The Wall Street Journal - 20.03.2020

A6| Friday, March 20, 2020 ** THE WALL STREET JOURNAL.

THE CORONAVIRUS PANDEMIC

BYMARGHERITASTANCATI
ANDERICSYLVERS

The gymnasium of Ponte San Pietro Hospital has been turned into a mortuary in Bergamo, where army trucks are carrying the dead away.

COZZOLI/FOTOGRAMMA/ROPI/ZUMA PRESS

ROME—Italy’s death toll
from the coronavirus epidemic
appears to have overtaken that
in China, the latest official
data show, as Chinese fatali-
ties fall sharply and Europe
becomes the epicenter of a
pandemic that is killing thou-
sands and devastating the
global economy.
The relentless rise in Italy’s
virus deaths reflects the par-
ticular danger the respiratory
disease poses for elderly peo-
ple in a country that has the
world’s second-oldest popula-
tion after Japan.
The economic and social
toll on Italy, which became the
first country to lock down its
entire population this month,
is a harbinger for other West-
ern countries, including the
U.S., where infections and
deaths are rising at a similar
pace to Italy only a few weeks
ago.
By Thursday afternoon,
3,405 people infected with the
coronavirus had died in Italy,
an increase of 427 from a day
earlier. Some 3,245 people car-
rying the virus had died in
China by the end of Wednes-
day, a toll that is now rising by
only around 10 a day, accord-
ing to Chinese official data.
China on Thursday reported
no new domestic infections for
the first time since the out-
break began, another sign of
how it has managed to bring
its outbreak under control af-
ter a prolonged lockdown of
around 500 million residents.
The U.S. and governments
across Europe are stepping up
efforts to combat the epidemic
and mitigate its economic im-
pact. The U.S. further tight-
ened its travel restrictions and
plans to close its northern
border with Canada. London
on Thursday shut part of its

“Don’t sing from your bal-

conies. Bergamo is on its

knees. We need a minute of si-

lence, not music,” she said.

“We underestimated this

disease. I keep on thinking: We

could have done more to pre-

vent Dad from getting sick,”

she said. “I hope people in

other countries don’t make

our same mistakes. Lock your

parents at home. Don’t let

them out.”

The small town of Castigli-

one D’Adda, in an area south-

east of Milan where Italy’s epi-

demic started, has recorded

more deaths in weeks than

they did all of last year. Some

50 people have died so far this

year in the town, which has a

population of about 4,600.

Italy’s deceased from the vi-

rus include Vittorio Gregotti, a

prominent architect who died

in Milan at 92. Mr. Gregotti,

who had severe arthritis, fell

in his house several days be-

fore his death, probably the

first sign that the virus was

beginning to ravage his body.

His wife didn’t think it was

anything serious until a few

days later when he came down

with a high fever. He was ad-

mitted to the hospital March

13 and he died two days later.

“The most terrible thing is

that we can’t even have a fu-

neral for him,” said Massimo

Cacciari, a friend of Mr.

Gregotti for more than four

decades and a former mayor

of Venice. “He won’t be forgot-

ten. We will have a chance to

remember him when this

nightmare is over.”

subway system. Everywhere,

restrictions on social interac-

tions have become the primary

method to prevent new infec-

tions.

Italy was the first Western

country to impose draconian

curbs on movement. Since

March 10, residents have been

allowed out of their homes

only if they can prove they

need to, for instance to buy

food or medicine. Most retail

outlets have shut.

But those rules haven’t yet

had a significant impact on

the trajectory of the outbreak

in Italy. The death toll is espe-

cially grim because its total

confirmed infections are still

much lower, at 41,035 people

as of Thursday, than China’s

total of around 81,000 con-

firmed cases.

Italy’s much older popula-

tion partly accounts for why

the virus is killing more peo-

ple, faster. In all countries,

people over 70 years old are

much more likely to develop

severe symptoms and die than

younger people.

Data compiled by Italy’s Na-

tional Health Institute, its top

disease-control body, shows

that 87% of those who have

died are over 70. Around 13%

of Italians in their 70s who

have tested positive for the vi-

rus have died, a ratio that

rises to 21% for those in their

80s, according to data from It-

aly’s top disease-control body.

Data from China in February

show 8% of infected people in

their 70s were dying, and

around 15% of people age 80

or over.

The even-higher fatality

rate among elderly Italians,

compared with China, may re-

flect an undercounting of total

infections in Italy, where test-

ing has been largely confined

to those with symptoms. Many

virus carriers have no symp-

toms or mild ones.

But it may also increasingly

reflect a health-care crisis in

some areas of northern Italy,

where the outbreak began and

a steep rise in infections has

overwhelmed some hospitals.

In towns such as Bergamo,

Italy’s Virus

Death Toll

Tops China’s

The higher numbers

reflect the European

nation’s larger

population of elderly

doctors have been forced to

give the last available beds in

intensive-care units to younger

or more robust patients, re-

ducing the survival chances of

severely ill patients over 70.

In Bergamo, so many people

have died in such a short time

that army trucks have been

deployed to carry the dead out

of the city for cremation.

Roberta Zaninoni was re-

lieved her own father wasn’t

in those trucks. “He deserves a

real funeraI,” she said. Her fa-

ther, Giuseppe Zaninoni, died

on March 10, only two days af-

ter admission to his local hos-

pital outside Bergamo.

Ms. Zaninoni, 31, wants no

part of the evening singalongs

staged in Italian cities as a

population stuck at home tries

to cheer itself up.

Sources: Johns Hopkins CSSE, Italian government, China National Health Commission (cumulative deaths); Istat (Italy population); United Nations

Department of Economic and Social Affairs (China population)

Note: Latest death total for China as of Wednesday. Provisional population data for Italy.

Population by age group

<

5-

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20-

25-

30-

35-

40-

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50-

55-

60-

65-

70-

75-

80-

>

Men ITALY Women

5 4 3 2 1 0% 0% 1 2 3 4 5

<

5-

10-

15-

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Men CHINA Women

5 4 3 2 1 0% 0% 1 2 3 4 5

Coronavirus deaths in Italy

are rising fast as those in

China flatten. Italy has

proportionately more elderly

people than China,

contributing to its death toll

from the coronavirus.

Cumulative deaths

,



,

,

,

Feb. March

Italy

China

scrambling to cover coronavi-

rus-related costs, pulling from

their reserves and preparing

for steep tax revenue declines

as restaurants close and tour-

ism wanes.

Manufacturers also were

rushing this week to produce

medical ventilators used to

help critically ill coronavirus

patients.

“Every state is shopping for

ventilators,” said Mr. Cuomo,

whose state has the most in-

fections in the U.S. “We’re

shopping for ventilators.” The

governor said New York is fo-

cused on increasing hospital

capacity and finding new hos-

pital beds.

Governors across the coun-

try expressed concerns over

their health-care systems, in-

dustries and first responders in

a call with President Trump

and Vice President Mike Pence

Thursday. Louisiana Gov. John

Bel Edwards said he worried

the virus would exceed the ca-

pacity of his state’s health sys-

tem in as soon as seven days,

and he asked Mr. Trump for

help dealing with a possible

surge. Mr. Trump said he

would consider block grants to

help states respond.

There were more than

244,000 confirmed coronavirus

cases world-wide Thursday, ac-

cording to data from Johns

Hopkins. More than 10,000 peo-

ple have died, while more than

86,000 have since recovered,

most of whom reside in China.

The rapid increase in reported

cases reflects how people in

many countries were unwit-

tingly transmitting the virus.

Health officials and research-

ers in the U.S. said they expect

to see more coronavirus cases

in elder-care facilities, despite

aggressive steps by the industry

and federal nursing-home regu-

lators to limit visitors and iso-

late residents to avoid transmis-

sion. Cases have emerged in

facilities from Illinois to Oregon

and Wyoming, following a

deadly outbreak at a Seattle-

area nursing home.

The number of people apply-

ing for first-time unemployment

benefits increased sharply last

week, the front end of a surge in

claims. Employers have laid off

workers, cut hours or sus-

pended work as preventive

measures have forced busi-

nesses to ratchet down opera-

tions and stop patrons from en-

tering.

Pennsylvania Gov. Tom Wolf

ordered all “non-life-sustaining”

businesses—which excludes

grocery stores, farms, health-

care facilities, and some manu-

facturers—to close by Thursday

evening.

The stimulus unveiled Thurs-

day by Senate Majority Leader

Mitch McConnell (R., Ky.) calls

for taxpayers to receive as much

as $1,200, with married couples

eligible to receive as much as

$2,400 with an additional $

for every child. The government

also would provide $50 billion

in loan guarantees for passen-

ger-air carriers, $8 billion for

cargo air carriers and $150 bil-

lion for other large businesses,

and the proposal authorizes the

government to take equity

stakes in them. The proposal in-

cludes $300 billion for loan

guarantees for small businesses.

The Senate Democratic

leader, Chuck Schumer of New

York, said any stimulus must in-

clude a strengthened form of

unemployment insurance for

Americans who have lost their

jobs because of the pandemic.

House Democrats have pro-

posed direct payments to work-

ers but haven’t agreed on a sin-

gle plan.

Congress passed an initial

$8.3 billion bill that included

funding for vaccine develop-

ment and subsequent legislation

providing for paid leave that is

estimated to cost more than

$100 billion.

A State Department travel

advisory warns Americans

against all international travel

and urges those abroad to re-

turn over fears the pandemic

could halt international com-

mercial travel.

In Washington, Senate Re-
publicans unveiled a stimulus
package that includes direct
cash payments to Americans
and help for businesses and
health-care professionals. The
proposal, days after a Trump
administration plan valued at
$1 trillion, would need support
from congressional Democrats.
U.S. stocks rose Thursday
after central banks deployed
emergency measures to try to
mitigate damage, with the Dow
Jones Industrial Average rising
188.27 points, or 0.9%, to
20087.19. U.S. oil prices re-
bounded from their lowest
level in 18 years, notching their
largest-ever one-day percent-
age climb.
Meanwhile, the slow fed-
eral-government response to
testing for the virus is over-
whelming many state and local
governments. Now, some are
pulling back, using their lim-
ited resources to test only the
most vulnerable. Leaders are

ContinuedfromPageOne

California

Ordered to

Lock Down

Martha Flores, 80, is following orders to remain in her Sherman Oaks, Calif., home during the outbreak.

SARAH REINGEWIRTZ/SOUTHERN CALIFORNIA NEWS GROUP/ZUMA PRESS

White House news conference.

Mr. Trump specifically men-

tioned two drugs, chloroquine

and hydroxychloroquine, that

have long been used for ma-

laria but aren’t approved for

the coronavirus, as well as an

antiviral drug, remdesivir, that

is currently being tested in

clinical research on Covid-19,

the coronavirus disease.

Some physicians are al-

ready using hydroxychloro-

quine and chloroquine to treat

patients with the disease.

These therapies were ap-

proved decades ago and are

off-patent.

“If things don’t go as

planned, it’s not going to kill

anybody,” Mr. Trump said, ar-

guing that the drugs pose less

risk because two of them have

been approved for other uses.

That approach is a depar-

ture from the FDA’s normal

procedure, which is to mea-

sure whether a drug achieves

a balance of safety and effec-

tiveness against a specific dis-

ease. This is done through

clinical studies, often with

some patients getting a study

drug while others are ran-

domly assigned to a control

group.

However, the FDA has al-

lowed compassionate use of

unproven investigational

drugs, such as when a patient

is otherwise on the verge of

death.

There is no known drug to

combat the coronavirus, and

pharmaceutical industry offi-

cials say it could take months

to find an effective treatment.

The timing of whether

drugs are effective and safe

has less to do with regulatory

decisions and more about how

long drug development takes.

Studies must be designed

properly to assess whether an

experimental medicine works,

then patients must be enrolled

in the study and tested.

Mr. Trump specifically

touted drug company Gilead

Sciences Inc., which produces

remdesivir, as offering promis-

ing therapies.

In addition to Gilead, Emer-

gent Biosolutions Inc. and

Takeda Pharmaceutical Co. are

also developing experimental

therapies. The companies and

industry officials have said

that it will be several months

before there is an indication of

whether the drugs are effec-

tive and can be applied

broadly to patients infected

with the disease.

Takeda said if testing is

successful, the company aims

to make the therapy available

to patients between nine and

18 months from now.

Former FDA commissioners

Scott Gottlieb and Mark Mc-

Clellan called for the FDA to

work with manufacturers in a

paper published Thursday. The

two said the agency should

create two task forces to de-

velop therapeutics and vac-

cines, exempt from some regu-

latory requirements.

Some in the Trump admin-

istration are arguing for allow-

ing experimental drugs to get

broader use in the country.

—Maria Armental

contributed to this article.

WASHINGTON—President
Trump said Thursday he is di-
recting the Food and Drug Ad-
ministration to expedite test-
ing and possible broader use
of some investigational medi-

cines to help treat patients di-
agnosed amid the pandemic of
the new coronavirus disease.
“Nothing will stand in our
way as we pursue any avenue
to find what best works
against this horrible virus,”
Mr. Trump told reporters at a

ByThomas M. Burton,

Andrew Restuccia

andJared S. Hopkins

White House Moves to Expand Possible Drug Therapies