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Experiencing the Coronavirus Outbreak in the North of Italy from Ground Zero

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Experiencing the Coronavirus Outbreak in the North of Italy from Ground Zero

Every morning, when I wake up in Cremona, Italy, I make myself a cup of tea, I sit at my desk by the window, peak at the grandiose Romanesque cathedral in the piazza and, before I start working, I quickly glance at the local news on my laptop. I say ‘quickly’ because nothing really happens in this quiet town that’s just about an hour south of Milan, in the region of Lombardy.

I know this for a fact. I was born here. And since, during my college years, I did work in the newsroom of the local newspaper, I am well aware of how deep you need to dig to find something to write about. Headlines here are all about agricultural commerce, dairy production and classical music events, since Cremona’s main business is centered around farming, local gastronomy and the violin making tradition, that dates back to the 16th century.

The title I least expected to see on the front-page February 21st was one about a case of coronavirus in the territory that surrounds my town. In Codogno to be precise, 24 miles away from Cremona.

Seriously? Here? Out of all the places where you’d expect a Chinese virus to spread, the countryside around my town seemed the most unlikely.

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On the night of February 16th, a 38 year old manager shows up at the ER in Codogno with a fever and flu like symptoms. The manager confirms to the doctors that he hasn’t been to China and that he hasn’t had any contact with people coming from there. The doctors give him a therapy to follow and an option to choose from: he can either stay in observation or complete his treatment at home. He chooses the latter.

On February 19th, at 3.12 am, the manager’s temperature is still high, and he goes back to the ER, where this time he is admitted to the hospital. On the 20th, when he starts having respiratory symptoms, his wife remembers that he’s been out to dinner with another manager from Fiorenzuola, who came back from China on January 21st.

It’s 4 pm, and the coronavirus protocol sets in. The patient, his wife and best friend are put in isolation and the swab tests are sent to Milan to be analyzed. After a few hours, they all come back positive and the madness begins.

In the middle of the night, health authorities show up at the house of Patient Zero, the guy from Fiorenzuola who’s supposedly started the chain of infection. The man is not sick, nor has he been in the previous days, but he’s taken to Sacco as well, where he tests negative to coronavirus. The doctors hypothesize that he could be an asymptomatic patient who became a carrier of the disease, but when they test for antibodies, again they find nothing.

From Patient Zero back to ground zero.

In the meantime, the ER in Codogno shuts down, the health personnel who got in touch with the 38 year old manager, Patient One as they call him, are quarantined, and new patients are diverted to other hospitals.

On the morning of the 21st, health authorities show up at the factory where Patient One works, and they test all of the 160 employees. All schools in the area are immediately closed, companies send workers home and implement telework. Sport and public events are cancelled, as well as the farmers markets and the celebrations for the Carnival. Everyone is asked to stay at home and avoid social contact.

By the end of the day, 50,000 people who reside in Codogno as well as in nine other villages in its proximity, are put on lockdown to prevent the spread of infection. Police officers guard entries to the towns. Nobody can get in nor out of the city limits.

Experiencing the coronavirus outbreak in the North of Italy from ground zero 1

Fast forward a few days and 25,856 swab test later, Italy now has 2,502 cases in 14 regions, 1000 of which have zero to mild symptoms and are in isolation at home, 1034 are hospitalized, 209 are in ICU in critical conditions, 160 are fully recovered and of the 79 people who died all of them were elderly and had preexisting conditions (the data is updated every day at 6pm on the Italian Ministry of Health website and published here).

Not all those who are positive had contact with China or with confirmed cases of infection in Italy. And it appears likely that coronavirus arrived in Italy well before February 16th. It likely arrived at the beginning of January (SOURCE). And it has been circulating undetected since then. Those who caught it may have thought they had the flu, or they may have had symptoms so mild that they did not even go to the doctor. Therefore, it’s likely that some people already affected by COVID-19 may have eluded the network of controls, helping the virus to spread silently.

It’s only natural to wonder: what would have happened if the doctors in Codogno didn’t test a patient with pneumonia who had never been to China? How many others have gone undetected?And in how many countries has the same thing happened?

On the evening of February 15th, a woman from Solano County, CA with flu-like symptoms walks into NorthBay VacaValley Hospital, where she spends three days. When her symptoms worsen, on February 19th, she is transferred to UC Davis Medical Center in Sacramento.

While doctors are concerned about a potential coronavirus diagnosis, the test for it is delayed since the patient “did not fit the existing CDC criteria for COVID-19”. On February 23rd, the swab test is sent to Atlanta to get analyzed, and by the time it comes back positive it’s already February 26th.

I am a US resident married to a Californian, and since we were about to fly back to the States and go to Orange County to see my in-laws at the beginning of March, I have been following the events surrounding “Patient One” in the States really closely, checking the local press multiple times a day (“Sacramento Bee”, “San Francisco Chronical”, as well as the press in SoCal (“La Times”, “OC Register”). Knowing what type of tsunami shocked the local community here in Italy, I was expecting to see a similar reaction in California. But I was wrong. And I found the differences in how the two countries reacted was quite odd.

If you think about it, on the same day, February 19th, in two different parts of the world, an Italian manager and an American woman were admitted to the hospital in serious conditions.

The former was diagnosed with coronavirus on the 20th, the latter on the 26th.

The former caused an entire hospital to be put under quarantine, 10 towns (50,000 people) to be put on lockdown, the schools of 9 regions to be closed, over 25,000 swabs to be tested across the country and the economy to come to a halt, with tourists cancelling trips and airlines stopping to fly here.

The latter, as of now, did not provoke any of this.

Today, more than 120 cases of the COVID-19 have now been reported across the US. And after March 1st, when the official number of total tests reported on the CDC website was 472, on March 2nd that number is not public information anymore (source).

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Walter Ricciardi, member of the WHO Executive Committee and now adviser to the Italian Ministry of Health for the coronavirus emergency, used these numbers to explain COVID-19:  “Out of 100 people with the disease, 80 recover spontaneously, 15 have more serious problems but that are manageable in a healthcare facility, 5 are in very serious conditions and 3 of them die”.

But, in order to understand what these numbers really mean, we need to keep in mind that, while the seasonal flu, for which there is a vaccine, has a mortality rate of 0.001 (0.1%), coronavirus has a mortality rate of 3,4%, which rises to 14.8% for those who are above 80 years of age.
In an interview with “Il Corriere della Sera”, Fabrizio Fregliasco, a virologist from the University of Milan, talked about the contagiousness of this novel virus saying that, while “the basic reproduction number of the flu stands at 1.5 (one infected person can infect another and a half), the medical value for COVID-19 is roughly 2.5”.

Not only does the coronavirus appear to be way more deadly than the flu, but its contagiousness at 2.5 means that for every one person who is infected, they can spread it to an additional 2.5 people, provoking the exponential growth of the disease. And an epidemic of people requiring hospitalization can put a severe toll on our health care system.

The effects of these numbers are easy to grasp by looking at the situation of the local hospitals in the areas affected by the outbreak.

Let’s take a look at the hospital here in Cremona, for example. On March 2nd, Dr. Giancarlo Bosio, Director of the local Pneumology Department, defined the last two weeks as a ‘tsunami.’ “Now we have 60 people hospitalized in my department where last week there were 30. Now we have 18 people on a mechanical ventilator, while last week we had 6. And while we usually treat 4-5 pneumonia cases per year, now we’re treating more than 100”.

In the last few days, the hospital of Cremona has been flooded with cases of coronavirus. Doctors and nurses have been tirelessly working 13 hour shifts to handle this emergency, and they had to open three new departments to treat the 149 coronavirus patients in need of hospitalization, 11 of which are in ICU.

Yesterday, the region of Lombardy allocated €2,500,000 to the hospital of Cremona to make urgent investments (such as medical equipment and the recruitment of doctors and nurses), and today the Italian Ministry of Health announced that they will increase the number of beds in ICU by 50% across the country and those in the pulmonology and infectious disease units by 100%.

All this was NOT happening a couple weeks ago. And I believe that looking at how rapidly things have changed in the local hospitals is the real thermometer to evaluate the risks of this situation.

Today, it takes me a little longer to read the news. Not only because I need to keep up with the rising cases of COVID-19, but also because some of the things I read are quite unbelievable. Things like countries demanding a ridiculous “virus free” certificate to import Made in Italy products, airports sending planes with Italians passengers back to where they came from, and foreign TV channels making fun of Italians with derogatory videos which depict them as “plague spreaders”.

And as I sit at my desk and open the newspaper, I wish I could go back to February 20th, when Cremona was the same tranquil, (a bit too) quiet and sleepy town it’s always been.

If you enjoyed this article, please share it with your friends and family. And don’t miss my other articles about the First Month of Quarantine in the North of Italy and why Being Afraid Is a Good Thing and Giving Up Our Personal Freedom is an act of responsibility.



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Ambra Torelli
Born and raised in Italy, Ambra visited over 20 countries and now she divides her time in between Italy and the US, where her husband is from and where she moved in 2011 work as university professor of Italian Literature. She writes about food, travel and things that inspire her! more about ambra

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  • Avatar
    Mal Wilkinson March 4, 2020 3:23 pm

    Thank you so much for sharing this Ambra, like you I find the difference in the response between Italy and America to be astounding. Here in Australia we have 41 cases with 2 deaths. Our government seems to be very well prepared and proactive, enacting the Emergency Response Plan on Feb 27th. The government website is updated at midnight every day with the latest information so I feel confident in Australia’s ability to cope should it turn into a major outbreak here.
    I hope the outbreak in your beautiful town passes over soon and you can get back to normal life.
    Sending much love form Australia xox

    • ambra
      ambra March 6, 2020 1:39 am

      So happy to hear the that the situation is being handled well in Australia. Thanks so much for sharing this with me and I send you a hug from Italy!

  • Avatar
    Rikki March 4, 2020 3:34 pm

    Thank you for such an in depth article on the Corona virus in Italy and how it compares to treatment in California. I have to say – it’s not a big surprise for the US to make a big deal about something in the media but do little when it comes to patient care. Under the ugly control of the insurance and pharmaceutical companies doctors and extremely limited in their ability to make decisions.

    • ambra
      ambra March 6, 2020 1:44 am

      Thank you for reading Rikki! I really hope that California speeds up testing. Here where I am the situation is becoming really serious.
      Share this article if you think it could raise awareness!

  • Avatar
    Lisa March 4, 2020 3:43 pm

    Hi Ambra,
    Hope you are well and that you stay well in your beautiful Italy. I live in Bellevue Washington, near Seattle. 9 have died in our immediate area from Covid19, which began in the city next to mine, in a Nursing Home. 50 people that live/work in theNursing Home are infected, but our area leaders feel it’s more important to protect image/diversity than to fully inform ALL citizens that live here. Politics never stops even in crisis. Hopefully the virus dies down with warm weather. I don’t know which would be scarier, living in your area and confined with armed police, or living in mine where local politicians act like morons. My prayers to you and your families.

    • ambra
      ambra March 6, 2020 1:49 am

      I feel you Lisa. I am scared too, and very disappointed by the fact that many people are not taking this seriously and, because they don’t stay isolated and therefore put the other ones at risk.

  • Avatar
    Sharon March 4, 2020 4:46 pm

    Hello Ambra,
    Thank you for a cogent and well-reasoned piece of writing about a topic that inspires fear and confusion. It was very interesting to read about Italy’s response to the first case; it sounds like your native country is taking the well-being of its citizens seriously. As for casting aspersions upon an entire nationality for something over which they have no control, that makes about as much sense as my neighbors here in Orange County, California hoarding paper towels and toilet paper. (Toilet paper! What are they going to do, stuff it up their noses?!) I wish you well and hope you are able to return to California soon.

    • ambra
      ambra March 6, 2020 1:50 am

      Thanks so much for taking the time to read Sharon! Stay safe!

  • Avatar
    Patty March 4, 2020 5:50 pm

    So far US Kansas is clear. My prayers to you and yours as well.

    • ambra
      ambra March 6, 2020 1:49 am

      Thanks so much for sharing! Stay safe dear!

  • Avatar
    Sharon H March 4, 2020 7:17 pm

    Very good and well-written information. Thank you, Ambra. I live in the SE corner of Kansas and we border Missouri, Arkansas, and Oklahoma. I know it will eventually reach us. I’m a relatively healthy 75-year old female, but my 63-year old husband has very poor health and I worry about him. Our government should be ashamed the way they dismissed the severity and seriousness of this epidemic, soon to be pandemic virus. I pray you remain healthy and safe.

  • Avatar
    Russell March 4, 2020 11:16 pm

    Ambra this is incredible, you’ve shared such important information and given a perfect picture of life on the ground in northern Italy! I hope everyone gets to read this and watch your video and know what is really going on. Thank you for sharing!!!

    • ambra
      ambra March 11, 2020 3:42 am

      Thank you so much for reading Russel! It’s so important to share this information! People need to start taking seriously!

  • Avatar
    Bryan March 7, 2020 7:27 am

    The stark differences in reaction to the first case is polarizing. If only other countries cared more about their citizens than they do about the way they are perceived by other. Bravo Italy.

    • ambra
      ambra March 11, 2020 3:40 am

      Thanks so much Bryan! I feel really proud of my country right now!

  • Avatar
    fourseasonslasercenter March 10, 2020 8:46 pm

    I feel so sad for Italy. This virus is rapidly spreading. For all of those people out there, please do a healthy lifestyle and exercise always! This outbreak is horrible but the community needs to stick and communicate because we are the only ones who can solve and fight this virus.

    • ambra
      ambra March 11, 2020 3:41 am

      Thanks so much for your support, dear! I am can’t wait until we are back to normal!

  • Avatar
    Marianne March 14, 2020 9:45 am

    This was very informative. I think Italy has acted quickly and made some difficult and unpopular, but necessary decisions. In the US the President was called ‘xenophobic’ because he quickly cut off travel from China and then from Europe. But I see this as political namecalling. Italy has proven that quickly quarantining areas and stopping travel drives the spread of Covid-19 down.

  • Avatar
    Arisela Shaw April 4, 2020 4:30 pm

    I hope you are holding strong. I read your article when you first sent it out. Since then the USA has also had it share of this virus. Our prayers are with you and all those affected. Thank you for sharing and please keep us posted, as we hear the news. I rely on first hand news than the news itself

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