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Crush the Curve: Italian town with first death in Italy stopped the virus

The first epicentre in Italy was Vò, a little town of 3,000. It was shut down, fully tested and twice and nine days apart. By testing, isolating, and tracking, they reduced the spread to almost nothing, and this is despite the extraordinary discovery that when the first death happened, already 3% of the town had the disease.

At that point surely the Italian government should have immediately closed everything?

https://www.livescience.com/small-italian-town-cuts-coronavirus-cases-testing.html

Italian village reports no new infections for days after blanket testing

Zoe Tidman, Independent

Mr Zaia, Veneto’s governor, said the trial was “criticised by most sides” but that isolating numbers of undetected positive cases has resulted in Vo Euganeo being today “the safest place in Italy”.

h/t Bill H

In one Italian town, we showed mass testing could eradicate the coronavirus

Andrea Crisanti and Antonio Cassone The Guardian, March 20.

Our experiment came to be by chance. The Italian authorities had a strong emotional reaction to news of the country’s first death – which was in Vò. The whole town was put into quarantine and every inhabitant was tested.

In the first round of testing, 89 people tested positive. In the second round, the number had dropped to six, who remained in isolation. In this way, we managed to eradicate coronavirus from Vò, achieving a 100% recovery rate for those previously infected while recording no further cases of transmission.

The headline is a bit silly — mass testing doesn’t eradicate anything, but it does make strict isolation and containment easier to achieve. Now we probably need mass blind shutdowns to achieve the same effect when earlier action and mass testing then could have crushed the curve with much less effort.

70% asymptomatic or mild — good but ominous data

Italy’s death rate of known cases is shockingly high (which is why I gave up calculating it weeks ago). These numbers are similarish to the Chinese rates where roughly 80% were described as asymptomatic or mild. It probably just depends on the definition of “mild”:

… asymptomatic or quasi-symptomatic subjects represent a good 70% of all virus-infected people and, still worse, an unknown, yet impossible to ignore portion of them can transmit the virus to others…

It shows it’s possible to Crush the Curve and get rid of this virus, but it takes mass testing which we now can’t do because we didn’t act soon enough. But we may be able to do if we ramp up production of tests kits like our lives (and our economy) depended upon it.

On the plus side, this reduces the mortality rate but even so, if we lose control of hospitals we know 3 to 5 times as many people will die if we can’t offer everyone who needs it an ICU unit.

If the fact that only those presenting with the virus were being tested was accounted for, the mortality percentage would fall to more “normal” levels. This is shown by the mortality in the Veneto region, which is steadily around 2.5-3%, still high but threefold less than the ones in Lombardy and Emilia-Romagna.

In Veneto about 8% of the total population was tested. So we still don’t know what the death rate really is.

From the beginning I’ve said that hidden asymptomatic cases will reduce the fatality rate.  We aren’t going to get good numbers on that til we do mass blood testing looking for antibodies that show people have fought off an infection. These have to be done before antibody titres fall (and we don’t know how fast that happens, and whether people carry some protection for a long period or not. SARS responses appear to stay for longer, but the common cold Coronavirus infections last in the order of one year.

Estimating mortality rates is still a guessing game

The best estimates we have are from The Diamond Princess where everyone was tested and South Korea which has done more testing per capita than anywhere. Respectively, the mortality rates were 1% and 0.9%. Given that the Diamond Princess passengers were older the mortality rate in a normal demographic group might be as low as 0.5%.

On the Diamond Princess half the people who tested positive were asymptomatic (49%). But the idea that 80% of the ship didn’t catch the virus is nothing to cheer about. On board the Diamond Princess one infection became 712 in just four weeks –– two of which were supposedly under quarantine conditions.

The cruise ship Diamond Princess set off from Yokohama on January 20, with about 3,700 passengers and crew. On Jan 23 a man got sick and left the boat in Hong Kong on Jan 25th. It took four weeks to infect 20% of the ship and half that time was spent under quarantine conditions.  Of the infected, fully 178 people have still not recovered and 14 remain classed as “severe/critical”. This is a bugger of a virus.

Stay out of the way of this virus, stay home if you can, get your kids out of school. Just stop mixing for the next few weeks and see what unfolds.

 

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Coronavirus Background: ☀ The Demographics: the young are spared, but the severity increases with age, and slightly more for men than women. ☀ The Ro is 2 – 3 and exponential curves are steep. How Coronavirus kills: why the number of ICU units matters so much. ☀ Illness progression: Dry coughs and Fevers, Aches. In 15% of people, by day 5 breathing trouble starts. In 3% (?) by day 8 they may need an ICU (intensive care unit). ☀ The good case of Singapore but the ominous calculations of how fast the ICU beds may run out.  ☀  Proof that viruses don’t have wings and we should have stopped all flights so much earlier. ☀ The story of how American Samoa avoided Flu Deaths with quarantine in 1918. ☀ The story of Vo, the Italian town that stopped the virus. ☀ Delay = Death, statistics show mortality rates rise tenfold if hospitals are overwhelmed.  ☀

Economics: ☀ The huge impact on the Chinese economy, the awful case of Iran.☀

Beware UN advice:Ethiopian WHO chief was part of China’s debt trap diplomacy ☀

Stats and Data: John Hopkins Live Map Worldometer Coronavirus data in Australia 

 

 

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