateral travel ban leaves Americans in Europe scrambling to get home.][Update: Trump’s unilateral travel ban leaves Americans in Europe scrambling to get home.]
The hospital’s doctors are busy calculating the probability of contagion, illness and death. Dr. Raffaele Bruno, director of the infectious disease unit at the San Matteo Hospital in Pavia, said they were compiling a data set to help international colleagues have a better sense of the stakes.The hospital’s doctors are busy calculating the probability of contagion, illness and death. Dr. Raffaele Bruno, director of the infectious disease unit at the San Matteo Hospital in Pavia, said they were compiling a data set to help international colleagues have a better sense of the stakes.
Cardano’s work contributed to the understanding that outcomes could be better estimated in a game of fixed rules and parameters, and so risks could be better assessed.Cardano’s work contributed to the understanding that outcomes could be better estimated in a game of fixed rules and parameters, and so risks could be better assessed.
That thinking has imbued modern life. The notion of providing an order and manipulating the odds has influenced thinking on an assortment of public health policies, including seatbelts, bike helmets and smoking bans. An assumed understanding of fixed risks contributes to myriad and subtle daily decisions, as varied as the likelihood of a commuter train derailing and the freshness of supermarket sushi.That thinking has imbued modern life. The notion of providing an order and manipulating the odds has influenced thinking on an assortment of public health policies, including seatbelts, bike helmets and smoking bans. An assumed understanding of fixed risks contributes to myriad and subtle daily decisions, as varied as the likelihood of a commuter train derailing and the freshness of supermarket sushi.
The coronavirus destabilizes those quotidian calculations. Activities as mundane as shopping or grabbing a drink with friends can suddenly take on calamitous dimensions.The coronavirus destabilizes those quotidian calculations. Activities as mundane as shopping or grabbing a drink with friends can suddenly take on calamitous dimensions.
The random-seeming nature of the virus is unsettling, but the parameters of risk also shift as it spreads, not just by infecting more people and increasing the chance of contagion, but by putting so much stress on health systems that the predicability of care and recovery is no longer certain. The shortage of hospital beds and respirators enters the equation. Triage is a variable.The random-seeming nature of the virus is unsettling, but the parameters of risk also shift as it spreads, not just by infecting more people and increasing the chance of contagion, but by putting so much stress on health systems that the predicability of care and recovery is no longer certain. The shortage of hospital beds and respirators enters the equation. Triage is a variable.
“You can calculate the odds when you have the numbers,” said Fausto Baldanti, a virologist at the San Matteo Hospital in Pavia. “If you don’t have the numbers, everything is hypothetical.”“You can calculate the odds when you have the numbers,” said Fausto Baldanti, a virologist at the San Matteo Hospital in Pavia. “If you don’t have the numbers, everything is hypothetical.”
He said that the hospital’s early efforts to separate coronavirus patients from others had helped bring the death rate down, as had what he called a “huge expansion of the intensive care units.”He said that the hospital’s early efforts to separate coronavirus patients from others had helped bring the death rate down, as had what he called a “huge expansion of the intensive care units.”
Those rigorous measures in the Lombardy region reduced the number of serious cases and deaths, he noted. Nevertheless the virus’s toll in Italy has continued to rise, this week surpassing 12,000 infections and more than 800 deaths.Those rigorous measures in the Lombardy region reduced the number of serious cases and deaths, he noted. Nevertheless the virus’s toll in Italy has continued to rise, this week surpassing 12,000 infections and more than 800 deaths.
The overload of the system, he said, meant that care was not a constant.The overload of the system, he said, meant that care was not a constant.
On Wednesday, Giorgio Gori, the mayor of Bergamo, a town in Lombardy, who had written on Twitter that intensive care units had become so overloaded that “the patients who cannot be treated are left to die,” said in an interview that doctors were forced to write off those with “smaller chances of survival.”On Wednesday, Giorgio Gori, the mayor of Bergamo, a town in Lombardy, who had written on Twitter that intensive care units had become so overloaded that “the patients who cannot be treated are left to die,” said in an interview that doctors were forced to write off those with “smaller chances of survival.”
Earlier in the week, a doctor in his town had posted on social media a graphic account of the stress on the health system, calling the situation an “epidemiological disaster” that had “overwhelmed” medical workers. Officials at the hospital said on Wednesday that it was close to collapse, with coronavirus patients taking up 60 of its 80 intensive care beds.Earlier in the week, a doctor in his town had posted on social media a graphic account of the stress on the health system, calling the situation an “epidemiological disaster” that had “overwhelmed” medical workers. Officials at the hospital said on Wednesday that it was close to collapse, with coronavirus patients taking up 60 of its 80 intensive care beds.
Nino Cartabellotta, a prominent public health researcher in Italy, said more than half of the 851 intensive care units in Lombardy were now occupied by coronavirus patients.Nino Cartabellotta, a prominent public health researcher in Italy, said more than half of the 851 intensive care units in Lombardy were now occupied by coronavirus patients.
“When the system is saturated, death rates spike,” he said, adding that a continuation of the current trend would cause the health care in the north, the jewel of the Italian system and equivalent to or better than that in much of Europe, to collapse. “That’s why it’s important that people stay at home.”“When the system is saturated, death rates spike,” he said, adding that a continuation of the current trend would cause the health care in the north, the jewel of the Italian system and equivalent to or better than that in much of Europe, to collapse. “That’s why it’s important that people stay at home.”
The entire nation must now base behavior on interpretations of percentage points and ratios as Italians seek to reassert a modern sense of control over a virus that feels maddeningly Old World.The entire nation must now base behavior on interpretations of percentage points and ratios as Italians seek to reassert a modern sense of control over a virus that feels maddeningly Old World.
Still, fear and fatalism go hand in hand.Still, fear and fatalism go hand in hand.
Last week, before Italy expanded its restrictions to slow the virus, a group of young women spent the evening playing cards around a small table in the center of Pavia, which is not far from the towns in the initial wave of the lockdown.Last week, before Italy expanded its restrictions to slow the virus, a group of young women spent the evening playing cards around a small table in the center of Pavia, which is not far from the towns in the initial wave of the lockdown.
“No matter how good you are, if you get lousy cards, you lose,” Giorgia Cassano, 21, said after winning a hand. She said the coronavirus was more or less the same.“No matter how good you are, if you get lousy cards, you lose,” Giorgia Cassano, 21, said after winning a hand. She said the coronavirus was more or less the same.
“No matter how many times a day you wash your hands, or how much you shut yourself at home, if you have bad luck you are going to get it,” she said.“No matter how many times a day you wash your hands, or how much you shut yourself at home, if you have bad luck you are going to get it,” she said.
That sentiment was not limited to the young. In the historic center of Pavia, even those more at risk didn’t feel so imperiled.
“You’ve got to die of something,” Cesarina Gregotti, 71, a retired medical school professor, said last week as she took a stroll after finishing a dry Martini aperitivo, which she hoped would “embalm” any trace of the virus.
Updated June 22, 2020Updated June 22, 2020
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
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.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.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
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.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.
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.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.)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.)
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’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.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.
That sentiment was not limited to the young. In the historic center of Pavia, even those more at risk didn’t feel so imperiled.
“You’ve got to die of something,” Cesarina Gregotti, 71, a retired medical school professor, said last week as she took a stroll after finishing a dry Martini aperitivo, which she hoped would “embalm” any trace of the virus.
Cardano’s name is all over Pavia. It is on closed schools and vacant hotels and streets. His contributions to algebra and mechanics are still used today, even if some of his ideas, including doing the horoscope of Jesus, ran afoul of the Roman Catholic Church.Cardano’s name is all over Pavia. It is on closed schools and vacant hotels and streets. His contributions to algebra and mechanics are still used today, even if some of his ideas, including doing the horoscope of Jesus, ran afoul of the Roman Catholic Church.
A portrait of Cardano, his face gaunt, hangs with other scientific standouts from the University of Pavia, including Alessandro Volta, in the medical museum. Some rooms dedicated to the school’s famous anatomists and biologists had a Frankenstein’s lab feel.A portrait of Cardano, his face gaunt, hangs with other scientific standouts from the University of Pavia, including Alessandro Volta, in the medical museum. Some rooms dedicated to the school’s famous anatomists and biologists had a Frankenstein’s lab feel.
In one glass cabinet sat a jar holding the bladder of Lazzaro Spallanzani, an 18th-century biologist whose name now graces the Rome hospital treating many coronavirus patients.In one glass cabinet sat a jar holding the bladder of Lazzaro Spallanzani, an 18th-century biologist whose name now graces the Rome hospital treating many coronavirus patients.
In another locked cabinet, wax models of smallpox infections stood across from the works of Luigi Sacco, the early Italian vaccinator for whom the Milan hospital treating many of Lombardy’s coronavirus patients is named.In another locked cabinet, wax models of smallpox infections stood across from the works of Luigi Sacco, the early Italian vaccinator for whom the Milan hospital treating many of Lombardy’s coronavirus patients is named.
Outside the museum, the grounds were empty of students, as regional officials had ordered the university, founded in 1361, closed. Dr. Marco Benazzo, the head of the university’s medical school, worried about the “exponential” growth of the virus and rushed to an emergency crisis meeting, where he said the number being thrown around for possible infections was at least 15,000.Outside the museum, the grounds were empty of students, as regional officials had ordered the university, founded in 1361, closed. Dr. Marco Benazzo, the head of the university’s medical school, worried about the “exponential” growth of the virus and rushed to an emergency crisis meeting, where he said the number being thrown around for possible infections was at least 15,000.
According to Mr. Rosso, the math historian, who teaches at the University of Pavia, Cardano realized that “there was never certainty, but one can put themselves in the condition to reduce risk.”According to Mr. Rosso, the math historian, who teaches at the University of Pavia, Cardano realized that “there was never certainty, but one can put themselves in the condition to reduce risk.”
In the case of the coronavirus, he said, that translated to “taking precautions that go in the direction of improving the parameters” against contagion.In the case of the coronavirus, he said, that translated to “taking precautions that go in the direction of improving the parameters” against contagion.
“Cardano says in the end the greatest advantage that you can have in gambling is not to play at all,” Mr. Rosso said, though Cardano himself did not see the fun in that.“Cardano says in the end the greatest advantage that you can have in gambling is not to play at all,” Mr. Rosso said, though Cardano himself did not see the fun in that.
For weeks, neither did many Italians, who alternately obeyed and bridled at the restrictions imposed on them.For weeks, neither did many Italians, who alternately obeyed and bridled at the restrictions imposed on them.
Gabriele Zanardi, a psychologist at the University of Pavia, said that Cardano showed that interpretation of numbers was just as important as the numbers themselves.Gabriele Zanardi, a psychologist at the University of Pavia, said that Cardano showed that interpretation of numbers was just as important as the numbers themselves.
He said that the initial government reaction and news reports had caused a spike in personal alarm systems, but that subsequent efforts to calm nerves had created a sense of security.He said that the initial government reaction and news reports had caused a spike in personal alarm systems, but that subsequent efforts to calm nerves had created a sense of security.
“One day it seemed the plague, the next a simple flu,” Mr. Zanardi said. Some people, he added, had a “psychology of invulnerability” that led them to rebel against precautions.“One day it seemed the plague, the next a simple flu,” Mr. Zanardi said. Some people, he added, had a “psychology of invulnerability” that led them to rebel against precautions.
“They look for control on what is not controllable,” he said. “It’s like gambling.”“They look for control on what is not controllable,” he said. “It’s like gambling.”
Emma Bubola contributed reporting from Pavia, Anna Momigliano from Milan, and Andrew Higgins from Paris.Emma Bubola contributed reporting from Pavia, Anna Momigliano from Milan, and Andrew Higgins from Paris.