The Lessons from Italy That Turned Into a Containment Success Story

I am not so sure about the explanation below.  I think COVID roared through Italy's care homes and killed off most of the vulnerable people.  So there is now nobody left for it to kill

ROME - When the coronavirus erupted in the West, Italy was the nightmarish epicenter, a place to avoid at all costs and a shorthand in the United States and much of Europe for uncontrolled contagion.

“You look at what’s going on with Italy,” President Trump told reporters on March 17. “We don’t want to be in a position like that.” Joseph R. Biden Jr., the presumptive Democratic nominee, used Italy’s overwhelmed hospitals as evidence for his opposition to Medicare for All at a presidential debate. “It is not working in Italy right now,” he said.

Fast forward a few months, and the United States has suffered tens of thousands more deaths than any country in the world. European states that once looked smugly at Italy are facing new flare-ups. Some are imposing fresh restrictions and weighing whether to lock down again.

Prime Minister Boris Johnson of Britain on Friday announced a delay to a planned easing of measures in England as the infection rate there rose. Even Germany, lauded for its efficient response and rigorous contact tracing, has warned that lax behavior is prompting a surge in cases.

And Italy? Its hospitals are basically empty of Covid-19 patients. Daily deaths attributed to the virus in Lombardy, the northern region that bore the brunt of the pandemic, hover around zero. The number of new daily cases has plummeted to “one of the lowest in Europe and the world,” said Giovanni Rezza, director of the infective illness department at the National Institute of Health. “We have been very prudent.”

And lucky. Today, despite a tiny uptick in cases this week, Italians are cautiously optimistic that they have the virus in check - even as Italy’s leading health experts warn that complacency remains the jet fuel of the pandemic. They are aware that the picture can change at any moment

How Italy has gone from being a global pariah to a model - however imperfect - of viral containment holds fresh lessons for the rest of the world, including the United States, where the virus, never under control, now rages across the country

After a stumbling start, Italy has consolidated, or at least maintained, the rewards of a tough nationwide lockdown through a mix of vigilance and painfully gained medical expertise.

Its government has been guided by scientific and technical committees. Local doctors, hospitals and health officials collect more than 20 indicators on the virus daily and send them to regional authorities, who then forward them to the National Institute of Health.

The result is a weekly X-ray of the country’s health upon which policy decisions are based. That is a long way from the state of panic, and near collapse, that hit Italy in March.

This week, Parliament voted to extend the government’s emergency powers through Oct. 15 after Prime Minister Giuseppe Conte argued the nation could not let its guard down “because the virus is still circulating.

Those powers allow the government to keep restrictions in place and respond quickly - including with lockdowns - to any new clusters. The government has already imposed travel restrictions on more than a dozen countries to Italy, as the importation of the virus from countries is now the government’s greatest fear.

There are a lot of situations in France, Spain, the Balkans, which means that the virus is not off at all,” said Ranieri Guerra, assistant director general for strategic initiatives at the World Health Organization and an Italian doctor. “It can come back at any time.”

There is no doubt that the privations of the lockdown were economically costly. For three months, businesses and restaurants were ordered closed, movement was highly restricted - even between regions, towns and streets - and tourism ground to a halt. Italy is expected to lose about 10 percent of its gross domestic product this year.

But at a certain point, as the virus threatened to spread uncontrollably, Italian officials decided to put lives ahead of the economy. “The health of the Italian people comes and will always come first,” Mr. Conte said at the time.

Italian officials now hope that the worst of the cure came in one large dose - the painful lockdown - and that the country is now safe to resume normal life, albeit with limits. They argue that the only way to start up the economy is to keep tamping down the virus, even now.

The strategy of closing down completely invited criticism that the government’s excessive caution was paralyzing the economy. But it may prove to be more advantageous than trying to reopen the economy while the virus still rages, as is happening in countries like the United States, Brazil and Mexico.

That does not mean that calls for continued vigilance, as elsewhere in the world, have been immune to mockery, resistance and exasperation. In that, Italy is no different.

Masks often are missing or lowered in trains or buses, where they are mandatory. Young people are going out and doing the things young people do - and risk in that way spreading the virus to more susceptible parts of the population. Adults started gathering at the beach and for birthday barbecues. There is still no clear plan for a return to school in September.

There is also a burgeoning, and politically motivated, anti-mask contingent led by nationalist Matteo Salvini, who on July 27 declared that replacing handshakes and hugs with elbow bumps was “the end of the human species.”

At his rallies, Mr. Salvini, the leader of the populist League party, still shakes hands and wears his mask like a chin guard. In July, during a news conference, he accused the Italian government of “importing” infected immigrants to create new clusters and extend the state of emergency.

This week, Mr. Salvini joined other mask skeptics - nicknamed the “negationists” by critics - for a protest in the Senate library, along with special guests such as the Italian crooner Andrea Bocelli, who said he did not believe the pandemic was so serious because “I know a lot of people and I don’t know anyone who ended up in an I.C.U.”

But the country’s leading health experts say that the lack of severe cases is indicative of a decrease in the volume of infections, as only a small percentage of the infected get very sick. And so far, Italy’s malcontents have not been numerous or powerful enough to undermine what has been a hardwon trajectory of success in confronting the virus after a calamitous star

Italy’s initial isolation by European neighbors at the outset of the crisis, when masks and ventilators were hardly pouring in from across the borders, may actually have helped, Mr. Guerra, the W.H.O. expert, said

“There was competition initially, there was no collaboration,” Mr. Guerra said. “And everyone acknowledged Italy was left alone at that time.” As a result, he said, “what they had to do at that time because we were left alone turned out to be more effective than other countries.”

Italy first quarantined towns and then the Lombardy region in the north and then the entire peninsula and its islands, despite the near absence of the virus in much of central and southern Italy. That not only prevented workers in the industrial north from returning home in the much more vulnerable south, but it also fostered and forced a unified national response.

During the lockdown, movement was strictly limited, between regions and towns and even city blocks, and people had to fill in “auto-certification” forms to prove that they needed to go outside for work, health or “other necessities.” Masks and social distancing regulations were enforced by some regional authorities with steep fines. Generally, if grudgingly, the rules were followed.

As searing scenes of human suffering, empty streets and the heavy toll on an elderly generation of northern Italians spread, the transmission rate of the virus quickly decreased, and the curve flattened, as opposed to other European countries, such as Sweden, which pursued an alternative to locking down.

That the initial outbreak was localized in the overwhelmed hospitals created enormous stress, but it also enabled doctors and nurses to expedite contact tracing.

Then the country reopened, gradually, expanding liberties at two-week intervals to respond to the virus’s incubation period.

The lockdown eventually had a secondary effect of decreasing the volume of virus circulating in society, and thus reducing the probability of coming in contact with someone who had it. At the end of the lockdown, the virus circulation had steeply fallen off and in some central and southern regions, there were hardly any chains of transmission at all.

“It’s always a matter of probability with these pathogens,” said Mr. Guerra, adding that new early alarm systems such as the monitoring of wastewater for traces of virus had lowered the probability of infection even more.

As the government considers a new decree to reopen night clubs, festivals and cruise ship travel, many health experts have implored the country not to let down its guard.

“Even if the situation is better than in other countries, we should continue to be very prudent,” said Dr. Rezza of the National Institute of Health, adding that he thought the question of what Italy had done right was better posed “at the end of the epidemic.”

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Patients deserve a 'right to try' drugs that are safe and might help with COVID-19

If a drug is proven to be safe, is Food and Drug Administration-approved, has been administered hundreds of millions of times, and your doctor believes that it might possibly help your health, would you want access to that drug?

Of course you would. You would want the right to try it, even if you weren’t sure it would be effective. Yet, the right to try a pharmaceutical that is safe and possibly effective is being denied throughout this country.

I led the fight that my predecessor in Congress, Arizona Rep. Matt Salmon, a Republican, had started in order to gain access to potentially lifesaving drugs that had not been fully approved by the FDA. The “Right to Try” legislation allowed for the use of drugs that had cleared phase one of FDA trials — the trials that determine drug safety.

President Trump and Vice President Mike Pence joined in supporting the effort, and the bill eventually passed both chambers of Congress in a bipartisan fashion. Trump signed the bill into law.

I did not anticipate that just a couple of years later, in the middle of a pandemic, that the medical establishment, primarily public health officials, would prevent the use of a medicine that has been proven safe and has been approved by the FDA. In fact, the drug has been used for almost 80 years and is safer than some over-the-counter pain relievers.

The drug I’m speaking about has been studied relentlessly. In fact, several months ago, the World Health Organization released a paper indicating that there were two identified drugs that showed promise as a prophylaxis and therapeutic: remdesivir and hydroxychloroquine. Oddly, when WHO officials issued a statement and announced their findings, they only mentioned remdesivir and were silent on hydroxychloroquine.

In numerous studies released since the COVID-19 outbreak, researchers have observed the efficacy of hydroxychloroquine when used early in the treatment process. Conversely, the studies most often cited against the use of hydroxychloroquine have been debunked (a paper from the prestigious medical journal Lancet was retracted within two weeks of publication), used dubious methods (researchers administered lethal rather than standard doses of hydroxychloroquine), or gave hydroxychloroquine exclusively to patients already hospitalized and near death.

Dozens of studies indicate that if a person with COVID-19 symptoms begins a regimen of hydroxychloroquine, zinc, and azithromycin, they have a better chance of surviving the disease.

You may say, “Oh, you’re just a congressman. What do you know?” That’s fair. But I have seen indications that hydroxychloroquine may be effective, and I know that it is both safe and FDA-approved.

At the same time, public health officials are fighting against a patient’s right to try hydroxychloroquine. In some states, such as Arizona, edicts by public officials have effectively criminalized the opportunity for a doctor to prescribe hydroxychloroquine for anything other than rheumatoid arthritis, lupus, or malaria prevention. In other states, doctors who have defied these officials and written prescriptions for hydroxychloroquine in cases of COVID-19 have been turned in by pharmacists and threatened with losing their licenses to practice medicine.

One must ask why we have to fight for the right to try yet again? With drugs that are safe and approved, doctors and patients must be allowed to make the decision about what is best. The choice should not be made by healthcare bureaucrats.

And if hydroxychloroquine is effective when used early, as so many studies indicate, then lives will be saved.

Once again, the people must fight the medical establishment so we can have the right to try.

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IN BRIEF

David Dorn's widow eviscerates the Black Lives Matter narrative (PJ Media)

Alice Johnson praises Trump for First Step Act, urges compassion for "forgotten faces" (The Hill)

After watching three days of the RNC, Pelosi says Joe Biden should stay in his basement (The Federalist)

White supremacist who organized Charlottesville race riots endorses Biden (The Federalist)

New York Times sympathizes with adults who pursue sex with 13-year-old girls (The Federalist)

Boneheaded Virginia Senate approves bill to downgrade penalty for assaulting a police officer (National Review)

U.S. Marshals recover 39 missing children in Georgia operation (FOX 5 Atlanta)

After correction, study that claimed mutilating trans people helps them now finds the opposite (The Federalist)

Policy: Why does the Post Office forbid private competition? (Foundation for Economic Education)

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