Thursday, March 19, 2020

Italy's lockdown doesn't seem to work

Apparently struggling countries should learn from the apparently successful ones
And the successful ones should cordially share know-how and drugs

Tonight around 6pm, Italy will surpass all of mainland China as the country with the highest number of Covid-19 fatalities – above China's 3250 or so. We probably couldn't have predicted that exactly Italy would become such a troubled place when the infection was getting started. Despite the Italian leadership, we were still more shocked by the pictures from China, right? It's because most of the shock was caused by their impersonal scenery, not by the underlying severity of the disease.

Maybe the Pakistani patient zero spreading the infected Chinese food was the reason. Maybe something else. But the Italian number of cases looks huge, has almost certainly surpassed the annual flu fatalities of Italy, I think, and the apparent fatality rate is even higher, clearly due to the insufficiency of testing that overlooks lots of mild cases, perhaps hundreds of thousands of them.



But Italy wasn't a country that would take a passive approach. It created the first impressive lockdowns and those were extended and deepened. On March 9th which is already 10 days ago, Italy entered a nation-wide lockdown for its 60+ million people. We have a superficially similar one in Czechia now. The slowdown of infections should already be visible because the symptoms appear in 5 days after infection in average. But there is nothing like a slowdown in yesterday's data. The latest 24-hour fatalities were almost 500, a new record. The new cases have "stabilized" a little bit but it surely seems like too little a reward for such draconian policies.



Despite the mandatory religion that "a lockdown is the reliable cure", the combo of Italian policies just doesn't seem to work. (Spain may be sadly catching up with Italy now.) This just seems to be an empirical fact. A lockdown isn't a reliable recipe for a slowdown of cases. We have an Italy-like lockdown here in Czechia but since the midnight, we are also obliged to cover our noses and mouths in public. Hasn't Italy forgotten about this detail that almost certainly mattered a lot for the suppression of this disease in Asia?

Sadly, the CNN says that doctors hope to see a slowdown from the lockdown because they have no Plan B. Very bad. They should have Plan B, C, ... I, L, ... and at least up to Z. Note that the Italian alphabet has neither J nor K.



Within hours after the declaration of the new rule, the Czech-Japanese band Mirai recorded the song "put on a face mask". ;-) Other viral videos show how to create a face mask. I totally tried to respect the rule – which I personally recommended to the minister of health care via Twitter a few days ago – yesterday but the new hospital-like appearance of the people outside is already driving me up the wall, too.

More generally, the differences between the nations seem huge. We still don't know for sure what are the main reasons because lots of the information is being hidden or tabooized. The fake news media don't really seem to be interested in some detailed patterns or information, just in the proliferation of hysteria. For example, as far as I can say, it's still possible that the virus affects whites more than the yellows, and it's even possible that it avoids the blacks. (Conspiracy theorists could say that it was designed to have this trait.) Does someone have some real data about this trivial point?

With its 572 infections, Czechia is the largest country (counted by the number of cases, it is 22nd in the world) that is still free of fatalities although 5 folks are counted as serious cases now. That would naively translate to less than a 0.2% case fatality rate. Wouldn't it be a good idea for some other countries with apparently much worse numbers to try to learn something from us? Incidentally, Czechia approved the Remdesivir yesterday and it should already be used now.

You may also want to look at Thailand. Thailand (272 cases, 1 fatality) uses anti-HIV drugs lopinavir/ritonavir along with Tamiflu against flu. And it seems to work. Shouldn't others simply try the same? In Italy, migrants in Naples still ignore the lockdown. Shouldn't you really do something about them?

More generally: Shouldn't you try to learn what the apparently successful countries do and try to emulate it? The real general point is that this is a somewhat new disease and people have lots of opinions. Most opinions about "what works" are really just worthless and arbitrary guesses and the belief in these guesses may be described as a pseudoscience. While we live in 2020, many people treat their beliefs in an utterly medieval way. They just decide that their belief is right, pick their fellow believers, and they are fighting against everyone who says something else. You should look at the medieval, 14th century epidemiological rules against the Black Death: only about 1 of 8 tends to be useful according to modern science. And some countries haven't learned anything in the subsequent 700 years!

That's not a modern or scientific approach. You actually need to pay attention to the empirical data. It seems very likely that Italy is making some serious mistake that isn't being done by many other countries. Or it fails to do something that actually matters although the Italians fool each other into thinking that it mustn't matter. Shouldn't you find the mistake, comrades? Even when we look at the Italo disco, we may see several mistakes that the "doctors" are making there!

Italy has extended the lockdown an hour ago. That's probably making them feel good but I think the following matter more:

* mandatory covering of mouth and nose in the public
* investigation of people who were in touch with recent infections
* testing of these people, more testing in general
* recommended social distancing at homes
* crackdown on the disobedient migrants
* our new, creative Czech policy: hours (10am-noon) when only people after 65th birthday may go to shops (segregation: the supermarkets still create some infections)
* anti-flu, anti-HIV drugs, Remdesivir, perhaps chloroquine
* Fujifilm's Favipiravir (Japanese drug for milder cases)
* more drugs
* ask comparable nations with many fewer fatalities what else they do differently!

While locally in Czechia, we persistently hear how nice all the people have become, everyone helps etc., nothing like that exists at the international level. That's too bad. I probably do care about the Italian seniors – some of whom remember the famous guy, Mussolini LOL – more than others. So I am trying to force the Italian doctors (incidentally, the doctors' infections must also be tamed, a huge problem in Italy) to move their ass and learn how to do things more effectively.

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