“‘Patient One,’ Super-spreader
When a 38-year-old man went to the emergency room at a hospital in Codogno, a small town in the Lodi province of Lombardy, with severe flu symptoms on Feb. 18, the case did not set off alarms.
The patient declined to be hospitalized and went home. He got sicker and returned to the hospital a few hours later and was admitted to a general medicine ward. On Feb. 20, he went into intensive care, where he tested positive for the virus.
The man, who became known as Patient One, had had a busy month. He attended at least three dinners, played soccer and ran with a team, all apparently while contagious and without heavy symptoms.
Mr. Ricciardi said Italy had the bad luck of having a super spreader in a densely populated and dynamic area who went to the hospital not once, but twice, infecting hundreds of people, including doctors and nurses.
“He was incredibly active,” Mr. Ricciardi said.
But he also had not had any direct contacts with China, and experts suspect he contracted the virus from another European, meaning Italy did not have an identifiable patient zero or a traceable source of contagion that could help it contain the virus.
The virus had already been active in Italy for weeks by that time, experts now say, passed by people without symptoms and often mistaken for a flu. It spread around Lombardy, the Italian region that has by far the most trade with China and the home of Milan, the country’s most culturally vibrant and business-centered city.”
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“Who we call ‘Patient One’ was probably ‘Patient 200,’ ” said Fabrizio Pregliasco, an epidemiologist.
On Sunday, Feb. 23, the number of infections clicked past 130 and Italy sealed off 11 towns with police and military checkpoints. The last days of Venice Carnival were canceled. The Lombardy region closed its schools, museums and movie theaters. The Milanese made a run on the supermarkets.“
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“As Lombardy officials scrambled to free up hospital beds, and the number of infected people rose to 309 with 11 dead, Mr. Conte said on Feb. 25 that “Italy is a safe country and probably safer than many others.”“
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“”They were convinced that the situation was less serious and they did not want to hurt our economy too much,” said Mr. Fontana.“
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“The government started providing some economic assistance, which would later be followed by a 25 billion euro ($28 billion) relief package, but the nation became divided between those who saw the threat and those who didn’t.
Ms. Zampa said that it was around that time that government learned that infections in the town of Vò, the virus epicenter of the Veneto region, had no epidemiological link to the Codogno outbreak.“
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“In a surprise 2 a.m. news conference on March 8, when 7,375 people had already tested positive for coronavirus and 366 had died, Mr. Conte announced the extraordinary step of restricting movement for about a quarter of the Italian population in the northern regions that serve as the country’s economic engine.
“We are facing an emergency,” Mr. Conte said at the time. “A national emergency.”
A draft of the decree, leaked to Italian media on Saturday night, pushed many Milan residents to rush to the train station in crowds and attempt to leave the region, causing what many later considered a dangerous wave of contagion toward the south.“
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“In the meantime, some regional governors independently ordered people coming from the newly locked-down area to self quarantine. Others didn’t.
The broader restrictions in Lombardy also effectively lifted the quarantine on Codogno and other “red zone” towns linked to the original outbreak. Checkpoints disappeared. Local mayors complained that their sacrifices had been wasted.
A day later, on March 9, when the positive cases reached 9,172 and the death toll climbed to 463, Mr. Conte toughened the restrictions and extended them nationally.
But by then, some experts say, it was already too late.”
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“Italy is still paying the price of those early mixed messages by scientists and politicians. The people who have died in staggering numbers recently — more than 2,300 in the last four days — were mostly infected during the confusion of a week or two ago.
Roberto Burioni, a prominent virologist at the San Raffaele University in Milan, said that people had felt safe to go about their usual routines and he attributed the spike in cases last week to “that behavior.”“
-much more at link
Italy, Pandemic’s New Epicenter, Has Lessons for the World
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