Wuhan Coronavirus: Lessons from the Italian Skew

Old, Sick Italians are Dying with Coronavirus

Wuhan Coronavirus is loose inside the Italian medical system. While there, it preys upon health care workers. 4,824 of them so far. Most of these Italian healthcare workers will survive the virus.

But while the virus is loose inside the medical system, it also preys upon the old and the sick — the kind of person who can be counted on to occupy the beds of medical institutions of all kinds. Many of these old, sick Italians have been catching the virus both inside and outside of medical institutions — and dying.

Most of the Italians who are dying with coronavirus have been living for years with hypertension, diabetes, heart disease, cancer, renal failure, stroke, and a number of other common degenerative afflictions of people living in modern countries.

Co-morbidities of Persons Who Tested Positive for Coronavirus

Perhaps coronavirus is pushing them over the edge, just as often happens with influenza or any community infection — even the common cold. And sometimes being diagnosed with coronavirus infection may be incidental to the actual facts of their death. We need a lot more data to better understand the interaction between this virus and societies with aging populations loaded with co-morbidities.

Out of the 2,003 [Italian] deaths, seventeen were people under fifty, and only 5 people under thirty died, while almost two hundred deaths were of people over 90. I’d read that the people dying in Italy were old, but I didn’t realize quite how old they actually are …

  • The average age was 79 years.
  • All but three of them had at least one other disease, so basically all of them were already sick.
  • Three-quarters of them had two other diseases, and half of them had three or more other diseases. Half!
  • … Here’s what I suspect. I think that the COVID-19 disease got established in a couple of areas in Italy well before anyone even knew the disease was there, perhaps even before the Chinese recognized it as a novel disease.

    And in some fashion, it got into the medical system. Doesn’t matter how. But once there, it was spread invisibly to other patients, in particular the oldest and weakest of the patients. It went from patient to patient, from patient to visitor and back again, and it was also spread by everyone in the hospital from administrators to doctors and nurses to janitors. In many, perhaps most cases, they didn’t even know they were sick, but they were indeed infectious.

    And that’s why the pattern of the Italian deaths is so curious, and their number is so much larger than the rest of the world. It’s not a cross-section of the general population. It’s a cross-section of people who were already quite sick, sick enough that they were already visiting doctors and having procedures or being bedridden in hospitals. It was 85-year-olds with three diseases.

    And it’s also why the death rate in Italy is so high—these people were already very ill. I can see why the Italians are distinguishing between dying FROM the virus and dying WITH the virus. __ The Italian Skew

    Figure 1. Deaths from the COVID-19 coronavirus expressed as deaths per ten million of the country population.

    We are trying to learn lessons from the broad range of experiences across the different nations. We cannot learn much from China because the communist party controlled nation has not been honest with its disease reporting, not from the very start and not now. We know that Japan and South Korea started with large outbreaks, but somehow brought them under a modicum of control. We know that Hong Kong, Taiwan, Singapore, and other nations closely connected to China were able to slow the spread of coronavirus from the beginning. There are lessons to be learned from them. Take South Korea, for example, and its voluntary “social distancing plan:”

    • go to work
    • stay away from crowds
    • wash your hands
    • wear a mask
    • don’t touch your face
    • __ Steve Mosher from Seoul, quoted here

    The South Koreans are not shutting everything down, but instead are following a rigorous program of contact tracing, testing every person with any conceivable contact with persons who have been diagnosed with Wuhan virus. The CDC needs to learn from that, along with other lessons from other nations that have successfully limited viral spread.

    Despite the Global Panic, Life Goes On

    In the throes of panic there is a tendency to lose perspective.

    Europe has about 8 million fatalities per year ( all causes ). That is around 22,000 per day every day. So far there are 8,000 COVID attributed deaths in Europe. The media breathlessly report “spikes ” of a hundred deaths like no one would ever die if it was not for COVID-19.

    France has average of 9000 seasonal flu deaths per year. Today is 670 covid fatalities.
    __ Comment on Climate Etc.

    If we surrender to this “tunnel vision,” we risk giving up a lot more than we will ever lose from a virus like Wuhan.

    US President Donald Trump wants to send America back to work by Easter, in about 3 weeks. But another optimistic person wants to put America to work in one week! He makes an interesting argument.

    America will change some things about the way it works, the way it schools, and the way it lives. And if we are lucky, a lot of Americans will develop a more realistic attitude toward vaccines.

    In any case, treatments for Wuhan Covid19 Chinese virus are being rolled out. New treatments and vaccines are being developed, tested, and trialed. More toilet paper is being rushed to supermarket shelves. And in the spaces around the panic, life goes on.

    Bonus Section on Wearing Masks:

    Remember the personal methods used in South Korea to limit spread?

  • go to work
  • stay away from crowds
  • wash your hands
  • wear a mask
  • don’t touch your face
  • You may wonder whether wearing a mask is helpful. In crowded, confined circumstances, a mask can be helpful. If you can get it to conform to your face, it can reduce the number of virus particles that get through, making you less prone to catch the disease. At the same time, it will reduce the amount of respiratory droplets that you yourself will release into the environment. This helps protect others who may be quite vulnerable.

    The routine use of facemasks is not recommended by WHO, the CDC, or the ECDC in the community setting. However, the use of facemasks is recommended in crowded settings (such as public transport) and for those at high risk (older people, pregnant women, and those with a medical condition) during an outbreak or pandemic. A modelling study suggests that the use of face-masks in the community may help delay and contain a pandemic, although efficacy estimates were not based on RCT data. Community masks were protective during the SARS outbreaks, and about 76% of the population used a facemask in Hong Kong __ https://slatestarcodex.com/2020/03/23/face-masks-much-more-than-you-wanted-to-know/

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    2 Responses to Wuhan Coronavirus: Lessons from the Italian Skew

    1. Mirco Romanato says:

      I can explain the “Italian Exception”. It is already explained by epidemiologists in Italy, but not widely known.


      In February there was a train wreck in Lodi (link above) and emergency responders and various police forces converged to help. But they had not implemented safety protocol for an infectious disease nor had enough safety equipment to prevent contagion.

      They spread the wounded between the hospitals of the region, the military returned to their barracks and everyone spread the disease to someone else. Military living together in closed quarters, health personnel spreading to hospitals and retirement homes. In fact, some retirement home lost half of their guests in Lombardy. And the police/military was used to keep order during a crowded soccer game.

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