At the Venice Carnival, they were very present again: the typical beak masks that doctors wore to protect themselves in times of the plague. However, a different mouthguard is increasingly determining the streetscape in northern Italy and a very young epidemic is scaring people: the new type of coronavirus Sars-CoV-2 is in the country. How large it has already spread is hard to predict at the moment.
It is by far the worst known Sars-CoV-2 outbreak in Europe. In the severely affected city of Codogno, many streets were deserted at the weekend, the city looked like an Italian miniature version of the sealed Chinese city of Wuhan. More and more residents in regions with proven infections are wearing face masks. Many schools and shops are closed, umpteen sporting events and other major events have been canceled. Even the Venice Carnival was stopped.
Up until Wednesday the world still seemed in order. The shock followed on Thursday
The rapid development is hard to believe for the people of northern Italy, fear is spreading. Up until Wednesday the world still seemed in order, only three infections were known nationwide, all three were recognized early. The shock followed on Thursday: The virus was detected in a seriously ill 38-year-old in a clinic in Codogno, then in more and more people around him. The Italian authorities reacted quickly, quarantined tens of people, had the virus tested on hospital staff, relatives, colleagues and friends.
But the virus had long since caught dozens of other people, including doctors and nurses from the Codogno clinic. Meanwhile, another, initially much smaller, outbreak in Veneto became known. There, a 78-year-old died in the community of Vo from Covid-19, the lung disease caused by the virus, as the authorities assume. In Lombardy, the virus was detected in a 77-year-old who died on Thursday.
The Italian government is cracking down on Saturday evening to curb the further spread of Covid-19 in the economically important north: Almost a dozen locations southeast of Milan with around 50,000 inhabitants and Vo with around 3,000 inhabitants are being sealed off. “Entering and leaving these areas is prohibited,” said Prime Minister Giuseppe Conte. Security forces would be deployed. “If necessary, it will also be the armed forces.” Anyone who tries to circumvent the barriers faces “criminal prosecution”.
The search for “Patient 0”
Meanwhile, the origin of the outbreaks is searched. So far it is completely unclear. In contrast to the flare-up of Sars-CoV-2 in Bavaria with a total of 14 infected, there is no “patient 0”, no known first-time sufferers. Tourists or business people from China may have unwittingly brought the virus with them at some point. The statisticians count around 300,000 Chinese in Italy, and the last 5.3 million overnight stays came from the country.
The development in Italy, as well as the increasingly critical situation in South Korea, Iran and other countries, shows that a pandemic, an unstoppable worldwide triumph of the virus, can no longer be stopped. On Friday, the head of the World Health Organization (WHO) warned that the time window for this was getting smaller. “We must not look back one day and regret that we did not make use of this window of time,” said Tedros Adhanom Ghebreyesus. Is it too late now?
“Containment at the last second is probably no longer achievable with all available forces,” said Berlin-based virologist Christian Drosten on Sunday of the German Press Agency. The virus that has probably jumped onto humans at a wild animal market in Wuhan plays its trump card: Because most infections with Sars-CoV-2 are mild, they are hardly detectable.
Its properties enabled Sars-CoV-2 to go unnoticed, explains Drosten. Those who have only mild or no symptoms do not go to the doctor and are not tested – but can transmit the virus to dozens of other people, who in turn carry it into their network of social and work contacts. According to a model calculation by Imperial College London, only a third of all imported cases from China are noticed, according to Drosten. “I no longer believe that a pandemic can be avoided.”
This also increases the risk for Germany
In more and more countries, it is only noticeable that the virus has long been in circulation when people become seriously ill or die. It was like this in Iran, it was like that in South Korea, it is like that in Italy. And also in a number of other countries, outbreaks that nobody has suspected so far could long have spread – including in Germany. “At some point it will likely happen that unnoticed infections are suddenly noticed,” Drosten had recently said.
In many private comments on the Internet in the past few weeks it has been read that there is too much fuss about a virus that only a few old people let die, that the epidemic should simply be let go. For one thing, it remains to be seen whether the writers of such comments would say the same to their parents or grandparents. Second, there are good reasons to contain outbreaks as much as possible.
First, it cannot be estimated exactly what the severity, mortality and risk groups would look like if Covid-19 covered large parts of the population of Germany, explains Gérard Krause from the Helmholtz Center for Infection Research in Braunschweig. “Second, unlike influenza, we don’t have a vaccine against Covid-19 and won’t be able to use it in time.” Medicines tailored to the fight against the virus are also not available so quickly.
As early as mid-February, the Robert Koch Institute (RKI) had said that the goal in Germany was to delay a wave of illnesses in order to prevent the Covid-19 and the current flu waves from coinciding. That would mean a double burden on clinics and medical practices that can hardly be handled. “We have to make reasonable efforts to slow down the spread to alleviate an intense stress pulse on the health care system,” explains Drosten. “The number of infections should be extended as long as possible.”
Some experts are still hoping that the Covid-19 pathogen could fare like the genetically closely related Sars virus: the epidemic with a total of around 8,000 infections was very rapid in early summer 2003 after a stormy increase due to strict countermeasures in early summer 2003 subsided. The Sars virus was never detected in humans again after 2003.
Similar to the flu wave, the Covid 19 wave could subside in the spring, so a vague hope. However, given the sheer number of infections in Covid-19, complete disappearance is unlikely: lung disease could become an established disease like the flu, Wang Chen, president of the China Academy of Medical Science, said recently.