Was the COVID-19 epidemic preventable?

Novel virus
On December 31st, 2019, China reported several cases of unusual pneumonia to the World Health Organization (Al Jazeera, 2020). For those who do not immediately know what pneumonia is; pneumonia is a lung infection. A week later Chinese authorities announced that these cases were caused by a new, unknown virus. This virus was similar to the one of the SARS epidemic of 2003, where 774 people died as a result of it (Centers for Disease Control and Prevention, 2005).

Two weeks after the virus was discovered, it started spreading to other countries (Al Jazeera, 2020). And as of now – more than three months later – the official amount of infections has exceeded 1.5 million, leaving more than 90.000 people dead (Worldometer, 2020). I am talking about the coronavirus, also known as COVID-19, as you must surely understand by now.

The most important response at this time is to minimize and stop the infection- and death rate and to limit the economic effects for those who have to live month by month. However, it begs for the question: Could this outbreak have been prevented? We live in a hypermodern world and have dealt with epidemics in the past decades already. That does not just cover SARS, but also Ebola, Cholera, Zika, and Swine Flu. The international community surely must have learnt from that, right? To answer this question, we will look at the outbreak of COVID-19 in Italy, which is linked to the outbreak of the virus in several other countries in Europe (BBC News, 2020).

Outbreak in Italy
One month after the virus was reported in China, the first two cases were announced in Italy: a Chinese couple that was on vacation in Rome (Corriere Della Sera, 2020). Two weeks later it spread to 76 cases (Corriere Della Sera, 2020), and just a month after the first reports, there were more than three thousand cases (Avenire, 2020).

The graph below visualizes the excessiveness of this outbreak best. Each bar on the left describes a rise of ten times the amount of the previous bar. When you look at this graph further, you can see that stopping the outbreak did not succeed. So, what actions did Italy actually take to prevent this epidemic?


Figure 1. Total Coronavirus Cases in Italy. This figure illustrates the number in logarithmic scale (Worldometer, 2020).

Italian response
On February 4th, news was reporting that panic was spreading faster than the coronavirus (Lowen, 2020). There were also reports of xenophobia, with Chinese restaurants being empty and Chinese tourists being spat on or insulted (Lowen, 2020 & The Guardian, 2020).

However, there was also action being taken. Four governors in Italy announced that kids that came from a trip from China were not allowed to enter school for fourteen days. While everyone can agree now wholeheartedly that this was a just and sensible measure, at that time it created upset. The prime minister told the governors they can’t make that decision (Lowen, 2020).

While quarantining children was still too early for the public eye, flights to and from China were already cancelled. Furthermore, 56 Italian nationals who travelled from China to Italy were quarantined (Lowen, 2020). On top of that, the Italian government did declare a six-month state of emergency just a day after the first two cases of COVID-19 were announced (Schneider, 2020). When the Italian government had a month to monitor the outbreak in China and is taking these initiatives only a day after the first report in Italy, one can only conclude that is some good, decisive action.

Then – during the fourth weekend of February – the number of infected people suddenly jumped to above 200. Italy took measures such as closing schools and bars and cancelling events. Furthermore, Italy implemented a local lockdown for affected cities. This meant that more than 50.000 people in that region had to stay at home (RTL Nieuws, 2020). These are all quite rigorous measures, but it showed that Italy is doing what it can to stop the spread of this disease.

While one could argue that these measures should have been taken earlier, you should keep in mind the public opinion back then. The bank of Italy for example was more concerned with economic growth and remarked only economical risks of people travelling less (Za & Mandala, 2020). Instead, it would be better if they explained the sensible judgement of avoiding contact and social distancing. Furthermore, newspapers covering the COVID-19 outbreak in Italy during this first spike still remarked that the fear is much worse than the situation (Van der Ploeg, 2020). In addition, closing the borders was simply not reasonable yet before the outbreak in Italy. To suspend the Schengen agreements was at that moment called “Not scientifically justified” by Andrea Ammon, the director of the European Center for Disease Control (Schengen Visa Info, 2020).

Effectiveness of measures against COVID-19
Recent research found that without measures every person spreads the virus on average to six others. However, with drastic measures implemented, this drops to below one (Leung, Wu, Liu, & Leung, 2020). The effects of these measures can slowly be seen, as Italy is now reporting the fewest infections per day since almost a month (Al Jazeera, 2020).

As a result, businesses in the country’s northern industrial heartland have been urging the government to allow them to reopen as soon as next week. This is quite controversial, since the north is the area hit worst by the coronavirus. The industry insists that maintaining the measures against the virus will cost companies income and the ability to pay its employees (Euractiv, 2020).

Health officials disagree with these notions and are urging the government to continue the restrictive measures. As WHO official Ranieri Guerra mentioned: “The trend of the epidemic curve is not declining, it is slowing, we are looking at a plateau”. Furthermore, he warned that there is still a large remaining group of contagious people without symptoms (Euractiv, 2020). Looking back to the situation as it was a few months ago, it is good that Prime Minister Conte is following the advice from these health experts. Remember that two months ago, just a few ill people in Italy resulted in the 150.000 cases in Italy of today. If businesses were allowed to be opened, it is only logical to assume that the COVID-19 outbreak will worsen.

 

“The trend of the epidemic curve is not declining, it is slowing, we are looking at a plateau” ~ Ranieri Guerra

 

Responsibility
In hindsight it is easy to say that more drastic measures should have been taken earlier. However, when you actually delve into it, you notice that the Italian government was proactive and followed the guidelines recommended by experts.

It is better to look at individual responsibilities for this outbreak. Whether you are feeling ill because of the COVID-19 virus or not, you have no business of going outside with the risk of infecting others. Furthermore, businesses wanting to open up with the risk of harming their employees for profit is ridiculous. If businesses are having trouble paying their bills when they are closed for a month, they should go to the government for aid and not risk the lives of thousands of people.

Could an outbreak this large have been prevented? It might have been smaller if both people and businesses would be less selfish, think about the implications of their actions, and took individual responsibility.

 

 

 

Reference list
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Euractiv. (2020). Italy PM rebuffs employers’ call to ease coronavirus lockdown. Retrieved from https://www.euractiv.com/section/economy-jobs/news/italy-pm-rebuffs-employers-call-to-ease-coronavirus-lockdown.

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Leung, K., Wu, J. T., Liu, D., & Leung, G., M. (2020). First-wave COVID-19 transmissibility and severity in China outside Hubei after control measures, and second-wave scenario planning: a modelling impact assessment. The Lancet. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30746-7/fulltext.

Lowen, M. (2020). Coronavirus: Chinese targeted as Italians panic. Retrieved from https://www.bbc.com/news/world-europe-51370822.

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Schneider, O. (2020). Coronavirus update: Italy declares state of emergency. Retrieved from https://www.brusselstimes.com/all-news/belgium-all-news/105624/coronavirus-consider-carefully-before-taking-family-out-of-nursing-home.

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Za, V., & Mandala, A. (2020). Bank of Italy says coronavirus may have significant impact on growth. Retrieved from https://www.reuters.com/article/us-china-health-italy-economy/bank-of-italy-says-coronavirus-may-have-significant-impact-on-growth-idUSKBN2020LK.

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