What Americans Should Learn From Italy To Stem The Spread Of Coronavirus

My OpEd in The Tennessean, Nashville’s daily newspaper:

On Sunday, Nashville’s mayor and health department announced they intend to close bars and limit capacity at restaurants. It is an all-too familiar step that at this point of the COVID 19 pandemic isn’t enough.

Every conversation and hesitation in Nashville today was still being had across Italian cities two weeks ago. I know, I was privy to them. I lived in Rome most of my adult life, most of my closest friends are in Italy, my father too. Think of this as a message from the very-near future.

We can’t lock down our citizens as quickly as China did. But to start from the beginning of Italy’s containment trajectory is to ignore science, math and some major differences between our nations.

Italy too tried to limit capacity at public watering holes and staggered office hours and shifts for employees. Then Masses and funerals were banned; movie theaters, concert halls, museums and the like were closed.

Yet the number of infections and deaths continued to rise, first slowly, then exponentially. Because this virus that we’ve never encountered before doesn’t care how much optimism bias or hand sanitizer we employ. Its only job is to reproduce, fast.

Containment zones came next in Italy, then a regional lockdown, then the first national lockdown.But the numbers kept rising. Because some still gathered in bars and restaurants that were open until 6 p.m. Finally, last week the government closed virtually all stores but those that sell medicine and groceries.

But unlike Italy, we haven’t tested tens of thousands of people at this point, so we don’t know our actual numbers. Free access to medical care is not an inalienable right here. Our healthcare infrastructure is more fractured due to competing, private entities. And we have among the most economically vulnerable people in the developed world.

Italy’s hardest-hit region, Lombardy, has one of the most robust health care systems in Europe and still it’s collapsing because there aren’t enough medical professionals, hospital beds or supplies (e.g. ventilators) for a massive influx of patients, hundreds of whom are now in makeshift ICUs.

Wuhan, China, the outbreak’s epicenter, built two new hospitals in two weeks — and it wasn’t enough. Because COVID 19 can require much more intensive care treatment that the common flu, so it drains resources in a flash. Every hospital bed and hallway, makeshift triage and medical professional (active or retired) is recruited to help those patients. That means other serious problems perhaps can’t be treated. Major surgeries are canceled. You have a car accident, or go into labor, and precious few staff may be around. 

Doctors and nurses are themselves getting sick, some dying, from COVID 19. And all having to choose who gets oxygen when it becomes available, who gets intubated — and lives — and who does not. Sometimes based on age or, say, if both patients are 40, what they have to live for (kids vs. no kids). These unthinkable decisions are so frequent right now, they have been formally codified.

Roughly 20,000 new cases were confirmed in Italy this week — half of them this weekend alone, when nearly 400 more people died, the highest 24-hour tally since their outbreak began. The U.S. is only days behind.

So if you run a public space that doesn’t offer medical care, groceries or shelter, shut it down. It’s a painful, even terrifying decision. But not as much as choosing near-certain economic collapse of a nation, which Italy did to help its people, to help all of us, especially the most vulnerable.

That is what civic duty and love of one’s neighbors and country looks like.

If you’re still balking at this idea, ask yourself: What do I know that the Chinese, Italians and Austrians don’t? What innovative measures am I implementing that they haven’t tried?

If you’re frequenting public spaces you don’t have to be in; if you don’t believe the emergency responders begging us to stay isolated, because carriers who don’t know they have COVID 19 are the biggest threat of all, see the questions above.

As of Tuesday, we had more than 4,482 cases in the U.S. and 73 in Tennessee. That’s all we’ve confirmed, from a painfully low number of tests.

So unless you have to go out, do not. If you can work from home but your employer doesn’t want you to, demand they confirm none of your co-workers has COVID 19. They can’t. Without testing, none of us can.

Donate to your local food bank, buy gift cards to your favorite haunts and shops for later use, buy food from local stores (online, if possible).

Press local, state and national lawmakers to enact shutdowns and extreme social distancing measures for all non-essential organizations and gatherings, for our collective greater good. Press them for greater transparency and urgency on testing.

Not because this is a partisan issue with partisan solutions — it isn’t. But because it’s a human issue, and we’re all in this together, like it or not.

Lastly, to quote my Italian friends: “They asked our grandparents to go to war. They're asking us to stay on the couch.”

We can do this.