you ask me to send you an update on the situation in Italy.
I never imagined I’d have to give you the news I am about to communicate to you: we live as in a nightmare, an unrecognizable reality, our habits and certainties vanish, but for many of us it is not easy to cope with the emptiness they leave. So some try to pretend nothing’s happening, while the whole society around them is mobilized as in a war, because now this is the reality: the enemy is not a foreign power, but a disease whose diffusion speed exceeds the capacity of our healthcare system to address care needs.
How can we deal with the fact that soon, in the hospitals of the Milan area, it could be possible that patients who need to be hospitalized in the intensive care unit might not be taken care of, that is, they won’t be attached to assisted ventilation machines if the are over 60 years old?The hospital is the place of care and we grew up with the convinced and sometimes obvious expectation that every remedy available to the possibilities of science and technology would be given to us, free of charge and promptly, in case of need. This has been the case up to now. Today, doctors and nurses are forced daily and repeatedly to decide which patient to intubate, and which to let die. They follow codes and methods studied at the university which for many of them (except a small part who would have gone on mission in areas of war or natural disaster anyway) had to remain an academic preparation, and not the reality of their job in which to wake up every morning .
This incredible and distressing news has only leaked outside of hospitals since yesterday. There is such a terror of panic that public administrators tend to communicate an untrue picture to the public. Unfortunately, this understandable caution means that too few citizens assume the behaviors that constitute the only real possibility of facing the virus, any behavior whose effect is to limit the spread of the infection. We know what we have to do, and we know that to do it effectively and on a scale sufficient to stem the epidemic, first of all we need to eliminate the opportunities for infection.
Ginevra and Paolo Naldini.
The infected have risen from 1500 on 1 March to more than 10,000 today, which is 10 March. In less than 10 days. But we know that in many cases the tests are not made. I have been home since Sunday, I contacted the family doctor and then the national emergency number COVID19; I have the classic symptoms except respiratory fatigue, a couple of collaborators of mines – whom I met in recent days – come from the most affected areas of Italy; yet, I am told to take paracetamol, and if the symptoms worsen until I find it hard to breathe, then I should call an ambulance or family doctor.
Your uncle Massimo tells me that one of his collaborators who lives in one of the most affected cities in the Milan area, who returned from China in February, saw his mother and mother-in-law fall ill and die, and his wife hospitalized in intensive care: but he also says that the two women were not considered death from COVID19. You will think that in this case the test has been done, since he has had frequent contacts with that collaborator and since he has also developed the typical symptoms (including a breathing difficulty): no, denied, to him and to your aunt to whom the doctor has diagnosed with pleurisy, that is an inflammation of the pleura, the pulmonary membrane, coincidentally… but in her case, in their case, there is no mention of COVID19.
Hence, the real numbers must be much higher than the official ones. What we know is certainly underestimated. Yet the reality that the official numbers represent is terrible: in Lombardy there are already more than 6000 infected people, of whom 3000 in hospital and 466 in intensive care (there are 900 discharged and 400 deceased): therefore, you can see that the inpatients are almost two out of three (also including the deceased). Out of three sick people, two end up in the hospital: it is not a simple flu! And it seems that the lanes are also full of “boys” my age, under 50.
I said that we know what we have to do: Wuhan is now seeing the figure of infected people drop a lot. And also in the city of Codogno, the Italian epicenter, today we had 0 new infections, for the first time. Why? Because drastic measures have been taken! City closed and everyone stays home. You don’t go to work or anywhere else except for very serious reasons. Yet, even if yesterday the government launched measures unprecedented in the history of our country (which has also seen many calamities and plagues), we have not reached a real closure of cities and houses: there has not been the will, essentially for reasons of economic strategy and panic prevention. But both reasons are irrational: economically, as many entrepreneurs claim, it is convenient to have a total but as short and clear closure as possible, rather than a long and confused partial closure, even more so if the mild interventions cause the contagion to spread exponentially and you run the risk it becoming an unsustainable bomb from all points of view.
For panic, however, we really fear that if the contagions are allowed to grow at this rate, we will soon have corpses that cannot even receive dignified treatment, and scenes that we thought we only would see anymore in the American apocalyptic series, sitting on a sofa in one winter night.
What to do?
– Today we must all go into real isolation at home for at least two weeks.
– In these two weeks, therefore, there should no longer be new infections, nor new patients, but all the infected of the past will fall ill in this period.
– If, on the other hand, you do not go into isolation, there will never be an end to the infection, you will not even start to fight, the infections will grow as they do now; double every 2.3 days … in 3 weeks, if different factors do not intervene to reduce the growth rate, an impressive and unthinkable number of people will be infected! It will be the “end of the world”, in the sense that in addition to the death of many people, there will be unrest and violence (who will ensure public order?) And the nightmares that we have dreamed of (and partly lived) in history will come true in front of our eyes.
– Everyone’s collaboration is needed to defeat the virus in the world, but there is more: everyone can (and must begin to) defeat it in his/her own family environment: if a group that lives in the same house has been isolated from contacts with others for two weeks, then all the members of the group will be “healthy”: either they already have had the disease or they have not yet been infected.
– At that point, that is after two weeks, there will be a very different situation from today: one scenario is the virus did not slow down. It means that the isolation did not work, the hospitals are clogged, thousands die every day, many elderly and adults and young immunosuppressed people will die. A dramatic hecatomb that will not spare any family. The second scenario is that the virus has slowed down. The measures work. Perhaps in certain situations changes to the insulation can be introduced. Hospitals can respond to the request. There is time to organize other hospitals and doctors etc… in a nutshell: the virus will be defeated over time, no one knows how long.
I think of you, Ginevra, living with your 3 friends of yours, whom I know well, smart, brilliant and sensitive guys, capable of going against the current with thought and actions. I understand that everything around you seems normal, and therefore my words seem to sing a song out of tune. But believe me: not even ten days ago, in Italy we were like you now. People thought that only the elderly with multiple serious illnesses would die, and to this thought they felt relieved, without admitting it, of course; but in fact, then, they acted as if they didn’t really intend to avoid that scenario.
But do we really want to make our elders die like this? And who knows how many will go away with them even though they are not elderly! We want to pretend nothing’s happening and continue to go to pubs, parties, concerts, but also on the subway and train and at work and everywhere else in the city as if the virus had not already infected more than 100 thousand people in the world (officially)?
Ginevra and Paolo Naldini.
Get ready: I don’t know how many days, this disease will also break out in London. And the administrators will no longer hesitate as they do now.
The sooner you stop, the less death and damage you will count. The sooner you decide to reduce or eliminate your encounters with other people, the sooner you will stop being a potential infected and a potential transmitter of infection.
Stay at home. Spread the contagion of the commitment to others, which today is paradoxically achieved by staying at home.
Sneaky is the virus COVID19 that spreads through sociality, that uses in order to infect the other the hand that the other offers us in greeting or help. That exploits the last common good that unites us, the air, making sharing sinisterly a synonym of infection. Sneaky because it travels with the music of our words exchanged when we meet, when we tell each other our stories, when we advance proposals. Meanwhile we await for scientists to find a cure, and while doctors and nurses make immense efforts to save lives, the part that each of us can undertake begins with a subtraction exercise. Step back. Return home. Living with your friends and family for a very long period of two weeks: if we all did, the virus would be defeated world wide. I know it will not be possible, but we can give it a strong blow and slow it down, slow down enough to allow the health system and public administrators to withstand the impact and take time, precious time to find the weapon capable of defeating it once and for all. And for everyone. Regardless of age.
Your generation, who inherits an unsustainable world from their fathers, receives from this virus a responsibility that perhaps has never given itself in history to another emerging generation: that of saving the fathers, and the fathers of the fathers. And to do this, you are asked to give up socializing and discovering the world and the joy of living with others for at least two weeks.
It is a fate that a great novelist could have entrusted to your generation. A great novelist, or a virus. But the pages of this book have yet to be written and it’s up to you to decide what to write. It could be a passage that unites fathers and sons in this third millennium born under such fatal auspices.
We all have a great opportunity: to transform the greatest threat to survival of a part (large or not large we do not know for sure) of the humans into the occasion of conjunction and sharing between fathers and sons (mothers and daughters) that has never been in history realized. Having won this battle together, climate change, the demographic crisis, the post-oil transition and all the other epochal challenges that await us, will be easier.
Biella, March 10 2020