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Italy, Pandemic’s New Epicenter, Has Lessons for the World Italy, Pandemic’s New Epicenter, Has Lessons for the World
(about 8 hours later)
ROME — As Italy’s coronavirus infections ticked above 400 cases and deaths hit the double digits, the leader of the governing Democratic Party posted a picture of himself clinking glasses for “an aperitivo in Milan,” urging people “not to change our habits.”ROME — As Italy’s coronavirus infections ticked above 400 cases and deaths hit the double digits, the leader of the governing Democratic Party posted a picture of himself clinking glasses for “an aperitivo in Milan,” urging people “not to change our habits.”
That was on Feb. 27. Not 10 days later, as the toll hit 5,883 infections and 233 dead, the party boss, Nicola Zingaretti, posted a new video, this time informing Italy that he, too, had the virus.That was on Feb. 27. Not 10 days later, as the toll hit 5,883 infections and 233 dead, the party boss, Nicola Zingaretti, posted a new video, this time informing Italy that he, too, had the virus.
Italy now has more than 53,000 recorded infections and more than 4,800 dead, and the rate of increase keeps growing, with more than half the cases and fatalities coming in the past week. On Saturday, officials reported 793 additional deaths, by far the largest single-day increase so far. Italy has surpassed China as the country with the highest death toll, becoming the epicenter of a shifting pandemic.Italy now has more than 53,000 recorded infections and more than 4,800 dead, and the rate of increase keeps growing, with more than half the cases and fatalities coming in the past week. On Saturday, officials reported 793 additional deaths, by far the largest single-day increase so far. Italy has surpassed China as the country with the highest death toll, becoming the epicenter of a shifting pandemic.
The government has sent in the army to enforce the lockdown in Lombardy, the northern region at the center of the outbreak, where bodies have piled up in churches. On Friday night, the authorities tightened the nationwide lockdown, closing parks, banning outdoor activities including walking or jogging far from home.The government has sent in the army to enforce the lockdown in Lombardy, the northern region at the center of the outbreak, where bodies have piled up in churches. On Friday night, the authorities tightened the nationwide lockdown, closing parks, banning outdoor activities including walking or jogging far from home.
On Saturday night, Prime Minister Giuseppe Conte announced another drastic step in response to what he called the country’s most difficult crisis since the Second World War: Italy will close its factories and all production that is not absolutely essential, an enormous economic sacrifice intended to contain the virus and protect lives.On Saturday night, Prime Minister Giuseppe Conte announced another drastic step in response to what he called the country’s most difficult crisis since the Second World War: Italy will close its factories and all production that is not absolutely essential, an enormous economic sacrifice intended to contain the virus and protect lives.
“The state is here,” he said in an effort to reassure the public.“The state is here,” he said in an effort to reassure the public.
But the tragedy of Italy now stands as a warning to its European neighbors and the United States, where the virus is coming with equal velocity. If Italy’s experience shows anything, it is that measures to isolate affected areas and limit the movement of the broader population need to be taken early, put in place with absolute clarity, then strictly enforced.But the tragedy of Italy now stands as a warning to its European neighbors and the United States, where the virus is coming with equal velocity. If Italy’s experience shows anything, it is that measures to isolate affected areas and limit the movement of the broader population need to be taken early, put in place with absolute clarity, then strictly enforced.
Despite now having some of the toughest measures in the world, Italian authorities fumbled many of those steps early in the contagion — when it most mattered as they sought to preserve basic civil liberties as well as the economy.Despite now having some of the toughest measures in the world, Italian authorities fumbled many of those steps early in the contagion — when it most mattered as they sought to preserve basic civil liberties as well as the economy.
Italy’s piecemeal attempts to cut it off — isolating towns first, then regions, then shutting down the country in an intentionally porous lockdown — always lagged behind the virus’s lethal trajectory.Italy’s piecemeal attempts to cut it off — isolating towns first, then regions, then shutting down the country in an intentionally porous lockdown — always lagged behind the virus’s lethal trajectory.
“Now we are running after it,” said Sandra Zampa, the under secretary at the Ministry of Health, who said Italy did the best it could given the information it had. “We closed gradually, as Europe is doing. France, Spain, Germany, the U.S. are doing the same. Every day you close a bit, you give up on a bit of normal life. Because the virus does not allow normal life.”“Now we are running after it,” said Sandra Zampa, the under secretary at the Ministry of Health, who said Italy did the best it could given the information it had. “We closed gradually, as Europe is doing. France, Spain, Germany, the U.S. are doing the same. Every day you close a bit, you give up on a bit of normal life. Because the virus does not allow normal life.”
Some officials gave in to magical thinking, reluctant to make painful decisions sooner. All the while, the virus fed on that complacency.Some officials gave in to magical thinking, reluctant to make painful decisions sooner. All the while, the virus fed on that complacency.
Governments beyond Italy are now in danger of following the same path, repeating familiar mistakes and inviting similar calamity. And unlike Italy, which navigated uncharted territory for a Western democracy, other governments have less room for excuses.Governments beyond Italy are now in danger of following the same path, repeating familiar mistakes and inviting similar calamity. And unlike Italy, which navigated uncharted territory for a Western democracy, other governments have less room for excuses.
Italian officials, for their part, have defended their response, emphasizing that the crisis is unprecedented in modern times. They assert that the government responded with speed and competence, immediately acting on the advice of its scientists and moving more swiftly on drastic, economically devastating measures than their European counterparts.Italian officials, for their part, have defended their response, emphasizing that the crisis is unprecedented in modern times. They assert that the government responded with speed and competence, immediately acting on the advice of its scientists and moving more swiftly on drastic, economically devastating measures than their European counterparts.
But tracing the record of their actions shows missed opportunities and critical missteps.But tracing the record of their actions shows missed opportunities and critical missteps.
In the critical early days of the outbreak, Mr. Conte and other top officials sought to down play the threat, creating confusion and a false sense of security that allowed the virus to spread.In the critical early days of the outbreak, Mr. Conte and other top officials sought to down play the threat, creating confusion and a false sense of security that allowed the virus to spread.
They blamed Italy’s high number of infections on aggressive testing of people without symptoms in the north, which they argued only created hysteria and tarnished the country’s image abroad.They blamed Italy’s high number of infections on aggressive testing of people without symptoms in the north, which they argued only created hysteria and tarnished the country’s image abroad.
Even once the Italian government considered a universal lockdown necessary to defeat the virus, it failed to communicate the threat powerfully enough to persuade Italians to abide by the rules, which seemed riddled with loopholes.Even once the Italian government considered a universal lockdown necessary to defeat the virus, it failed to communicate the threat powerfully enough to persuade Italians to abide by the rules, which seemed riddled with loopholes.
“It is not easy in a liberal democracy,” said Walter Ricciardi, a World Health Organization board member and a top adviser to the health ministry, who argued that the Italian government acted on the scientific evidence made available to it.“It is not easy in a liberal democracy,” said Walter Ricciardi, a World Health Organization board member and a top adviser to the health ministry, who argued that the Italian government acted on the scientific evidence made available to it.
He said the Italian government had moved at a much faster clip, and took the threat much more seriously, than its European neighbors or the United States.He said the Italian government had moved at a much faster clip, and took the threat much more seriously, than its European neighbors or the United States.
Still, he acknowledged that the health minister had struggled to persuade his government colleagues to move more quickly and that the difficulties of navigating Italy’s division of powers between Rome and the regions resulted in a fragmented chain of command and inconsistent messages.Still, he acknowledged that the health minister had struggled to persuade his government colleagues to move more quickly and that the difficulties of navigating Italy’s division of powers between Rome and the regions resulted in a fragmented chain of command and inconsistent messages.
“In times of war, like an epidemic,” that system presented grave problems, he said, adding that it perhaps delayed the imposing of restrictive measures.“In times of war, like an epidemic,” that system presented grave problems, he said, adding that it perhaps delayed the imposing of restrictive measures.
“I would have done them 10 days before, that is the only difference.”“I would have done them 10 days before, that is the only difference.”
For the coronavirus, 10 days can be a lifetime.For the coronavirus, 10 days can be a lifetime.
On Jan. 21, as top Chinese officials warned that those hiding virus cases “will be nailed on the pillar of shame for eternity,” Italy’s culture and tourism minister hosted a Chinese delegation for a concert at the National Academy of Santa Cecilia to inaugurate the year of Italy-China Culture and Tourism.On Jan. 21, as top Chinese officials warned that those hiding virus cases “will be nailed on the pillar of shame for eternity,” Italy’s culture and tourism minister hosted a Chinese delegation for a concert at the National Academy of Santa Cecilia to inaugurate the year of Italy-China Culture and Tourism.
Michele Geraci, Italy’s former under secretary in the economic development ministry and a booster of closer relations with China, had a drink with other politicians but looked around uneasily.Michele Geraci, Italy’s former under secretary in the economic development ministry and a booster of closer relations with China, had a drink with other politicians but looked around uneasily.
“Are we sure we want to do this?” he said he asked them. “Should we be here today?”“Are we sure we want to do this?” he said he asked them. “Should we be here today?”
With the benefit of hindsight, Italian officials say certainly not.With the benefit of hindsight, Italian officials say certainly not.
Ms. Zampa, the health ministry under secretary, said in retrospect she would have closed everything immediately. But in real time, it wasn’t that clear.Ms. Zampa, the health ministry under secretary, said in retrospect she would have closed everything immediately. But in real time, it wasn’t that clear.
Politicians across the spectrum worried about the economy and feeding the country, and found it difficult to accept their impotence in the face of the virus.Politicians across the spectrum worried about the economy and feeding the country, and found it difficult to accept their impotence in the face of the virus.
Most importantly, Italy looked at the example of China, Ms. Zampa said, not as a practical warning, but as a “science fiction movie that had nothing to do with us.” And when the virus exploded, Europe, she said, “looked at us the same way we looked at China.”Most importantly, Italy looked at the example of China, Ms. Zampa said, not as a practical warning, but as a “science fiction movie that had nothing to do with us.” And when the virus exploded, Europe, she said, “looked at us the same way we looked at China.”
But already in January, some officials on the right were urging Mr. Conte, their former ally and now political enemy, to quarantine schoolchildren in the northern regions who were returning from holidays in China, a measure aimed at protecting schools. Many of those children were from Chinese immigrant families.But already in January, some officials on the right were urging Mr. Conte, their former ally and now political enemy, to quarantine schoolchildren in the northern regions who were returning from holidays in China, a measure aimed at protecting schools. Many of those children were from Chinese immigrant families.
Many liberals criticized the proposal as populist fear-mongering. Mr. Conte declined the proposal and responded that the northern governors should trust the judgment of education and health authorities who, he said, had proposed no such thing.Many liberals criticized the proposal as populist fear-mongering. Mr. Conte declined the proposal and responded that the northern governors should trust the judgment of education and health authorities who, he said, had proposed no such thing.
But Mr. Conte also demonstrated that he was taking the threat of contagion seriously. On Jan. 30, he blocked all flights in and out of China.But Mr. Conte also demonstrated that he was taking the threat of contagion seriously. On Jan. 30, he blocked all flights in and out of China.
“We are the first country in Europe to adopt such a precautionary measure,” he said.“We are the first country in Europe to adopt such a precautionary measure,” he said.
Over the next month, Italy responded swiftly to coronavirus scares. Two sick Chinese tourists and an Italian returning from China received care from a prominent infectious disease hospital in Rome. A false alarm led authorities to briefly confine passengers on a cruise ship docked outside of Rome.Over the next month, Italy responded swiftly to coronavirus scares. Two sick Chinese tourists and an Italian returning from China received care from a prominent infectious disease hospital in Rome. A false alarm led authorities to briefly confine passengers on a cruise ship docked outside of Rome.
When a 38-year-old man went to the emergency room at a hospital in Codogno, a small town in the Lodi province of Lombardy, with severe flu symptoms on Feb. 18, the case did not set off alarms.When a 38-year-old man went to the emergency room at a hospital in Codogno, a small town in the Lodi province of Lombardy, with severe flu symptoms on Feb. 18, the case did not set off alarms.
The patient declined to be hospitalized and went home. He got sicker and returned to the hospital a few hours later and was admitted to a general medicine ward. On Feb. 20, he went into intensive care, where he tested positive for the virus.The patient declined to be hospitalized and went home. He got sicker and returned to the hospital a few hours later and was admitted to a general medicine ward. On Feb. 20, he went into intensive care, where he tested positive for the virus.
The man, who became known as Patient One, had had a busy month. He attended at least three dinners, played soccer and ran with a team, all apparently while contagious and without heavy symptoms.The man, who became known as Patient One, had had a busy month. He attended at least three dinners, played soccer and ran with a team, all apparently while contagious and without heavy symptoms.
Mr. Ricciardi said Italy had the bad luck of having a super spreader in a densely populated and dynamic area who went to the hospital not once, but twice, infecting hundreds of people, including doctors and nurses.Mr. Ricciardi said Italy had the bad luck of having a super spreader in a densely populated and dynamic area who went to the hospital not once, but twice, infecting hundreds of people, including doctors and nurses.
“He was incredibly active,” Mr. Ricciardi said.“He was incredibly active,” Mr. Ricciardi said.
But he also had not had any direct contacts with China, and experts suspect he contracted the virus from another European, meaning Italy did not have an identifiable patient zero or a traceable source of contagion that could help it contain the virus.But he also had not had any direct contacts with China, and experts suspect he contracted the virus from another European, meaning Italy did not have an identifiable patient zero or a traceable source of contagion that could help it contain the virus.
The virus had already been active in Italy for weeks by that time, experts now say, passed by people without symptoms and often mistaken for a flu. It spread around Lombardy, the Italian region that has by far the most trade with China and the home of Milan, the country’s most culturally vibrant and business-centered city.The virus had already been active in Italy for weeks by that time, experts now say, passed by people without symptoms and often mistaken for a flu. It spread around Lombardy, the Italian region that has by far the most trade with China and the home of Milan, the country’s most culturally vibrant and business-centered city.
“Who we call ‘Patient One’ was probably ‘Patient 200,’ ” said Fabrizio Pregliasco, an epidemiologist.“Who we call ‘Patient One’ was probably ‘Patient 200,’ ” said Fabrizio Pregliasco, an epidemiologist.
On Sunday, Feb. 23, the number of infections clicked past 130 and Italy sealed off 11 towns with police and military checkpoints. The last days of Venice Carnival were canceled. The Lombardy region closed its schools, museums and movie theaters. The Milanese made a run on the supermarkets.On Sunday, Feb. 23, the number of infections clicked past 130 and Italy sealed off 11 towns with police and military checkpoints. The last days of Venice Carnival were canceled. The Lombardy region closed its schools, museums and movie theaters. The Milanese made a run on the supermarkets.
But while Mr. Conte again commended Italy for its firm hand, he also sought to downplay the contagion, attributing the high numbers of infected to Lombardy’s overzealous testing.But while Mr. Conte again commended Italy for its firm hand, he also sought to downplay the contagion, attributing the high numbers of infected to Lombardy’s overzealous testing.
“We have been the first ones with the most rigorous and accurate controls,” he said on television, adding that more people in Italy appeared infected because “we did more tests.”“We have been the first ones with the most rigorous and accurate controls,” he said on television, adding that more people in Italy appeared infected because “we did more tests.”
The next day, as infections surpassed 200, seven people died and the stock market plunged, Mr. Conte and his health aides doubled down.The next day, as infections surpassed 200, seven people died and the stock market plunged, Mr. Conte and his health aides doubled down.
He blamed the Codogno hospital for the spread, saying it had handled things in “a not-completely-proper way” and argued that Lombardy and Veneto, another northern region, were inflating the severity of the problem by diverging from global guidelines and testing people without symptoms.He blamed the Codogno hospital for the spread, saying it had handled things in “a not-completely-proper way” and argued that Lombardy and Veneto, another northern region, were inflating the severity of the problem by diverging from global guidelines and testing people without symptoms.
As Lombardy officials scrambled to free up hospital beds, and the number of infected people rose to 309 with 11 dead, Mr. Conte said on Feb. 25 that “Italy is a safe country and probably safer than many others.”As Lombardy officials scrambled to free up hospital beds, and the number of infected people rose to 309 with 11 dead, Mr. Conte said on Feb. 25 that “Italy is a safe country and probably safer than many others.”
On Friday, Mr. Conte’s office offered an interview on the condition that he could answer questions in writing. When sent questions, including those about his past statements, he declined to respond.On Friday, Mr. Conte’s office offered an interview on the condition that he could answer questions in writing. When sent questions, including those about his past statements, he declined to respond.
Reassurances from leaders confused the Italian population.Reassurances from leaders confused the Italian population.
On Feb. 27, Mr. Zingaretti posted his aperitivo picture. That same day, the country’s foreign minister, Luigi Di Maio, the former leader of one of the governing parties, the Five Star Movement, held a news conference in Rome.On Feb. 27, Mr. Zingaretti posted his aperitivo picture. That same day, the country’s foreign minister, Luigi Di Maio, the former leader of one of the governing parties, the Five Star Movement, held a news conference in Rome.
“In Italy, we went from the risk of an epidemic to an infodemic,” Mr. Di Maio said, disparaging media coverage that highlighted the threat of the contagion, and adding that only “0.089 percent” of the Italian population was quarantined.“In Italy, we went from the risk of an epidemic to an infodemic,” Mr. Di Maio said, disparaging media coverage that highlighted the threat of the contagion, and adding that only “0.089 percent” of the Italian population was quarantined.
In Milan, only miles from the center of the outbreak, the mayor, Beppe Sala, publicized a ‘‘Milan Doesn’t Stop’’ campaign, and the Duomo, the city’s landmark cathedral that is a draw for tourists, reopened. People went out.In Milan, only miles from the center of the outbreak, the mayor, Beppe Sala, publicized a ‘‘Milan Doesn’t Stop’’ campaign, and the Duomo, the city’s landmark cathedral that is a draw for tourists, reopened. People went out.
But on the sixth floor of the regional government headquarters in Milan, Giacomo Grasselli, who is the coordinator of the intensive care units throughout Lombardy, saw the numbers going up and quickly realized that it would be impossible to treat all the sick if the infections continued unabated.But on the sixth floor of the regional government headquarters in Milan, Giacomo Grasselli, who is the coordinator of the intensive care units throughout Lombardy, saw the numbers going up and quickly realized that it would be impossible to treat all the sick if the infections continued unabated.
His task force worked to match the sick to beds in intensive-care units in the nearest possible hospitals and appropriate dwindling resources.His task force worked to match the sick to beds in intensive-care units in the nearest possible hospitals and appropriate dwindling resources.
Updated June 16, 2020Updated June 16, 2020
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.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
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.)
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.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.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’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.
At one of the daily meetings of about 20 health and political officials, he told the regional president, Attilio Fontana, about the growing numbers.At one of the daily meetings of about 20 health and political officials, he told the regional president, Attilio Fontana, about the growing numbers.
An epidemiologist showed the curves of infection. There was a catastrophe facing the region’s well-respected health system.An epidemiologist showed the curves of infection. There was a catastrophe facing the region’s well-respected health system.
“We need to do something more,” Mr. Grasselli told the room.“We need to do something more,” Mr. Grasselli told the room.
Mr. Fontana, who had been pressing the central government for tougher action, agreed. He said that the mixed messages from Rome and the easing of restrictions had led Italians to believe “that everything was a joke, and they kept living as they used to.”Mr. Fontana, who had been pressing the central government for tougher action, agreed. He said that the mixed messages from Rome and the easing of restrictions had led Italians to believe “that everything was a joke, and they kept living as they used to.”
He said he appealed for tougher national measures in video conferences with the prime minister and other regional presidents, arguing that climbing numbers of cases threatened to collapse the hospital system in the north, but that his requests were repeatedly turned down.He said he appealed for tougher national measures in video conferences with the prime minister and other regional presidents, arguing that climbing numbers of cases threatened to collapse the hospital system in the north, but that his requests were repeatedly turned down.
“They were convinced that the situation was less serious and they did not want to hurt our economy too much,” said Mr. Fontana.“They were convinced that the situation was less serious and they did not want to hurt our economy too much,” said Mr. Fontana.
The government started providing some economic assistance, which would later be followed by a 25 billion euro ($28 billion) relief package, but the nation became divided between those who saw the threat and those who didn’t.The government started providing some economic assistance, which would later be followed by a 25 billion euro ($28 billion) relief package, but the nation became divided between those who saw the threat and those who didn’t.
Ms. Zampa said that it was around that time that government learned that infections in the town of Vò, the virus epicenter of the Veneto region, had no epidemiological link to the Codogno outbreak.Ms. Zampa said that it was around that time that government learned that infections in the town of Vò, the virus epicenter of the Veneto region, had no epidemiological link to the Codogno outbreak.
She said that the health minister, Mr. Speranza, and Mr. Conte deliberated about what to do and within the day, they decided to close down much of the north.She said that the health minister, Mr. Speranza, and Mr. Conte deliberated about what to do and within the day, they decided to close down much of the north.
In a surprise 2 a.m. news conference on March 8, when 7,375 people had already tested positive for coronavirus and 366 had died, Mr. Conte announced the extraordinary step of restricting movement for about a quarter of the Italian population in the northern regions that serve as the country’s economic engine.In a surprise 2 a.m. news conference on March 8, when 7,375 people had already tested positive for coronavirus and 366 had died, Mr. Conte announced the extraordinary step of restricting movement for about a quarter of the Italian population in the northern regions that serve as the country’s economic engine.
“We are facing an emergency,” Mr. Conte said at the time. “A national emergency.”“We are facing an emergency,” Mr. Conte said at the time. “A national emergency.”
A draft of the decree, leaked to Italian media on Saturday night, pushed many Milan residents to rush to the train station in crowds and attempt to leave the region, causing what many later considered a dangerous wave of contagion toward the south.A draft of the decree, leaked to Italian media on Saturday night, pushed many Milan residents to rush to the train station in crowds and attempt to leave the region, causing what many later considered a dangerous wave of contagion toward the south.
Yet the following day, most Italians were still confused about the severity of the restrictions.Yet the following day, most Italians were still confused about the severity of the restrictions.
To clarify the issue, the interior ministry issued “auto-certification” forms that would allow people to travel in and out of the locked-down area for work, health or “other” necessities.To clarify the issue, the interior ministry issued “auto-certification” forms that would allow people to travel in and out of the locked-down area for work, health or “other” necessities.
In the meantime, some regional governors independently ordered people coming from the newly locked-down area to self quarantine. Others didn’t.In the meantime, some regional governors independently ordered people coming from the newly locked-down area to self quarantine. Others didn’t.
The broader restrictions in Lombardy also effectively lifted the quarantine on Codogno and other “red zone” towns linked to the original outbreak. Checkpoints disappeared. Local mayors complained that their sacrifices had been wasted.The broader restrictions in Lombardy also effectively lifted the quarantine on Codogno and other “red zone” towns linked to the original outbreak. Checkpoints disappeared. Local mayors complained that their sacrifices had been wasted.
A day later, on March 9, when the positive cases reached 9,172 and the death toll climbed to 463, Mr. Conte toughened the restrictions and extended them nationally.A day later, on March 9, when the positive cases reached 9,172 and the death toll climbed to 463, Mr. Conte toughened the restrictions and extended them nationally.
But by then, some experts say, it was already too late.But by then, some experts say, it was already too late.
Italy is still paying the price of those early mixed messages by scientists and politicians. The people who have died in staggering numbers recently — more than 2,300 in the last four days — were mostly infected during the confusion of a week or two ago.Italy is still paying the price of those early mixed messages by scientists and politicians. The people who have died in staggering numbers recently — more than 2,300 in the last four days — were mostly infected during the confusion of a week or two ago.
Roberto Burioni, a prominent virologist at the San Raffaele University in Milan, said that people had felt safe to go about their usual routines and he attributed the spike in cases last week to “that behavior.”Roberto Burioni, a prominent virologist at the San Raffaele University in Milan, said that people had felt safe to go about their usual routines and he attributed the spike in cases last week to “that behavior.”
The government has urged national unity in obeying its restrictive measures. But on Saturday, hundreds of mayors from the hardest-hit areas told the government those measures were fatally insufficient.The government has urged national unity in obeying its restrictive measures. But on Saturday, hundreds of mayors from the hardest-hit areas told the government those measures were fatally insufficient.
Leaders in the north are desperate for the government to crack down harder.Leaders in the north are desperate for the government to crack down harder.
On Friday, Mr. Fontana complained that the 114 troops the government deployed were insignificant, and that at least 1,000 should be sent. On Saturday, he closed public offices, work sites and banned jogging. He said in an interview that the government needed to stop messing around and “apply rigid measures.”On Friday, Mr. Fontana complained that the 114 troops the government deployed were insignificant, and that at least 1,000 should be sent. On Saturday, he closed public offices, work sites and banned jogging. He said in an interview that the government needed to stop messing around and “apply rigid measures.”
“My idea is that if we had shut everything in the beginning, for two weeks, probably now we would be celebrating victory,” he said.“My idea is that if we had shut everything in the beginning, for two weeks, probably now we would be celebrating victory,” he said.
His political ally, Luca Zaia, the president of the Veneto region, pre-empted the national government with his own crackdown, and said that Rome needed to enforce “a more drastic isolation,” including closing all stores and prohibiting public activities other than commuting to work.His political ally, Luca Zaia, the president of the Veneto region, pre-empted the national government with his own crackdown, and said that Rome needed to enforce “a more drastic isolation,” including closing all stores and prohibiting public activities other than commuting to work.
“Walks should be banned,” he said.“Walks should be banned,” he said.
Mr. Zaia has some credibility on the issue. As new infections have proliferated around the country, they have significantly dropped in Vò, a town of about 3,000 people that was one of the first quarantined and which had the country’s first coronavirus death.Mr. Zaia has some credibility on the issue. As new infections have proliferated around the country, they have significantly dropped in Vò, a town of about 3,000 people that was one of the first quarantined and which had the country’s first coronavirus death.
Some government experts attributed that turnaround to the strict quarantine that had been in place for two weeks. But Mr. Zaia had also ordered blanket tests there, in defiance of international scientific guidelines and the national government. The government has argued that testing people without symptoms is a drain on resources.Some government experts attributed that turnaround to the strict quarantine that had been in place for two weeks. But Mr. Zaia had also ordered blanket tests there, in defiance of international scientific guidelines and the national government. The government has argued that testing people without symptoms is a drain on resources.
“At least this slows down the virus’ speed,’’ Mr. Zaia said, arguing that testing helped identify potentially contagious people without symptoms. ‘‘And slowing down the virus’ speed allows the hospitals to breathe.’’“At least this slows down the virus’ speed,’’ Mr. Zaia said, arguing that testing helped identify potentially contagious people without symptoms. ‘‘And slowing down the virus’ speed allows the hospitals to breathe.’’
If not, the overwhelming number of patients would crater health care systems and cause a national catastrophe.If not, the overwhelming number of patients would crater health care systems and cause a national catastrophe.
Americans and others, he said, “need to be ready.”Americans and others, he said, “need to be ready.”