I have been practicing for this my whole life

As the coronavirus epidemic advances in Italy with a 25-30% growth rate (meaning that the numbers are doubling every 3-4 days), and after two weeks of “lockdown-lite” in Northern Italy seems to have made no difference, the Italian government imposed on Sunday morning a stricter lockdown on the region of Lombardy and some cities outside the region including Venice. Several people have reached out to ask how things are going, so here is a brief recap.

First of all, I would like to give a shoutout to Taiwan, which is currently the country that has done the best job stopping an outbreak. The Taiwanese have several things going for them: the SARS scare made the government plan for the next epidemic, instead of making it up as it would go along, and their preparedness was impressive. The plan focused on isolation, contact-tracing, and people being careful: kudos to the Taiwanese for how well they complied. From the little that I have learned about Taiwan after living there for two months a couple of years ago, the Taiwanese are not rule-followers the way the Swiss or the Singaporean can be. But if they bend or break rules, they do that after a lot of consideration for how this impacts others. Basically, people care about strangers, a disposition that helps a lot in controlling an epidemic (and which is not a big part of the Italian national mood).

But let’s talk about me. This is my mood right now:
self_isolate

(Image credit: xkcd by Randall Munroe)

Since we are past isolation-and-contact-tracing, the main goal is to reduce person-to-person contact so that we can stop the exponential growth. For the past two weeks, besides the usual recommendations (do not kiss hello and goodbye, do not shake hands, wash hands frequently, do not touch your face) the government recommended keeping a one-meter distance from other people. There has been some inventive ways to keep going under these requirements. For example cinemas (in the regions in which they were not required to shut down) sold tickets for at most a third of the seats, asking people to leave two empty seats between any occupied seats.

Last Saturday, before the newest set of regulations were in place, I went out for a drink. The bar had cordoned off the counter area

IMG_9383

They asked everybody who came in to seat down, at one of a few well-separated tables. Gloves-wearing servers took orders and brought some food (instead of the usual buffet). Once all tables were taken, a server stood outside preventing other people from coming in.

As we were drinking our aperitivi at a safe distance from each other, news began to leak of the new measures, which the government eventually announced at 2am Sunday morning. The leak suggested that Lombardy, Venice, and other places, would be included in the so-called red zone, which was a group of small towns that had been completely isolated for the past two weeks (nobody could go in and out except ambulances, trash collection trucks, and deliveries). In a development that might not have happened in Taiwan, a few hundred people rushed to train stations in Milan and Venice to flee South.

The actual regulations allowed travel in and out of the places affected by the new lockdown, but only for demonstrated work or health reasons. This is what the regulation said, but how would people prove their reason? The Italian genius for bureaucracy started cranking in the next few hours, and now, at train stations, people are required to sign an affidavit stating the existence of such a reason before boarding a train:

affidavit

In the locked-down cities, all bars and restaurants have to close by 6pm, and all places where people may congregate (including churches, gyms, swimming pools, in addition to museums, schools and universities which were already closed) are closed all day. Even funeral and weddings are banned. Grocery stores will have to ensure that people stay within a meter of each other, making people wait outside and enter in small groups if necessary.

What about me? I am procrastinating on writing blog posts about online optimization and on reviewing papers for ICALP, I have started reading William Gibson’s latest novel Agency and watching the tv series Pose, and I am cooking every meal. Considering that I like to sleep and that I am spending a fair amount of time on the phone, I have got the whole day covered.

What is next? At this point in Lombardy about a person in 2,500, or 0.04% of the population, is infected, and we have run out of ICU beds. The rate of infection in Wuhan peaked at about 0.6% of the population, and this was well past the point at which they had run out of hospital beds in general. Hopefully, here we will peak well below that. On the other hand, left to its own devices, in the absence of any containment measures, I have seen estimates that the disease would peak a bit higher than a flu epidemic, at 20% or even 60% of the population.

So, find the Taiwanese in yourself, think about others, and wash those hands.

3 thoughts on “I have been practicing for this my whole life

  1. Question about “flattening the curve”: Assume that
    1. The health system can handle at most 0.04% of the population being sick at any given time.
    2. Containment measures like the lockdown successfully keep the number of sick people below 0.04%.
    3. Every person is sick for at least a week

    Putting 1, 2 and 3 together, it will take at least 500 weeks to reach the natural peak where 20% of the population have recovered and the outbreak declines naturally.

    Doesn’t that mean 10 years of lockdown? What am I missing?

  2. Jon & Abb, you are right, “flattening the curve” takes about ten years, unless the availability of ICU beds ramps up very dramatically. In fact you will notice that those graphs that go around showing the “flattened curve” do not have numbers on the axes.

    China has not just “flattened the curve”. They have reduced the number of new cases to almost zero. It is not clear what the long game is going to be (because we don’t know enough), but presumably it will be to do the same, then relax the lockdown a bit, hope that the summer will end contagion, go through all this again next winter and spring, and have a vaccine by summer 2021.

    This NYT Op Ed is quite sobering.

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