2020-03-23 Bloomberg Businessweek

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BloombergBusinessweek March 23, 2020

WHENTHEMOVIEABOUTITALY’SNOVELCORONAVIRUS

outbreakis made,theherowillbea bespectacleddoctoron

thecuspofretirement,whoselastrodeoissavinghiscity,

hiscountry,andpossiblytheworld.Inthefictionalversion,

he’llprobablyperishinanactofnobleself-sacrifice.Butfor

now,MassimoGalliofMilan’sSaccohospitalis notonlywell,

butona missiontomakepeoplewhominimizetheconta-

gion’sseverityunderstandthatthey’requitesimplywrong.

Throughouthistory,denialhasyieldedtorealityin

stages—andusuallytoolate,accordingtoGalli,whohelps

overseethefightagainstinfectiousdiseasesinLombardy,

theregionaroundItaly’sfinancialcapital,Milan.“There’sa

firstphase,inwhichyouelbowit away,saying,‘Ourneigh-

borhasit,ah,scary,buthe’sgotit.’Thenthere’sthephase

inwhichyourealizeit’sarrivedinyourhouseandyoudeny

it,‘Noit’simpossible!’” GallisaidonItaly’sLa7television

networkonMarch5.Nextcomesa tugofwarinwhich

inhabitantsdebateharshpreventivemeasuresthatare,trag-

ically,reducedortakentoolate.

“Finally,there’sthephaseoftotalruin,inwhichthesick-

nessrunsrampant,”hesaid—emphasizingthatpartsofItaly

havereachedthatpoint.“IfpeoplethinkI’mexaggerating,

tellthemtocomeandseewhat’shappeninginourwards.”

WhathappenednextonthatTVprogramhelpedcatapult

mefromthelandof“maybeit’sjusta flu”to“howdareany-

oneleavehomewithoutgoodreason.”Thenetworkaccepted

Galli’schallengeanddispatcheda crewtoanintensivecare

unitinCremona,anhour’sdrivesoutheastofMilan.

Thefootageshowsrowsofnakedmen,unconscious,face-

down,handsattheirsidespalmsup,connectedtotubes,

withonlysmall,whiteblanketscoveringtheirbacksides.

Theyaren’twrinkledandancientasyoumighthavepic-

tured(orcallouslywrittenoff ),butrobust-lookingand

pink-fleshed—aliveonlybecausethey’rehookeduptothose

machines.Whatregistersis themotionlessbodies—andthat

theycouldjustaswellbeina morgue.Bynow,someofthem

probablyare.

OnMarch10,Italybecamethefirstdemocraticcoun-

trysinceWorldWarII toimposea nationwidelockdown.

Injustdays,theoutbreakspreadfrom a northerncri-

sistoa nationalone,nowwithmorethan31,000known

infections  and more than 2,500 deaths, second only to

China. France and Spain were the next to clamp down, and

in the U.S., dozens of cities including New York, Los Angeles,

and San Francisco are rolling out restrictions that look an

awful lot like Italy’s just a few days ago. I hope they hurry up.

I’m writing at my dining room table in Rome (I’ve been

instructed not to go to the office) and taking breaks to join

my neighbors in singing out the window. (Last night it was

an Italian version of A Spoonful of Sugar from Mary Poppins.)

As we descend deeper into the lockdown, it’s become clear

that a lot of people back home in the U.S., and even else-

where in Europe, remain in Galli’s denial stages. “If you are

old, sick or in poor health you should stay home, but my

kids are none of the above,” a friend-of-a-friend in the U.S.

wrote on Facebook, complaining he was paying tuition for
internet schooling. “This is just a joke. It’s the flu.”
When the first coronavirus case hit Rome, my wife and
I mused that our kids should maybe find a new way to
school; their standard route involved a shortcut through
the grounds of a hospital that treats infectious diseases. Like
me, you probably didn’t read a lot of the early coverage of
the outbreak in China. Initially swept under the rug by the
communist government, it seemed far removed from what
we might experience in Europe or the U.S. Sadly, Italy pro-
vides an example closer to home. “It’s a precursor of what
will happen in the U.S. and in Europe because of the speed
at which the virus spread,” says Nathalie Tocci, director of
the Italian Institute of International Affairs in Rome.
For me, fully acknowledging where we are required facts,
images,andanecdotes.Sohere’swhatthingslooklikeon
theground:
○ About half of those known to be infected in Italy have no
symptoms. But when symptoms appear, they do so quickly.
About 9% of known positive cases in Italy require intensive
care, and the death rate hovers around 6.5%. For those in
their80s,it’s19%.Evenforthoseofusinour50s,it’s1%—
oddsthatsoundprettylousytome.
○ Those intensive care beds can run out. Lombardy reports
thattheregionstartedwithabout 900 slotsandhasramped
upto1,200byaddingequipmentandcancelingscheduled
surgeries.Anddozensofnonviruspatients—people with
strokes or other ailments—were moved elsewhere in the coun-
try. Those measures have helped Lombardy barely stay ahead
ofthecurve.ByMarch 17 it had 879 coronaviruspatientsin
intensivecare.
○ A more macabre reason Lombardy was able to free up ICU
beds: death. The province notched an additional 220 deaths
from March 16 to 17, bringing the total to 1,420. The city of
Bergamo, northeast of Milan, has run out of space at the hos-
pitalmorgue,andthecrematoriumatthelocalcemeteryis
burningnonstop.
○ On March 6, Italy’s national society of anesthesiology
and intensive care published recommendations for dealing
with “exceptional conditions of imbalance between needs
and available resources” in admissions. In other words, tri-
age. If you’re elderly or deemed to have little chance of sur-
vival,you’llbethefirsttobebumpedofftherespirator.The
stateofNewYorkhashadsimilarguidelinessince2015.
○Even when it’s not fatal, the virus can steal life’s irre-
placeable moments. Sara Herskovits Barrias, a 34-year-
old expectant mother in Milan, had a low fever. When she
tested positive for Covid-19, the disease caused by the virus,
doctors delivered her daughter by Caesarean. For a brief
time, Herskovits Barrias was allowed to nurse after scrub-
bing with sanitizer and donning a mask and rubber gloves.
But when her fever spiked, doctors took the baby away,
likely until the mother is fully recovered. “In the mean-
time,” she told La Repubblica newspaper, “I listen to the
LUCA SANTINI/CONTRASTO/REDUX sounds of the other babies.”