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As Italian I can confirm you guys should hurry and close everything down sooner. I would however prefer the title said “don’t be like the Italian government” in

As Italian I can confirm you guys should hurry and close everything down sooner. I would however prefer the title said “don’t be like the Italian government” instead of just “Italy”. Not everybody here is behaving like a moron, luckily.

easytiger 7y ago
What's the point in closing everything down? What happens when it reopens? Will the virus admit defeat and run away?
- sneak 7y ago
  To assume good faith in your question: the point is to slow the spread, and to flatten the curve so that the hospital system is not overburdened and that as few people as possible that need emergency critical medical care fail to receive it.
  - JumpCrisscross 7y ago
    > so that the hospital system is not overburdened To go one step further, it's to reduce the mortality rate. Mortality when everyone has access to a respirator is one thing. Mortality when hospitals must deny care to thousands is another. Distancing slows down the rate so we spend more time in the first scenario. (It's too late, now, to entirely avoid it.)
    - asjw 7y ago
      Mortality rate in Italy was high only for people 65 and up. But lot more have been brought to hospitals for no real reason, once they were there they couldn't be sent home anymore In fact home confinement has increased a lot once they understood not everyone was in need of medical attention Hell, we even tested people with no symptoms at the beginning because they said they weren't feeling fine or one of their acquittance had flu in the previous week's That of course became immediately problematic for the healthcare system
      - easytiger 7y ago
        That too is my understanding. Italy really screwed up by turning hospitals into disaster zones. Other countries are not letting people with symptoms near hospitals, even for testing, unless they have severe breathing difficulties
      - toyg 7y ago
        > Mortality rate in Italy was high only for people 65 and up. Part of the reason mortality rates are so high among the elderly, though, is the fact that they are de-prioritized in cases when there is a scarcity of beds, ventilators, or other stuff. Doctors are forced to concentrate efforts on people with better survival chances, which are typically the youngest. > home confinement has increased a lot once they understood not everyone was in need of medical attention This is a double-edged sword though. My father has some contacts in the health service near Bergamo (he was a nurse himself etc etc), and he was told some cases don't even make it to the hospital - they go from cough to full-on pneumonia in less than two hours, and die on the ambulance. They now refer to late afternoon as the critical shift, when the stream of intakes spikes and ensuring they are all treated becomes extremely hard. A lot of these cases might have been saved had they been monitored full-time in a hospital.
        asjw 7y ago
        > they go from cough to full-on pneumonia in less than two hours, and die on the ambulance From cough to full pneumonia in few ours sounds made up But people with severe pneumonia that die in the ambulance is not rare Pneumonia still kills 13 thousands people every year in Italy Pneumonia has a very high mortality rate, the average for EU is 25/100 thousands while covid-19 is at 2/100 thousands The flu kills between 9 and 10 thousands people every year in Italy Most die home because nobody goes to the doctor for a flu usually If they did, even with light symptoms, we would have the same situation we are having now
        easytiger 7y ago
        > Pneumonia still kills 13 thousands people every year in Italy In bad epidemic years it kills way more in Italy. 24k in 2017 epidemic You are absolutely right
  - threatofrain 7y ago
    So what does that mean in the long run? After virtual lockdown is lifted? A resurgence in winter?
    - ForHackernews 7y ago
      If we're really lucky, we might have an effective vaccine by early 2021.
    - sdkaufman 7y ago
      - If we can reduce / avoid overloading hospitals, people who get it after the lockdown will get better treatment and will be less likely to die than if they got it now. - Over time, we will come up with more effective treatments and perhaps a vaccine. We will likely also have more equipment like ventilators and protective gear at our disposal. - More people will have had it and built up some level of immunity, and "herd immunity" means it will not spread as quickly.
      - mr_toad 7y ago
        Herd immunity won’t make a significant difference until half the population have had it, and a vaccine could be a year away (if ever).
        threatofrain 7y ago
        This also all assumes that the virus won't be quickly mutating. If it is, vaccines and herd immunity will have diminished efficacy.
    - avip 7y ago
      In the long run we'll have protocols and procedures, and your physician will have seen hundreds of covid cases before treating you, and the fatality rate will (wishfully, possibly) converge to standard seasonal flu.
  - easytiger 7y ago
    Surely then it would make sense to only embargo people in identified vulnerable groups? Let the rest of the nation go about their business given they are very very unlikely to have anything bad happen and then, presumably they will stop being infectious even if the virus does get into their system again And what does it mean to quarantine people? How are they fed? Can they go outside? You can't get the virus walking down the street past an infected person.
    - hk__2 7y ago
      > Surely then it would make sense to only embargo people in identified vulnerable groups? Let the rest of the nation go about their business given they are very very unlikely to have anything bad happen and then, presumably they will stop being infectious even if the virus does get into their system again Vulnerable or not, the rest of the nation is a transmission vector. Also, not all deaths happen among the identified vulnerable groups: "they are very very unlikely to have anything bad happen" is completely false.
      - easytiger 7y ago
        It's not false. The rates of mortality being quoted are fundamentally wrong because testing is highly selective. I personally know people who likely have it, haven't been tested and so don't get counted. The virus is clearly more widespread than 200k infected who have actually been tested.
      - Zach_the_Lizard 7y ago
        > Also, not all deaths happen among the identified vulnerable groups: "they are very very unlikely to have anything bad happen" is completely false. Even assuming a 4% death rate (too high for the less vulnerable), that's a 96% chance of not having the worst possible consequences. So I'd say that's "very unlikely" for them. This isn't the flu, and it's possible for even people in their teens to die (true of the flu as well), but let's not act like it's the likely outcome. I've seen numbers in the 0.2% range for younger (< 39) age cohorts. That's twice as deadly as the flu (0.1%) but IMO not "shut society down" levels of bad for people in that age group.
    - 7y ago
- alasdair_ 7y ago
  The point is to avoid causing a giant spike in ER visits that end up overwhelming the system.
- deleted 7y ago
  [deleted]
- deleted 7y ago
  [deleted]
- ahupp 7y ago
  Closing everything down will spread out new infections so the healthcare system can handle them, and it buys time to roll out a testing process.
  - nullc 7y ago
    Not just testing, but treatment. There are a half dozen existing anti-viral drugs currently in testing which can be rapidly deployed if they turn out to be effective because they're already approved and manufactured for other usage. There are also several new anti-viral compounds and the potential for clonal antibody treatments whos approval might get fast-tracked if they prove highly effective. Even absent better treatment strong measures taken swiftly will do more than just delay the inevitable. But reducing our critical care saturation we'll save lives. But there is also a very realistic prospect of improved meaningfully treatment in the coming weeks/months.
- michaelbuckbee 7y ago
  It's to slow the spread of the virus so that those with serious life-threatening symptoms can get hospital care. Say you live in a town with 100 hospital beds, it's far better for everybody if they get 100 sick people a week for 10 weeks than 1,000 sick people this week.
  - asjw 7y ago
    That's wishful thinking in some ways though Virus has spread initially because it got into hospitals and family members visiting brought it around Italy should have locked down hospitals first, but it's kinda impractical As for the "stay home" mantra, of course it helps, but radically changing people habits make them also less predictable, so instead of people going to work, we had people who ran away from orange areas and even red, because they could, or gathering for not staying alone, spreading it even more Sometimes the perfect measure on paper doesn't work the way people imagine Of course if we talk about military personnel patrolling the streets that could work, but it's a little bit against what a democracy exists for...
    - wcoenen 7y ago
      > Sometimes the perfect measure on paper doesn't work the way people imagine This is true. Here in Belgium all restaurants and non-essential shops closed. The day before this took effect, restaurants were packed with people going out while they still could. The day after, people went shopping and dining en masse just over the border in France and the Netherlands, where the same measures had not been taken.
      - mcv 7y ago
        It's amazing how reckless some people can be. Shut down restaurants to stop the spread of the virus, so people go to restaurants further away, to spread the virus even more. You'd think shutting everything down would be a pretty clear signal, but apparently a lot of people just don't care.
        zozbot234 7y ago
- rrss 7y ago
  > Specific goals for implementing NPIs early in a pandemic include slowing acceleration of the number of cases in a community, reducing the peak number of cases during the pandemic and related health care demands on hospitals and infrastructure, and decreasing overall cases and health effects https://www.cdc.gov/mmwr/volumes/66/rr/rr6601a1.htm https://www.cdc.gov/mmwr/volumes/66/rr/rr6601a1.htm
- jm547ster 7y ago
  It reduces the R0 factor sufficiently to give time to get a proper treatment plan in place. Meaning antivirals that won’t require millions of people being placed in ICUs which the healthcare system currently cannot support neither in infrastructure nor manpower.
Udik 7y ago
The Italian government wasn't even that bad in this occasion. Italy's been the first western country to be badly hit, and given the exponential spread of the virus it had very little time to take absolutely unprecedented measures. Other countries have it a little bit easier as they can see what happened in Italy and follow the same road, earlier. Also, take in account that the Lombardy region and the Milan area are one of the most densely populated in Europe, with a huge traffic of people for business and tourism, as well as the economic center of the country. Preventing and containing the epidemic wasn't easy at all, and the decision to quarantine it extremely difficult given its importance.
mcv 7y ago
Two non-government-related issues that I heard complicated the situation in Italy: just before the shutdown of the north, a lot of people fled the north and moved to other parts of the country, bringing the virus with them. And Italians are very family-oriented, and therefore less willing to socially isolate their elderly. Normally an admirable quality, but in this case it can endanger the most vulnerable group.
- toyg 7y ago
  > just before the shutdown of the north, a lot of people fled the north Part of the North had already been in shutdown for a week or so. Unfortunately, a plan to greatly expand the quarantined zone was leaked to the press by a shady journalist-spy-henchman. This resulted in thousands of Milanese rushing to "escape" before the plan had officially been announced. At that point, instead of going ahead with that plan, the government shut down the whole country and instructed local authorities in the South to control and monitor the stream of "escapees". > less willing to socially isolate their elderly I think that's a bit of a stereotype - in reality there are plenty of socially-isolated elderly in any major Italian city. It's just that the average age is so high over there, "the elderly" as a category includes __a lot__ of people, very often still working in their 60s or 70s in key roles (or nominally retired but, say, running amateur football clubs or volunteering in other third-sector activities that end up being essential to local life). Socially isolating all of them is simply unfeasible - you'd end up paralizing most regional assemblies and even the national Parliament, for example.
jsjddbbwj 7y ago
Pretty sure the Italian government is chosen by the Italian citizens.
JimTheMan 7y ago
I mean, I'd take it as it was intended. Italy the state. If it was intended to be particular to the populace it would be: "Don't be Italian" OR "Don't be like the Italians"
hexl 7y ago
Mexico is poised to beat them all, our president is doing nothing to prevent the spread. A Maduro-like ignorant, stupid and psychopathic president that has left the country without essential drugs.

easytiger 7y ago

What's the point in closing everything down? What happens when it reopens? Will the virus admit defeat and run away?

sneak 7y ago
To assume good faith in your question: the point is to slow the spread, and to flatten the curve so that the hospital system is not overburdened and that as few people as possible that need emergency critical medical care fail to receive it.
- JumpCrisscross 7y ago
  > so that the hospital system is not overburdened To go one step further, it's to reduce the mortality rate. Mortality when everyone has access to a respirator is one thing. Mortality when hospitals must deny care to thousands is another. Distancing slows down the rate so we spend more time in the first scenario. (It's too late, now, to entirely avoid it.)
  - asjw 7y ago
    Mortality rate in Italy was high only for people 65 and up. But lot more have been brought to hospitals for no real reason, once they were there they couldn't be sent home anymore In fact home confinement has increased a lot once they understood not everyone was in need of medical attention Hell, we even tested people with no symptoms at the beginning because they said they weren't feeling fine or one of their acquittance had flu in the previous week's That of course became immediately problematic for the healthcare system
    - easytiger 7y ago
      That too is my understanding. Italy really screwed up by turning hospitals into disaster zones. Other countries are not letting people with symptoms near hospitals, even for testing, unless they have severe breathing difficulties
    - toyg 7y ago
      > Mortality rate in Italy was high only for people 65 and up. Part of the reason mortality rates are so high among the elderly, though, is the fact that they are de-prioritized in cases when there is a scarcity of beds, ventilators, or other stuff. Doctors are forced to concentrate efforts on people with better survival chances, which are typically the youngest. > home confinement has increased a lot once they understood not everyone was in need of medical attention This is a double-edged sword though. My father has some contacts in the health service near Bergamo (he was a nurse himself etc etc), and he was told some cases don't even make it to the hospital - they go from cough to full-on pneumonia in less than two hours, and die on the ambulance. They now refer to late afternoon as the critical shift, when the stream of intakes spikes and ensuring they are all treated becomes extremely hard. A lot of these cases might have been saved had they been monitored full-time in a hospital.
      - asjw 7y ago
        > they go from cough to full-on pneumonia in less than two hours, and die on the ambulance From cough to full pneumonia in few ours sounds made up But people with severe pneumonia that die in the ambulance is not rare Pneumonia still kills 13 thousands people every year in Italy Pneumonia has a very high mortality rate, the average for EU is 25/100 thousands while covid-19 is at 2/100 thousands The flu kills between 9 and 10 thousands people every year in Italy Most die home because nobody goes to the doctor for a flu usually If they did, even with light symptoms, we would have the same situation we are having now
        easytiger 7y ago
        > Pneumonia still kills 13 thousands people every year in Italy In bad epidemic years it kills way more in Italy. 24k in 2017 epidemic You are absolutely right
- threatofrain 7y ago
  So what does that mean in the long run? After virtual lockdown is lifted? A resurgence in winter?
  - ForHackernews 7y ago
    If we're really lucky, we might have an effective vaccine by early 2021.
  - sdkaufman 7y ago
    - If we can reduce / avoid overloading hospitals, people who get it after the lockdown will get better treatment and will be less likely to die than if they got it now. - Over time, we will come up with more effective treatments and perhaps a vaccine. We will likely also have more equipment like ventilators and protective gear at our disposal. - More people will have had it and built up some level of immunity, and "herd immunity" means it will not spread as quickly.
    - mr_toad 7y ago
      Herd immunity won’t make a significant difference until half the population have had it, and a vaccine could be a year away (if ever).
      - threatofrain 7y ago
        This also all assumes that the virus won't be quickly mutating. If it is, vaccines and herd immunity will have diminished efficacy.
  - avip 7y ago
    In the long run we'll have protocols and procedures, and your physician will have seen hundreds of covid cases before treating you, and the fatality rate will (wishfully, possibly) converge to standard seasonal flu.
- easytiger 7y ago
  Surely then it would make sense to only embargo people in identified vulnerable groups? Let the rest of the nation go about their business given they are very very unlikely to have anything bad happen and then, presumably they will stop being infectious even if the virus does get into their system again And what does it mean to quarantine people? How are they fed? Can they go outside? You can't get the virus walking down the street past an infected person.
  - hk__2 7y ago
    > Surely then it would make sense to only embargo people in identified vulnerable groups? Let the rest of the nation go about their business given they are very very unlikely to have anything bad happen and then, presumably they will stop being infectious even if the virus does get into their system again Vulnerable or not, the rest of the nation is a transmission vector. Also, not all deaths happen among the identified vulnerable groups: "they are very very unlikely to have anything bad happen" is completely false.
    - easytiger 7y ago
      It's not false. The rates of mortality being quoted are fundamentally wrong because testing is highly selective. I personally know people who likely have it, haven't been tested and so don't get counted. The virus is clearly more widespread than 200k infected who have actually been tested.
    - Zach_the_Lizard 7y ago
      > Also, not all deaths happen among the identified vulnerable groups: "they are very very unlikely to have anything bad happen" is completely false. Even assuming a 4% death rate (too high for the less vulnerable), that's a 96% chance of not having the worst possible consequences. So I'd say that's "very unlikely" for them. This isn't the flu, and it's possible for even people in their teens to die (true of the flu as well), but let's not act like it's the likely outcome. I've seen numbers in the 0.2% range for younger (< 39) age cohorts. That's twice as deadly as the flu (0.1%) but IMO not "shut society down" levels of bad for people in that age group.
  - 7y ago
alasdair_ 7y ago
The point is to avoid causing a giant spike in ER visits that end up overwhelming the system.
deleted 7y ago
[deleted]
deleted 7y ago
[deleted]
ahupp 7y ago
Closing everything down will spread out new infections so the healthcare system can handle them, and it buys time to roll out a testing process.
- nullc 7y ago
  Not just testing, but treatment. There are a half dozen existing anti-viral drugs currently in testing which can be rapidly deployed if they turn out to be effective because they're already approved and manufactured for other usage. There are also several new anti-viral compounds and the potential for clonal antibody treatments whos approval might get fast-tracked if they prove highly effective. Even absent better treatment strong measures taken swiftly will do more than just delay the inevitable. But reducing our critical care saturation we'll save lives. But there is also a very realistic prospect of improved meaningfully treatment in the coming weeks/months.
michaelbuckbee 7y ago
It's to slow the spread of the virus so that those with serious life-threatening symptoms can get hospital care. Say you live in a town with 100 hospital beds, it's far better for everybody if they get 100 sick people a week for 10 weeks than 1,000 sick people this week.
- asjw 7y ago
  That's wishful thinking in some ways though Virus has spread initially because it got into hospitals and family members visiting brought it around Italy should have locked down hospitals first, but it's kinda impractical As for the "stay home" mantra, of course it helps, but radically changing people habits make them also less predictable, so instead of people going to work, we had people who ran away from orange areas and even red, because they could, or gathering for not staying alone, spreading it even more Sometimes the perfect measure on paper doesn't work the way people imagine Of course if we talk about military personnel patrolling the streets that could work, but it's a little bit against what a democracy exists for...
  - wcoenen 7y ago
    > Sometimes the perfect measure on paper doesn't work the way people imagine This is true. Here in Belgium all restaurants and non-essential shops closed. The day before this took effect, restaurants were packed with people going out while they still could. The day after, people went shopping and dining en masse just over the border in France and the Netherlands, where the same measures had not been taken.
    - mcv 7y ago
      It's amazing how reckless some people can be. Shut down restaurants to stop the spread of the virus, so people go to restaurants further away, to spread the virus even more. You'd think shutting everything down would be a pretty clear signal, but apparently a lot of people just don't care.
      - zozbot234 7y ago
rrss 7y ago
> Specific goals for implementing NPIs early in a pandemic include slowing acceleration of the number of cases in a community, reducing the peak number of cases during the pandemic and related health care demands on hospitals and infrastructure, and decreasing overall cases and health effects https://www.cdc.gov/mmwr/volumes/66/rr/rr6601a1.htm https://www.cdc.gov/mmwr/volumes/66/rr/rr6601a1.htm
jm547ster 7y ago
It reduces the R0 factor sufficiently to give time to get a proper treatment plan in place. Meaning antivirals that won’t require millions of people being placed in ICUs which the healthcare system currently cannot support neither in infrastructure nor manpower.

Udik 7y ago

The Italian government wasn't even that bad in this occasion. Italy's been the first western country to be badly hit, and given the exponential spread of the virus it had very little time to take absolutely unprecedented measures. Other countries have it a little bit easier as they can see what happened in Italy and follow the same road, earlier. Also, take in account that the Lombardy region and the Milan area are one of the most densely populated in Europe, with a huge traffic of people for business and tourism, as well as the economic center of the country. Preventing and containing the epidemic wasn't easy at all, and the decision to quarantine it extremely difficult given its importance.

mcv 7y ago

Two non-government-related issues that I heard complicated the situation in Italy: just before the shutdown of the north, a lot of people fled the north and moved to other parts of the country, bringing the virus with them. And Italians are very family-oriented, and therefore less willing to socially isolate their elderly. Normally an admirable quality, but in this case it can endanger the most vulnerable group.

toyg 7y ago
> just before the shutdown of the north, a lot of people fled the north Part of the North had already been in shutdown for a week or so. Unfortunately, a plan to greatly expand the quarantined zone was leaked to the press by a shady journalist-spy-henchman. This resulted in thousands of Milanese rushing to "escape" before the plan had officially been announced. At that point, instead of going ahead with that plan, the government shut down the whole country and instructed local authorities in the South to control and monitor the stream of "escapees". > less willing to socially isolate their elderly I think that's a bit of a stereotype - in reality there are plenty of socially-isolated elderly in any major Italian city. It's just that the average age is so high over there, "the elderly" as a category includes __a lot__ of people, very often still working in their 60s or 70s in key roles (or nominally retired but, say, running amateur football clubs or volunteering in other third-sector activities that end up being essential to local life). Socially isolating all of them is simply unfeasible - you'd end up paralizing most regional assemblies and even the national Parliament, for example.

jsjddbbwj 7y ago

Pretty sure the Italian government is chosen by the Italian citizens.

JimTheMan 7y ago

I mean, I'd take it as it was intended. Italy the state. If it was intended to be particular to the populace it would be: "Don't be Italian" OR "Don't be like the Italians"

hexl 7y ago

Mexico is poised to beat them all, our president is doing nothing to prevent the spread. A Maduro-like ignorant, stupid and psychopathic president that has left the country without essential drugs.