Behind the scenes of Brussels – Containment: the debate prohibited

It only took a few moments, on March 16, for the Head of State and his government, in the name of the fight against the coronavirus pandemic, to place the French under house arrest and deprive them of most of their freedoms civil, political and social that we thought inalienable: freedom to come and go, freedom of assembly, freedom to undertake, freedom to work, etc. Justice has almost been brought to a halt, lawyers confined, provisional detentions automatically extended, the police (understood in a very extensive sense since they include municipal police officers and the like) invested with full powers apply these custodial measures.

Containment without legal basis

This suspension of the rule of law was done without legal basis. Indeed, the decree of March 16 restricting the movement of citizens does not fall within the powers of the executive, since only a judicial judge, the liberty judge, can normally decide on an individual basis. Nevertheless, administrative justice, in this case the Council of State, validated it on the basis of the jurisprudential theory of “exceptional circumstances”, which is probably not its most inspired decision.

It was only on March 23 that Parliament gave a legal basis to the measures announced on March 17 by hastily passing the law creating a “state of health emergency” which authorizes the government to trigger it “in the event of a disaster. health endangering, by its nature and gravity, the health of the population ”, a particularly vague definition. This whole law cultivates vagueness, the offenses it provides for example leaving a large part to police interpretation and therefore to arbitrariness. Renewable by Parliament – possibly for a period longer than two months – it gives full powers to the executive, Parliament being stripped of its powers and reduced to the role of mere spectator. If the Assembly has not changed the government’s plan, the majority being what it is, the Senate, dominated by the classic right, has fortunately managed to introduce some safeguards in this improvised text and poorly put together in providing in particular that it will cease to apply in any event on 1er April 2021, unless a law to the contrary is passed. A fundamental clarification which the government services had curiously not thought of.

Not quite a dictatorship

It is remarkable that this exceptional legislation, justified by the use of a warlike language unique in Europe (“We are at war”) was not the subject of a referral to the Constitutional Council, the opposition, all as forbidden from terror as public opinion, having given up exercising its rights, an unprecedented fact, when it is a particularly serious attack on the rule of law. The constitutional judges were only seized on one point of detail, the suspension of the time limits to judge the questions preliminary of constitutionality (QPC), a provision which it moreover validated.

As long as the state of health emergency applies (until the end of July we have just learned), France is no longer a democracy, even if it is not quite a dictatorship. In his time, François Mitterrand denounced the “permanent coup” that were the institutions of the Fifth Republic. The coronavirus has made it possible to carry out this institutional logic. The head of state, relying on a submissive majority and facing non-existent opposition, seized all the levers of power by invoking the need to preserve the health of the French and a health emergency that he does did not want to see it coming, he who ten days earlier encouraged the French to continue living as before.

This parenthesis of the rule of law was accompanied by the brutal halt of a large part of the economy, a logical consequence of confinement. Above all, the government decided, without any consultation, which businesses could remain open, forcing companies to lay off more than 11 million private sector workers.

Lack of debate

It is truly staggering that these exceptional powers entrusted to the State to apply a brutal and without nuance confinement to an entire country, one of the hardest in Europe with those of Spain, Italy and Belgium , did not give rise to any debate, as if there was no other choice. However, never a democracy used in the past this method to fight against a pandemic (there was only partial confinements at the beginning of the previous century), in particular during the Spanish flu of 1918-1919, of the Asian flu of 1959 or of the Hong Kong flu of 1969. The fact that containment was a solution invented by China, a totalitarian regime, to contain the coronavirus pandemic should at least have questioned its legitimacy. However, it imposed itself almost naturally, all playing in reality when Italy took the decision to confine the whole of its population from March 10, which caused a domino effect, each wanting to show that he was also keen to protect its population: Spain imposed it on March 15, France on March 16, Belgium on March 18 …

However, there was room for debate and on all fronts. On the principle of containment itself first. Because it is only a stopgap aimed at slowing the spread of the virus and avoiding congestion in hospitals which could result in additional deaths. Clearly, the virus will continue to circulate and kill those it must kill after the containment is lifted – in a proportion that no one knows – since it does not exist and will not exist for one or two years a vaccine and that treatments are still in the experimental stage.

Containment is a political trap

Obviously, no one realized that it was going to be very difficult to get out of the containment once decided without political damage, a part of the public opinion risking to be self-persuaded over the days that it is in eradicating the disease. If the pandemic continues to kill, and it will, the government will be automatically accused of endangering the health of its citizens to save “the economy”, a swear word for some French people as if working for a living was secondary to health… In other words, the temptation will be strong to return to blind confinement to silence the controversies or to get out of them as late as possible, the path chosen by France after six weeks of state of emergency sanitary.

This is also why countries like Sweden, Switzerland, Germany or the Netherlands either have not adopted this strategy, letting life take its normal course, or have applied it with much more finesse, which made it possible to avoid passing through the box of exceptional powers entrusted to the executive and especially to break the economy.

Why confine an entire country?

This total foreclosure of a country is all the more questionable since whole regions were and are almost untouched by the virus: why impose the same treatment in Creuse as in Ile de France, in Puglia as in Milan ? Why not have it confined to the extent of the pandemic, just like Germany, where the Länder are competent in public health, has done with the success we know? Thus, from the start, two foci were identified in France: the Oise and Mulhouse. However, rather than reacting immediately by isolating these two regions and deploying military medical means to relieve hospitals, the government procrastinated, allowing the virus to spread. It remains staggering that it was not until March 24, a week after the decision to confine the country, that the military medical service was sent to reinforce Mulhouse! From there to think that total containment was also motivated by the inability of the authorities to anticipate the crisis, there is only one step that I will be careful not to take.

Similarly, the choice of companies to close and the precautions to be taken would also have been a possible area of ​​discussion. For example, it quickly became known that air conditioning allowed the virus to circulate more than a meter and contaminate many people. So does closing shoe repair shops, art galleries or florists and leaving supermarkets open make medical sense? Likewise, was school closure necessary? All this was left to the discretion of a bureaucracy without control and without any consultation with all economic and social actors.

Why place an entire population under residence?

Finally, it appeared very early on that the disease was overwhelmingly fatal for people over the age of 70 (average age of death in Italy or France: 80) and those with serious pathologies, in particular clear the weak. Was it therefore rational to confine all assets and plunge the country into recession? Perhaps we should have focused on protecting these at-risk groups rather than putting a whole country under wraps without thinking of tomorrow, especially since we know full well that the virus is here for a long time.

The debate becomes, at this point, particularly emotional, because it refers to our relationship to death. Why has such a pandemic, which is not the first the world has faced and which is especially far from being the most deadly in history, led states to decide on unprecedented measures while knowing that they were not a cure? Why such a panic, especially when you compare the mortality caused by the coronavirus with that of other diseases? Although we must still be careful, since five months after its appearance, we still know very little about covid-19, which should warn us about the scientism that seized us, the doctors having said everything and its contrary to this pandemic, making political decision particularly difficult. However, let’s remember that 400,000 new cancers are diagnosed each year in France and that 150,000 French people die from it, and yet tobacco and alcohol are still not banned, while that would avoid much of it. If all life deserves to be saved, why be so casual about cancer? Similarly, seasonal flu (while there is a vaccine that a large majority considers dispensable) kill each year between 3,000 and 15,000 people (not to mention the more than 30,000 deaths from the Hong Kong flu in 1969 in a country of 51 million inhabitants or the equivalent number of deaths in 1959 in a country of 45 million inhabitants), seasonal respiratory infections 68,000 people, road accidents 3500 people to which must be added the disabled for life. And yet, no one has thought of banning the car (and every measure aimed at strengthening safety has its share of protests, remember the 80 km / h) or to make the fight against pollution or junk food a categorical imperative.

If we look at the statistics of mortality in the world, we see that hunger (yet easy and inexpensive to eradicate), malaria, AIDS or even wars (often made with the weapons produced by our industries) kill infinitely more than the coronavirus will ever kill.

Choose your comrade side, but there is only one good side, that of containment!

It would probably be necessary to question the responsibility of the audiovisual media in this panic which has taken hold of Western public opinion (with a German exception, German televisions having voluntarily decided to treat covid-19 in the place it deserves). Announce every morning the number of dead without putting them in perspective (compared to the usual average of the dead, their age, the comorbidity from which they suffered, etc.), devote entire newspapers to the pandemic can only shake even the best made heads … Imagine that every morning the number of deaths in France is truncated for all causes and that all the newspapers are devoted to it: who would still dare to simply live?

This is not to say that a death is immaterial, but simply that any public policy must be subject to a cost-benefit assessment. If we do not ban the sale of weapons, tobacco, alcohol, cars, trucks, thermal power stations, it is because collectively we believe that the cost would be greater than the benefit we would derive from it. But this debate, in the emotional surge that has been going on for two months, is in fact prohibited. Those who dared to question the chosen strategy and especially on its duration were pilloried by the most radical, those who are heard. To be opposed to the prolongation of confinement is to be for the “sacrifice” of those who are sick, “to spit in the mouth of the dead” and so on. In short, choose your comrade side, but there is only one good side, that of containment! I have even been threatened with death, myself and my family, by good people who believe that all life must be saved at any cost without the contradiction of their words touching their minds for daring to me. question in two tweets from April 9, three weeks after the start of confinement: ” It’s crazy when you think about it: plunging the world into the worst recession since the Second World War for a pandemic that has so far killed less than 100,000 people (not to mention their advanced age) in a world of 7 billion inhabitants. Seasonal flu, which kills especially young children, is between 290,000 and 650,000 per year worldwide. And everyone fucks, but serious. “

The worst recession of all time outside of the war (and more)

However, confinement will lead to an unimaginable recession by its violence: it should reach between 8% and 15% of GDP, an unprecedented decline in activity in peacetime (we must go back to 1942 to record a recession of -10 %). We have never brought an economy to a complete halt as we have just done, we must be aware of this. Partial unemployment now affects nearly twelve million workers (one in two private workers!) And the layoffs caused by thousands of business bankruptcies will number in the hundreds of thousands or even millions once the partial unemployment scheme supported by the state will expire (because it costs a fortune). And the longer the shutdown, the more difficult it will be to restart. The cost generated by the establishment of a social safety net and by economic plans will lead to an unprecedented deterioration in public accounts and the young generations who will have to pay twice for confinement: by the loss of their jobs and by raising taxes for those who will keep it.

It should not be forgotten that unemployment is also a health catastrophe, but more diffuse and therefore socially more acceptable: we thus estimate at 14,000 the deaths which it causes each year in France by induced diseases. And how not to speak of its procession of misery, hunger, social downgrading, etc. The effects of confinement are also going to have terrible consequences on the minds of French people, on violence against women and children, on their health (for example, early screenings for cancer, stroke, heart attack are suspended and nothing is known about suicides, etc.), about dropping out of school (how many children have simply disappeared from the system? ).

A lastingly weakened rule of law

Finally, to believe that public freedoms, democracy, will come out intact from this episode is just a sweet dream. The state of health emergency will remain enshrined in our law for a long time exactly as the state of emergency, launched in 2015, was finally incorporated into ordinary law. It is rare for a state to give up on its own the powers gained over the legislature and the justice system. The tracking of individuals, via smartphones, which some consider to be a necessity, could well become the rule in the name of safeguarding our health which has become THE priority, privacy being reduced to the rank of concern of another age. Having chosen total containment and the state of emergency will leave lasting traces in French democracy.

I do not pretend to provide an answer here. Simply, the first elements of the deconfinement show that another way would have been possible: confinement not department, wide discretion left to local authorities, referral to the judicial judge to register the carriers of the virus, etc. I just regret the absence of democratic deliberation before the establishment of the state of health emergency and its extension. As if sacrificing generations under the age of 60 and suspending the rule of law were obvious facts.

In provisional conclusion, I think that we should not be mistaken about the meaning of the unimaginable event that we are experiencing: it is the triumph of individualism, that of the immediate health of the individual in the face of well-being current and future collective. The terms of the debate are in reality identical to those of climate change: should we accept to sacrifice our immediate well-being to ensure the survival of the human species?

Some reading tips:

Note from the magistrates’ union on the state of health emergency

“Let us beware of falling into a sickly, viro-induced, social and political reactivity”

The catastrophic cost-benefit of containment

Breaking out of blind confinement

Dare to discuss confinement (a Belgian point of view)

Will the remedy ultimately be worse than the coronavirus? (a Swiss point of view)

“Let us die as we wish” and “I prefer to catch covid-19 in a free country than to escape it in a totalitarian state”

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“The most striking part of this epidemic? The political response ”

“With us, the lull continues. Last week, we only lamented one death, when before we could count four or five a week. More and more patients can go home.

→ LIVE – Coronavirus: the latest information in France and worldwide

But for many, the end of hospitalization does not mean that they are finished with the disease. As with all serious infections, the recovery phase can be long. In some, the lungs have been badly affected, and it will take time for respiratory function to return to normal.

If it is still too early to declare victory, I am relieved to note that at the level of our establishment, the drama has been avoided. This is the case for the vast majority of the country. There is a lot of talk about the Grand Est and Ile-de-France, the two main centers of the epidemic, but a large part of the territory has been much less affected.

The reasons are not always obvious. Why have there been so many people infected in Lyon but not in Toulouse, Bordeaux or Grenoble, only 100 km away? Only fine epidemiological analyzes will allow us to understand it.

A sense of fatality that tends to disappear

This epidemic will be a milestone, for sure. By its brutality and the resulting hospital overflow in certain regions. But above all by its political response. For the infectiologist that I am, this is the most striking. Never before has an epidemic resulted in measures of this magnitude.

I was still a student when the 1969 flu epidemic broke out. I don’t remember any panic, yet it was pretty spectacular. Information wasn’t as important, social media didn’t exist. But I also believe that there was at that time a certain sense of fatality which tends to disappear today.

In fact, the coronavirus crisis acts as the revealer of a change of mentality which has gradually taken root in the population and is reflected in political life: death from illness is no longer accepted. Not to heal has become inconceivable. I’m not saying it’s good or bad, but I see. And I wonder: in spite of fear, will we be able to keep reason and resist extremes? Will we choose life over security at all costs? “

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Coronavirus reader questions: Could I get the virus again later?

Updated April 7, 2020, 2:26 p.m.

The corona pandemic has turned our everyday lives upside down. We keep getting new information about the virus. That is why we receive numerous inquiries from our readers every day, which we collect and answer here.

More current information about the corona virus can be found here

The corona crisis affects every one of us and has changed all of our lives. Everyone has urgent questions – medical, legal and psychological: what else can I do? What is recommended What can I do?

We strive to answer what moves you with the help of experts and scientific sources. At the end of the text you have the possibility to send us your question!

Among other things, we clarify the following questions:

  • Could I get the corona virus a second time?
  • Up to what temperatures is the virus stable?
  • Can I get infected with delivered food?

Also read: All developments related to the corona virus in our live blog

Coronavirus: How Long Contagious? Can I get sick again?

Question: “Suppose I had been infected about six weeks ago on a skiing holiday in Austria, but was never tested due to the mild course. How long would I be contagious for my environment and could I get the virus again later?”

Answer: Currently there is hardly any data on the point up to which there is contagiousness after the onset of the disease. According to the Robert Koch Institute (RKI) Reproductive and thus infectious viruses were detected in a throat study up to four days after the onset of symptoms and in the sputum up to eight days after the onset of symptoms.

In various studies, individual components of the virus were detected in the patient’s airways up to 18 days after the onset of the disease. It is not known whether these viruses were able to reproduce and were therefore contagious.

According to experts, after an infection with SARS-CoV-2 has been overcome, humans are probably initially immune to the pathogen. As of today, it is known that people are infected with the novel after the infection Corona virus Virology forms, explained virologist Melanie Brinkmann from the Helmholtz Center for Infection Research in Braunschweig and Friedemann Weber, head of the Institute of Virology at the University of Giessen. It can therefore be assumed that immune protection will continue for several years after the infection. Exactly how long is unclear. However, the assumption is based only on experience with other human corona viruses.

Individual reports of possible re-infections, for example from China, Japan or Hong Kong, have so far not been confirmed. As a rule, the following applies: anyone who has become immune to a virus, its immune system reacts immediately when it comes into contact with this pathogen again. As a result, the virus cannot multiply in the body. The human body no longer produces new viruses and is therefore no longer contagious. This should also apply to the novel corona virus, my experts. (As of April 6)

Cleaning the breathing mask

Question: “When do I have to change the breathing mask? Do you also have to clean it? And if so, how?”

Answer: Regardless of whether it is a respiratory mask, surgical mask or self-made mouthguard: whether a mouth-nose covering is really helpful depends, among other things, on whether it is worn properly. This also includes changing the mouthguard regularly – especially if it is moisturized by the air you breathe. Masks that are used too long or very frequently can otherwise become a germ reservoir and lose their protective effect, as studies have found.

If a mask is used several times, special care must be taken, especially when putting it on again, since the outside of the used mask could potentially contain pathogens. It should not come in contact with the mouth or nose. The Robert Koch Institute also emphasizesthat the inside of the masks should not be touched with the fingers, especially when reused.

In addition to conventional protective masks, homemade mouth protection masks made of fabric are also becoming increasingly popular. In contrast to surgical masks and paper respirators, these can be easily reused. Doing so is recommended wash regularly at at least 70 degrees. (As of April 6)

Change in living will?

Question: “My living will contains the addition: ‘I am in the final stage of an incurable, fatal disease and do not want to be ventilated.’ Does that also apply to Corona or should I make a change? “

Answer: A living will will answer the question of which medical measures are desired or not desired in the event of illness if one is no longer capable of making one’s own judgment. These always apply regardless of the clinical picture. A COVID-19 living will should not be necessary.

However, to ensure that the formulations generally correspond to your own personal wishes, you can contact local health advice centers or the for specific questions Independent patient advice Germany call.

The general practitioner is also usually available to answer any questions. If you want to take a particularly professional form, you can also ask a lawyer for advice. However, this is not legally necessary. (As of April 6)

Influence of temperature on the corona virus

Question: “Up to what temperatures is the virus stable? At which freezing temperatures does it break?”

Answer: How SARS-CoV-2 reacts to cold is currently unclear. However according to the Federal Institute for Risk Research (BfR) the already known corona viruses SARS and MERS are insensitive to cold and can remain infectious in the frozen state for up to two years at minus 20 degrees Celsius. Whether this also applies to SARS-CoV-2 has not yet been extensively researched.

However, one thing is certain: The viruses are sensitive to heat. They are surrounded by a lipid layer, i.e. a layer of fat, which is not particularly heat-resistant, so that they quickly break when the temperature rises. At what degree the virus is killed is not yet clear. Research on this is still ongoing. (As of April 6)

Viruses in the daily newspaper?

Question: “What about the possibility of infection via paper, cardboard and daily newspapers? We keep a distance of two meters, but we read the daily newspaper, we get mail and parcels. Should it be better to wash your hands after touching it?”

Answer: First laboratory tests by American scientists show that the virus can remain infectious on cardboard for up to 24 hours. However, factors such as temperature, humidity or the stability of the virus also play a role in spreading across surfaces, the researchers emphasize.

But it also depends on how many viruses are ingested at one point, i.e. how large the virus concentration is. How many that would have to be for an infection is not yet known. Research is just being carried out here.

Basically is regular hand washing hence a simple and effective measure that can protect against infection. (As of April 1st)



This is how long corona viruses stay on surfaces. Source: The New England Journal of Medicine.

© 1 & 1

Contagion over delivered food?

Question from our reader Dr. Thomas S. from Münster: “Many restaurants offer delivery of freshly cooked food. Can I get infected with such a meal?”

Answer: The contagion pathways in the SARS-CoV-2 coronavirus have not yet been clearly clarified. It is primarily intended to be transmitted via droplet infection, but smear infections are also possible.

The Federal Institute for Risk Research assumes, however, that the virus is unlikely to be transmitted through contaminated food or imported products. However, the general rules of hygiene should be observed, according to the BfR.

In addition, the viruses are sensitive to heat, which means that the risk of infection from heating food can be further reduced. (As of April 1st)

Disease in young children and infants?

Question: “Is there an explanation, or at least an assumption, why so far toddlers or infants have obviously not contracted the disease, but still carry the virus?”

Answer: The risk group for coronavirus mainly includes people with a weakened immune system, the chronically ill and the elderly. Of the Federal Center for Health Education according to children, the course of the disease appears to be often less pronounced than that of adults. However, there were also occasionally severe courses in children.

However, it is currently not known for certain why the coronavirus infection is often less severe in children than in adults. An international research team does this published a first study.

A possible explanation would therefore be that the not yet developed immune system works more effectively in children with a corona infection than in adults. Because their immune defense has little experience with common pathogens, so they have not yet been able to develop specific antibodies. Perhaps the child’s defense against SARS-CoV-2 will react more strongly. Pneumonia, which can occur with Covid-19, is ultimately the body’s attempt to get rid of the pathogens.

A further thesis would be that the docking points through which viruses infect body cells have not yet been sufficiently developed in children. If the viruses do not enter the cells, they cannot multiply either. It also fits that the children in the study recovered faster than the adults. (As of April 1st)

Are you looking for answers to your questions in the corona crisis? Write us! Under “Contact the editorial staff” under this article you can send us your question.

(kad, with material from dpa)

The University Clinic of Schleswig-Holstein wants to find out to what extent nutrition depends on the course of COVID-19 with a nationwide study.

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The EU delays its response to the coronavirus crisis by two weeks and worsens its division

Neither coronabonos nor rescue fund. North blocks both options. And the south remains with the commitment that it will go further so that the coronavirus does not condemn a new financial crisis. But not now. In practice, two more weeks to present a “clear and forceful” coordinated fiscal plan, according to Pedro Sánchez, with which to alleviate the post-health crisis effects. In broad outline, that was the result of the ‘video summit’ that the Heads of State and Government held this Thursday. Six hours (when only two were planned). Closer from Germany, Holland and other Nordic countries … And a blow on the table from Italy and Spain, the European partners hardest hit by the pandemic, which avoided an even more decaffeinated statement. Conclusion: even a pandemic cannot catalyze more European integration. And all for a paragraph.

THE KEYS:

Economic – Coronabonos:

Issuance of joint debt to share risks and obtain better financing conditions.

Economic – ESM:

Rescue fund endowed with 410,000 million euros.

Health and research- Equipment:

Joint purchases through the Commission.

Health and research- The vaccine:

140 million.

Before the summit started, and while it was being held, several draft conclusions were disseminated. They included the drafting of objectives in matters such as containing the expansion of the pandemic (with measures already known as the reinforcement of external border controls, or the “storms” introduced within the Schengen area); the provision of medical equipment; or promoting research to get a vaccine (remembering that 140 million euros from the EU already finance 17 projects).

The touches were happening in a couple of points. It could be said that in one, the 14, integrated in the block on measures to face the socioeconomic consequences. There was the Gordian knot of this summit. Input, none of the text ‘projects’ mentioned the activation of eurobonds (Today renamed ‘coronabonos’). Not even indirectly. So the ‘club of nine’ that advocated for them (with France, Italy and Spain in the lead) already received a blow from Germany, Holland or Finland. The rich.

Direct | This is how the fight against the coronavirus progresses

But in ‘version 1’ (let’s call it that) there was a light. He did speak of the ESM (European Stability Mechanism). This rescue fund, endowed with some 410,000 million euros, was the resource to which the ministers referred on Tuesday to ‘sell’ a joint and coordinated solution of the euro countries. They discussed that this box would open up to 2% of the GDP of the country that needed it. Many details were missing. Then Mario Centeno, president of the Eurogroup, spoke of “broad agreement”. But Holland (and others, the same) were not part of it. So The Eurogroup passed the ball to the leaders.

Not even the ESM

Which leads to ‘version 2’ of the conclusions document: even the ESM disappeared. Perhaps because the tool is not necessary today (no country currently has problems accessing public debt auctions). One could even think that this ‘insurance’ was meaningless considering that the ECB has already confirmed that it will throw out the rest: that it will buy debt for more than a trillion euros and even assume more than 33% of that generated by each country. .

The G-20 injects 4,500 million euros

In any case, it disappeared. Moreover, even the temporary allusions were dispelled. In a first text, the ministers of economy and finance were summoned to outline technical solutions “next week”. In the following one it was passed to “next weeks”. And in a later one, not even a term. In all, yes, a declaration of intent appeared. “Our response must take into account the unprecedented nature of the Covid-19 crash” that affects everyone “and will escalate (the response) as needed.”

But the urgent, concrete and practical had led to a dead end. So at about eight o’clock ESpain and Italy set foot on the wall. They were planted. They did not accept ambiguities and gave ten days to come up with a plan to break the blockade. It was then that the presidency got to work with a new version.

And in this there is still no ESM or Eurobonds, the ball is returned to the ministers of Economy to «Present a new proposal». And it includes the need to work on a reconstruction plan for when the pandemic is controlled. Actually a new kick forward. Two or three weeks, when the economic emergencies will be greater. Worse.

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Chaos, inconsistency Marks the launch of the Drive-thru Virus – NBC Los Angeles test

Drive-thru sites have been opened in the United States to make testing the new coronavirus faster and safer. But just like the rest of the United States’ response to the pandemic, the system has been characterized by inconsistencies, delays and shortcomings. Many people who have symptoms and a doctor’s order have waited hours or days for a test.

More than a week after President Donald Trump promised that states and retail stores such as Walmart and CVS would open drive-through test centers, few sites are active and are not yet open to the public. Some states are leaving the test sector open to the private sector; others are coordinating efforts through state health departments.

Patients complained that they had to jump through bulky red tape and wait for days to get tested, then wait even longer for a result. The test centers were opened in some places to be closed shortly afterwards due to the shortage of supplies and staff. And while the drive-through test centers that have been opened are generally sorted, in some there have been long lines.

The slow increase in COVID-19 tests and the unpredictable nature of the system make it difficult for public health officials to track the spread of the disease and bring it under control.

“We need to do more extensive testing to fully understand the scale of the public health situation we are facing,” said Joseph Wendelken, a spokesman for the Rhode Island Department of Health.

Dr Brett Giroir, the federal health officer in charge of overseeing the tests, said on Saturday at a White House briefing that approximately 195,000 people have so far been tested in the United States. This figure does not include some people who have been tested in private laboratories.

For most people, the new coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more serious illnesses, including pneumonia. The vast majority of people recover from the new virus. According to the World Health Organization, people with mild illness recover in about two weeks, while those with more severe illness can take anywhere from three weeks to six weeks to recover.

Drive-through test sites have sprung up in places in over 30 states: in state parks and parking lots, near medical centers and universities, the Mississippi state fairgrounds, and near where the Jacksonville Jaguars play. The governor of Maryland last week ordered the stopping of vehicle emission inspection programs across the state, so that the offices could be used as drive-thru centers to test the virus.

But as of Friday, there were no open drive-through tests available in Maryland inspection centers.

The Utah health department said it is not responsible for the sites and is not monitoring them. The North Carolina health director said the state is leaving the tests to the private sector and declined to say how many sites there are. In contrast, in Rhode Island, health organizations manage the sites in collaboration with the state health department.

On Thursday, cars lined up for more than a mile outside a hospital in Houston when the first drive-through test site was opened. U.S. representative Sheila Jackson Lee said she administered fewer than 200 tests in the first six hours.

Elsewhere, at various sites visited by Associated Press reporters, the scenes were well controlled and sometimes quite silent.

Dozens of people waiting by car in a downtown Homestead, Florida on Wednesday waited for their turn to speak with a screener who was wearing a suit and mask and carrying notes. Some were apparently removed. Others were stirred, checked their temperatures, and swabbed for the samples.

But the shortage of supply has stopped the thrusters in several states, including Colorado, New Mexico, Virginia, Florida, Louisiana, Alabama, North Carolina and Utah. A Las Vegas site was shut down because it didn’t have enough workers.

New York state opened several centers with great fanfare on Tuesday. By Friday, however, the New York City health department issued a warning saying that only people requesting hospitalization should be tested, due to a shortage of protective equipment such as face masks. Drive-thru sites in New York State remain open, but only to people who meet certain criteria.

Nevada Governor Steve Sisolak said he had asked the federal government for additional test kits and supplies, but the state received a warning Thursday that all of its requests for drive-through test pods and test kits “are undefined arrears, without any estimate of a timeline for delivery. “

“This is our unfortunate Nevada reality. It depends on us, “he said.

The sites themselves are dotted with tents and traffic cones. The most important features are medical personnel who wear masks, gloves and protective vests or other clothing. They take nose and throat swabs from people sitting in their cars or help people get in for the test.

Some states have only one drive-thru site. Montana’s only site is in Billings, the largest city in the state. Others have a dozen.

Security guards have been reported on many sites, but an AP survey of states did not reveal any security concerns. In Rhode Island, the National Guard was on hand to set up the state’s three drive-thru sites and even to buffer patients.

The vast network of drive-thru sites in retail chains that Trump claimed was coming over a week ago has not materialized yet. CVS has opened a site in Massachusetts that defines a “test model”. Walmart launched two sites on Sunday and Walgreens said it will launch one, all three in Illinois. Only healthcare professionals and first responders are allowed, and Walmart said that a maximum of 150 tests per day could be performed on its federal sites.

The patchwork of approaches has caused confusion for patients. Caroline Mauldin was sentenced to get tested by her doctor in Charleston, South Carolina on Tuesday after suffering from pain and chills for several days.

To make an appointment at a center in a medical center, she had to fill out a long online questionnaire and spent two days calling a number that went to voicemail and did not answer messages. He resorted to tweets in the hospital several times just to get things going.

Finally, on Thursday, he had an appointment for Monday. And she was told that the results would not return until after 4-5 days. The visit will cost you $ 25, he said. Complicating things, he doesn’t have a car and has to borrow it from a friend.

“Here we have a lot of older, low-income people who don’t have Internet access and who don’t have access to transportation. And since they’re the highest risk population, how are we testing for them?” She asked.

In urban areas such as New York and Philadelphia, some sites offer “walk-up” dating for people without cars.

At the Penn Medicine test site in West Philadelphia, two security agents were late on Thursday to make sure that people arriving by car or on foot had an appointment. For about 40 minutes that evening, the line of cars never grew to more than six or seven. But Patricia Sullivan, Penn Medicine’s quality manager, said every morning last week, 25-35 cars were lined up and six or seven standing patients were 6 feet apart on a porch waiting to be seen.

The 20 sites in Greater Philadelphia are testing around 1,000 people a day, but that hasn’t eliminated pent-up demand.

Rosanne Tanner’s 79-year-old mother has been suffering from fever and chest pain since returning from a visit to Tanner’s brother and wife, who had recently been on a cruise ship.

His doctor ordered a test on Tuesday, but when he tried to make an appointment at a drive-through site in a hospital outside of Philadelphia, he was told that “they are overloaded, they are bogged down,” Tanner said.

Medical staff told her that they are scheduling 15 minutes apart, so there are no bottlenecks on the test site.

Finally on Thursday his mother made sure of an appointment for the following Tuesday. Then, he will have to wait another five days for a result.

“The delay in these tests is putting people at risk,” said Tanner.

In Rhode Island, state officials said they are testing 100 to 200 people per day at all test sites, including three drive thrusters.

Governor Gina Raimondo said they want to perform 500 to 600 a day, but they don’t have the supplies they need.

“It is our top priority to reach a place where everyone who needs it can be tested and you will get results very quickly,” said Raimondo during a press conference held on Facebook Live on Friday on Friday. “So if you’re positive, we can quarantine you.”

____

Associate press writers Michelle L. Price in Las Vegas, Lynne Sladky in Homestead, Florida, Claudia Lauer in Philadelphia, Chris Ehrmann in Hartford, Connecticut, Brady McCombs in Salt Lake City and Jonathan Drew in Raleigh, North Carolina and Anne D ‘Innocenzio and Mike Sisak in New York contributed to this report.

___

The Associated Press receives support for health and scientific coverage from the Howard Hughes Medical Institute’s Department of Education. The AP is solely responsible for all content.

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Nurse tested for coronavirus health care system is failing workers – NBC 7 San Diego

A San Diego nurse who is being tested for coronavirus says the health system is not doing enough to protect workers and patients, and fears that she has unwittingly exposed others to the virus while they were at work.

She
he spoke exclusively to NBC 7 on FaceTime on Wednesday.

“Hi, so I’ve just been tested for coronavirus,” explained nurse Megan Ucich in a cell phone video recorded at home earlier this week.

Ucich treats patients in three separate health centers.

“So last Tuesday,” continues Ucich, “I started having this strange chest tightness, almost like chest pain.”

She thought it was right
muscle soreness, so he continued to work.

So on Monday he started to vomit, he had diarrhea and a high fever.

“This sucks,” Ucich described. “For people who think this is just like the flu – no.”

Now it is
quarantined in her bedroom – away from her husband – while she waits
test results.

“I
I think this is revealing cracks in our healthcare system that are occurring
for a long time, “said Ucich in the Facetime interview on Wednesday.

The cracks to which it refers
be the lack of protective devices and the lack of tests for healthcare professionals.

In fact, her primary care physician sent to her home, telling her that she probably had just had the common flu.

“Not
the answer we should give to our healthcare professionals, “said Ucich.

He went to another
hospital where she was screened and tested immediately.

“If we don’t have the resources to keep ourselves safe, we can’t even protect you. And that’s what’s scary. That’s what needs to change,” he said.

Ucich hopes that officials will soon undertake routine tests for healthcare professionals.

“We are probably adding fuel to the same fire we are trying to put out every day,” said Ucich in one of his home videos.

We want to be clear: Ucich’s test results are still pending. However, it has already shown negative results for influenza A, influenza B and RSV, the most common strains of influenza and common respiratory infections.

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Who gets the most credit: Brady or Belichick? – NBC Boston

From 2001 to 2019, the New England Patriots have won the AFC East 17 times. The other two years ended in a tie in first place.

In that time frame, they went to 12 AFC championship games and nine Super bowls. Six have won.

Bill Belichick and Tom Brady have been together for the entire race and – thanks to the past two decades – are now recognized as the best coach and quarterback in NFL history respectively.

Trying to share credit for a race never seen before the NFL domination and perhaps the most incredible trait in the history of professional sport – to some extent – is missing the point.

Did the ancient Egyptians stand in front of the pyramids and discuss whether the architect or builders deserved more credit? Did Mrs Wright analyze which of her children – Wilbur or Orville – was primarily responsible for the invention, construction and flight of the first plane?

There is something to be said just to close and appreciate the realization, isn’t there? Yup.

And we will get there.

But right now, with the engines going down Route 1 to pack Tom Brady’s remaining stuff and take him out of Foxboro forever, the question hangs on everything. Which man was most responsible for creating the story we’ve seen written in the past two decades: Belichick or Brady?

Results may vary. In fact, I know they will. But here’s how I see it.

If it hadn’t been for Belichick, there would never have been the mini-dynasty that they became in the decade 2000-2009.

If it weren’t for Brady, the Patriots would never have become the Super Dynasty that they became from 2010 to 2019 when they blew up the 60s Packers, 70s Steelers, 80s Niners and 90s Cowboys to become the only franchise that has dominated two decades.

Bill gets the first decade

The moment Mo Lewis cut an artery in Drew Bledsoe’s chest in September 2001, he is touched as the history of the NFL has changed. It wasn’t. It will only speed up a trial that began when Robert Kraft decided to hire Belichick to succeed Pete Carroll in January 2000.

Belichick took a look at the team’s register and management and started fumigating and renewing. In the end – despite the heavy contract that the Patriots gave Bledsoe in January 2001 to help strengthen public confidence and private investment in building CMGI Field (possibly Gillette Stadium) – Belichick was wary of being tied to a quarterback that the coach was able to routinely undress whenever he trained against him.

Especially a quarterback who had to be paid as the top of the market, as Bledsoe and his agent David Dunn made clear.

Brady was not enlisted in the sixth round of the 2000 draft as Bledsoe’s successor, but in September it became clear to Belichick that he had something. And it became obvious during the 2001 offseason and the training camp that – although not better than Bledsoe in all – the child who made $ 298,000 was more mobile, more precise, more ready in his pocket and destined to be more suited to handling a Bledsoe game.

Mo Lewis accelerated the process and – with a painful stroke – made the transition relatively painless. But the credit goes to Belichick for seeing what he had, promoting it and having the decision to pull the trigger.

The fact that the Patriots went 14-5 under Brady after starting 5-13 under Bledsoe is persuasive evidence that Brady was the missing piece. But Belichick created the register, built the culture and hired the right people – from managers to coaches – to put the team in a position to succeed. It deserves more credit.

Brady may have helped them get where they did, but the Patriots were undoubtedly headed in the right direction and the fruits of Belichick’s designs were collected in 2003 and 2004.

Those Super Bowl wins – the first at the end of a season that started with the shooting down of lawyer Milloy in favor of Rodney Harrison; the second thanks largely to a dice throw on Corey Dillon – they were the victories for “culture”.

Disinterest imposed. All done for the greatest good of the team. Everything ego in your pocket. The most impressive aspect of the patriots was therefore their stamina and mental endurance. Brady was an important part. But so were Tedy Bruschi and Harrison, Matt Light, Richard Seymour, Mike Vrabel and so on.

Fifty-three very intelligent and capable players row together in the hold of the big ship while Belichick was over the bridge to trace a route. It was from 2001 to 2004.

The dips in 2005 and 2006 began the process that would have led Brady to become, largely on Belichick’s design, the engine.

The 2005 Patriots were hit by injuries – not a hindsight surprise when you consider the nine extra games played in the previous four seasons and the difficulty of staying on top. They started to see some friction to grow old – Troy Brown was 34 then – and the ongoing game was marked as well as their defense on the run. They went 10-6 and lost in the division round.

The following season, a protracted squabble over the contract led to the Deion Branch being swapped with Seattle shortly before the season began. Reche Caldwell led the team in receptions followed by Ben Watson, Troy Brown and Kevin Faulk. However, they were unable to advance to the Super Bowl, but lost on the road to the Colts.

That season, Brady got a toy he had never had in Randy Moss and a Troy Brown replica model named Wes Welker. The entire set of record sets went 16-0 and lost in the Super Bowl.

Which brings us to 2008. This is the season that many are aiming for when they say that it is Belichick’s genius that is most responsible for twenty-year success. The Patriots went 11-5 with Matt Cassel starting in quarterback. Hadn’t he been a beginner from high school, yet the patriots still went 11-5?

Cassel was exceptional, better than anyone could hope for. But it’s still a sharp drop from 16-0 to 11-5.

In 2009, the central defense core was expelled or withdrawn: Vrabel, Bruschi, Seymour and Harrison. Belichick complained to Brady on the sidelines during a defeat for the Saints that season that “I just can’t get these kids to play the way I want them. So frustrating.”

The season ended with an ignominious home defeat against the crows in the AFC division playoff round.

Brady gets the second decade

The patriots renewed in the off-season and, in my opinion, Brady was at the forefront of finding their places where they had no business at that stage of their reconstruction. In 2010, the Patriots went 14-2, they were seed no. 1 and Brady was the unanimous MVP.

The offense, moving away from the narrow final position, enlisted two – Rob Gronkowski and Aaron Hernandez – and their production would become historic in 2011 when the Patriots arrived at the Super Bowl and lost again to the Giants. Brady launched for 5,235 career yards with 39 touchdowns and 12 picks.

In the 2012 season, he launched 637 times, a career high and one of three times in four seasons that attempted more than 600 passes. With a defense that too often seemed to resist better teams, it was Brady and the offense to score and score and score a little more. They were the first, third, first and third in points marked from 2010 to 2013. Defensively in that period they were eighth, 15th, ninth and tenth.

Even in 2013, when Hernandez was jailed for murder, Gronkowski was grounded due to back surgery and then with an ACL, Brady still ran by hitting the ball with Julian Edelman, Danny Amendola and – to a lesser extent – Kenbrell Thompkins, Aaron Dobson and Shane Vereen.

They won the Super Bowl in 2014, winning a shootout against the Ravens in the Divisional Round, 35-31, and then overcoming a 24-14 deficit against the Seahawks in the fourth quarter when Brady moved to a completely different level in the fourth quarter.

The previous April, Belichick had enlisted Brady’s aspiring successor, Jimmy Garoppolo, in the second round. Brady, perhaps remembering the shrug that Drew Bledsoe had encountered Brady’s arrival 14 years earlier, would not have fallen asleep on the move with the team that ran Garoppolo.

Brady went on to launch 69 touchdowns and 16 predictions in 2014 and 15. He lost four suspension games in 2016 – Garoppolo overcame six quarters of Brady’s relief before hurting himself and giving way to Jacoby Brissett – but he still threw 28 touchdowns and two interceptions before ending that season with a 43- record. by-62, 466 yards in the Super Bowl when the Patriots canceled out a deficit of 28-3. Brady did it at 39.

At 40 in the AFCCG, without Edelman, without an injured Gronkowski, Brady and Amendola joined together to push the Patriots beyond the Jaguars and in the Super Bowl against Philly where he would have launched for 505 yards.

So let’s tell here. From 2010 to 2017, the Patriots have reached seven consecutive AFC Championship Games and the year they didn’t, Brady was the unanimous MVP. He wrote the filming of the playoffs against Ravens and Seahawks in 2014, the Falcons in 2016, the Jaguars in 2017 and led the team to two Super Bowl wins.

In 2018, Edelman was exiting an ACL and was therefore suspended for the first four games. Gronk was injured for a large chunk of the year. Phillip Dorsett and Chris Hogan were the main gimmicks for a while until the team faced Josh Gordon. It’s still? The team went 11-5, Brady put them on his back in the fourth quarter and overtime in Kansas City in the AFCCG and then the Patriots defense checked against the Rams and delivered a Super Bowl to Brady – apart from the shot at Gronk which led to the game’s winning touchdown – he just had to play OK to win the team.

The final verdict

So, see what my answer to this debate is now. Bill gets a bigger share of the first three Lombards. Tom gets a higher share than the second three.

So many people over the years have speculated that Belichick wants to prove that he can win a championship without Brady. I don’t know if it’s true.

I think if Brady was gone, Belichick would appreciate the opportunity, but I never thought he would have wanted to get rid of what he thinks is a quarterback capable of giving him a title that the others couldn’t.

Maybe that’s why we’re here. Belichick doesn’t see Brady as special as he once was. Great? Sure. Are there other guys who can do things they can’t do now? Belichick seems to think so. Brady has apparently survived its usefulness here.

Bill will do what he has done to so many other players. Go ahead. But this is the life cycle of the NFL.

From what I’ve been told and what I’ve collected, Brady agrees. He hoped to be special and to be able to write a different ending here, but to realize he couldn’t shock him. For a legend, it is rather well established.

Playing for Bill Belichick will help keep a player that way. And maybe even for that, Belichick deserves a lot of credit. He allowed Tom Brady to become Tom Brady because he was eternally and exasperatedly Bill Belichick.

Every. Single. Year.

.

For the Sick, an agonizing wait for tests in Massachusetts – NBC Boston

Danni Aubain has cancer, so when she started feeling lousy late last month, she was particularly worried.

Aubain said the disease hit her like a ton of bricks. He had a 103-degree fever and a horrible, dry cough.

“I really couldn’t breathe,” he said, “and that’s scary for anyone undergoing chemotherapy.”

When seeking medical attention, Aubain said that both her oncologist and a Massachusetts General Hospital emergency room doctor pushed for her to be tested for COVID19, the new coronavirus disease that spreads worldwide.

But despite their recommendations, the response they got from state epidemiologists was that Aubain did not meet the test criteria.

“They called the Public Health Department and I was told that if I couldn’t name a person I knew had a positive test and that I hadn’t traveled outside the country, I couldn’t have been tested,” he said.

In response to NBC10 Boston’s questions, Mass. General said he cannot discuss the treatment of any patient.

But Aubain’s story is like so many others streamed to NBC10 Boston investigators in the past week by spectators across the state who have not been able to take a test. Many said they experienced symptoms of the disease, such as fever and shortness of breath. Like Aubain, some have also been seen by doctors who were convinced they need to be screened.

But with a shortage of test kits available in the state until the end of last week and with restrictive guidelines in place by the federal government, many said they were frustrated, scared and confused as to what to do next.

Federal officials are rapidly increasing the nation’s infrastructure to test COVID-19 this week after a series of missteps hampered the country’s ability to control the virus as it migrated from its epicenter in China to destinations around the world. As of Monday, there have been over 4,000 disease cases reported in the United States, which have so far seen over 70 deaths.

On Monday, health officials in Massachusetts announced that around 1,300 people were tested for the disease and 197 tested positive.

The state’s ability to test patients has increased significantly in the past few days when federal officials have granted Massachusetts clearance to begin testing the samples at the state’s public health laboratory, rather than sending them to a centralized, managed location. by the US Centers for Disease Control and Prevention.

Federal officials also expanded their testing guidelines, offering doctors more discretion to order a test for the virus, and last week they shipped around 5,000 additional test kits to Massachusetts, easing local supply.

The CDC has also published new guidelines that allow doctors and nurses to subject a single nasal swab to tests, rather than a nasal swab and another sample from the patient’s throat. The change is expected to allow Massachusetts to double its testing capacity, bringing the number of tests conducted every day from 200 to 400, public health commissioner Monica Bharel said at a press conference on Sunday.

The Food and Drug Administration, which must approve the test sites, also granted permission at the end of last week to a couple of private companies – Quest Diagnostics and LabCorp – to begin testing samples collected from patients in Massachusetts. Massachusetts hospital labs are expected to launch their testing programs shortly.

“With more and more clinical labs in Massachusetts working to gain FDA approval, more online capabilities will also be available soon,” said Bharel on Sunday.

Federal officials say the United States is now on track to test thousands of patients a day for the virus after falling far behind other countries in its efforts to detect the virus.

Independent research cited by the CDC indicates that the United States had completed approximately 20,000 tests as of March 13. That number pales in comparison to the aggressive testing effort in South Korea, which has a much smaller population, but has tested around 15,000 people per day.

While the United States is ready to learn more about the extent of the pandemic soon, many in the Bay State who fear having contracted the disease say they believe the government has missed an important opportunity to help curb its spread.

“I have a couple of friends in my social circle who are experiencing flu-like symptoms and are just writing it as flu,” said Rita Czernewski, a Cantonese resident who had an unexplained illness a few weeks ago and was frustrated by her inability to get tested for the new coronavirus.

“We are just a little stuck,” he said. “The only thing we can do is just be careful.”

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The mass tombs of the Coronavirus in Iran allegedly shown in satellite images while experts question the official figures of the country’s virus

updated

March 14, 2020 5:20:32 PM

Satellite images seem to show evidence of mass burial pits in Iran to deal with an increasing number of coronavirus deaths, while experts question the official toll on Iranian victims.

Key points:

  • The Iranian government reported 429 deaths and 10,075 confirmed cases
  • The videos were shared on social media showing body bags lined up in a morgue and locals told ABC that they believe the death toll is much higher than the government admits.
  • Deputy Prosecutor Says “False” or Unauthorized Filming on Social Media Outbreaks Within the Country is Prohibited

A series of images showing the excavation of a new section of the cemetery in the city of Qom – the epicenter of the Iranian outbreak COVID-19 – which began around February 21, just two days after Iran reported its first cases of coronavirus, were published by the New York Times.

The images, provided to the Times by the US space technology company Maxar, show what appear to be new rows of tombs inside the city’s largest cemetery and increased activity around the new site.

Dalton Bennett, a reporter with the Washington Post investigative unit, tweeted that Maxar’s analysis revealed “the size of the new trenches and the speed with which they were excavated together mark a clear departure from previous burial practices involving individual and family plots on the site “.

The Iranian government reported 429 deaths and 10,075 confirmed cases, but Iranian internal health officials had previously told the BBC that the real number was much higher than reported.

Among the dead are dozens of officials, including members of Parliament and a senior adviser to the Supreme Chief.

Civilians inside Iran, who did not want to be named, told ABC that the death toll was in the thousands and the hospitals were so full that other public buildings were being used to house infected people.

Between 19 and 23 February, Iran reported 43 cases and eight deaths from viruses, but three exported cases originating in Iran were identified in the same period.

‘We don’t trust official statistics’

A report published on the health sciences website medRxiv – entitled COVID-2019 burden estimate and potential for the international spread of infections from Iran – estimates that by February 23 “18,300 COVID-19 cases should have occurred in Iran , assuming an outbreak duration of 1.5 months in the country, in order to observe these three cases exported internationally reported at the time of writing. “

Kaveh Taheri, Turkish researcher, investigative journalist and president of the Human Rights Capacity Development Institute, said: “Based on the basic reports received by the country, I am convinced that the estimates would be very close to reality and we do don’t trust official statistics. “

“The Iranians inside the country are extremely scared,” he said.

Your coronavirus questions answered:

“You can’t imagine how desperate people are.”

The videos were also shared on social media showing body bags lined up in a morgue, tombs and people passed out on the street.

A video shows multiple immovable bodies arranged on a morgue floor.

According to Iranian state media, the person who released the footage was subsequently arrested by local authorities.

A Qom deputy prosecutor, quoted by Fars News, said the publication of fake or unauthorized images of the virus is prohibited.

What coronavirus experts say:

Themes:

Health,

government and politics,

Diseases-and-disorders,

Infectious-disease-other,

world-politics,

Iran (Islamic Republic of

First published

March 14, 2020 08:16:25

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Virus outbreaks in Italy and South Korea reveal disparity in deaths and tactics

MILAN / SEOUL (Reuters) – In Italy, millions are blocked and over 800 people have died from the coronavirus. In South Korea, affected by the disease around the same time, only a few thousand are placed in quarantine and 67 people have died. As the virus travels the world, the story of two outbreaks illustrates an imminent problem for countries that are now grappling with an explosion in cases.

FILE PHOTO: Medical operators wearing protective masks check patients at a medical checkpoint at the entrance to the Spedali Civili hospital in Brescia, March 3, 2020. REUTERS / Flavio Lo Scalzo

It is impractical to test every potential patient, but unless authorities can find a way to see how widespread the infection is, their best answer is blockage.

Italy has widely started testing, so it has reduced focus so that authorities don’t have to process hundreds of thousands of tests now. But there is a compromise: they cannot see what is coming and are trying to curb the movements of the entire population of 60 million people in the country to contain the disease. Even Pope Francis, who has a cold and delivers his Sunday blessing on the Internet from inside the Vatican, says he feels “caged in the library”.

Thousands of miles away in South Korea, the authorities have a different response to a similar-sized outbreak. They are testing hundreds of thousands of people for infections and monitoring potential couriers as detectives, using cellphone and satellite technology.

Both countries saw their first cases of disease called COVID-19 in late January. South Korea has since reported 67 deaths out of nearly 8,000 confirmed cases, after testing more than 222,000 people. By contrast, Italy had 827 deaths and identified more than 12,000 cases after performing over 73,000 tests on an unknown number of people.

Epidemiologists say that numbers cannot be directly compared. But some claim that dramatically different results point to an important insight: aggressive and sustained tests are a powerful tool for fighting the virus.

Jeremy Konyndyk, senior researcher at the Center for Global Development in Washington, said that extensive tests can provide countries with a better picture of the extent of an outbreak. When tests in a country are limited, he said, authorities need to take bolder actions to limit the movement of people.

“I’m uncomfortable with the blockade-type forced movement restrictions,” he said. “China has done it, but China is able to do it. China has a population that will respect it. ”

The democracies of Italy and South Korea are useful case studies for countries such as America, which have had problems installing test systems and are weeks behind on the infection curve. So far, particularly in Japan and the United States, the problem is not yet fully evident. Germany has not experienced significant constraints in the tests, but on Wednesday Chancellor Angela Merkel warned her people that 60% to 70% of the population is likely to be infected, the only option is containment.

South Korea, which has a slightly smaller population than Italy with around 50 million people, has around 29,000 people in quarantine. It imposed blocks on some structures and at least one apartment complex hit hardest by the outbreaks. But so far no whole regions have been cut.

Seoul says it is building on lessons learned from an outbreak of Middle Eastern respiratory syndrome (MERS) in 2015 and is working to make as much information available publicly available. He has started a massive testing program, including people who have a very mild illness or who perhaps don’t even have symptoms, but who may be able to infect others.

This includes applying a law that grants government authority to access data: CCTV footage, GPS tracking data from phones and cars, credit card transactions, immigration information and other personal details of confirmed persons have an infectious disease. The authorities can then make some of this public, so that anyone who has been exposed can get tested – or their friends and family.

In addition to helping understand who to test, the South Korean data-driven system helps hospitals manage the case pipeline. People deemed positive are placed in self-quarantine and monitored remotely via a smartphone app, or checked regularly in phone calls, until a hospital bed becomes available. When a bed is available, an ambulance picks up the person and takes the patient to the hospital with air-sealed isolation rooms. All of this, including hospitalization, is free.

South Korea’s response is not perfect. While over 209,000 people have turned negative there, the results are still pending over around 18,000 others – an information gap which means there are likely to be more cases in the pipeline. The rate of recently confirmed cases has dropped from a peak in mid-February, but the largest test on the system may still be ongoing as authorities try to track and contain new clusters. South Korea does not have enough protective masks – it has started to ration them – and is trying to hire more qualified staff to process the tests and map the cases.

And the approach comes at the expense of privacy. The South Korean system is an invasive mandatory measure that depends on people who give up what, for many in Europe and America, would be a fundamental right to privacy. Unlike China and the island state of Singapore, which have used similar methods, South Korea is a great democracy with a population that is ready to protest against policies that they don’t like.

“Disclosure of patient information always involves privacy violation issues,” said Choi Jaewook, professor of preventive medicine at Korea University and senior official at the Korean Medical Association. Disclosure “should be strictly limited” to patient movements and “should not relate to their age, gender or employers.”

Traditional responses such as blocking affected areas and isolating patients can only be modestly effective and can cause problems in open societies, says South Korean Vice Minister of Health Kim Gang-lip. In the South Korean experience Blockades mean that people are less involved in finding contacts than they may have had, he told reporters on Monday. “Such an approach,” he said, “is broad-minded, coercive and inflexible.”

ITALY “AL LIMITE”

Italy and South Korea are over 5,000 miles apart, but there are many similarities when it comes to coronaviruses. The main outbreaks of both countries were initially grouped into small towns or cities, rather than a large metropolis, meaning that the disease quickly threatened local health services. And they both involved doctors who decided to ignore the test guidelines.

The Italian epidemic started last month. A local man with flu symptoms was diagnosed after he told medical staff that he had not been to China and had resigned, said Massimo Lombardo, head of local hospital services in Lodi.

The diagnosis was made only after the 38-year-old, whose name was given only as Mattia, returned to the hospital. The test guidelines at the time said that it was not necessary to test people who had no connections to China or other affected areas. But an anesthesiologist pushed the protocols and decided to go ahead and test COVID-19 anyway, Lombardo said. Now, some experts in Italy believe that Mattia may have been infected by Germany, rather than by China.

Test decisions depend in part on what can be done with people who test positive, at a time when the healthcare system is already under stress. In Italy, the regional authorities initially tested and counted all the positive results in the total published, even if people had no symptoms.

So, a few days after the patient known as Mattia discovered that he had COVID-19, Italy changed tack, testing and announcing only cases of people with symptoms. Authorities said it was the most effective use of resources: the risk of contagion seemed lower in patients without symptoms and limited tests help produce reliable results faster. The approach carries risks: people without symptoms can still be infected and spread the virus.

On the other hand, the more you find the more tested, so testing in large numbers can put a strain on hospital systems, said Massimo Antonelli, director of intensive care at the Agostino Gemelli University Hospital Foundation in Rome. The test involves elaborate medical processes and follow-up. “The problem is actively looking for cases,” he said. “It simply means that the numbers are large.”

Italy has a generally efficient health system, according to international studies. Its universal health care receives funding below the European Union average, but is comparable to that of South Korea, at 8.9% of GDP compared to 7.3% in South Korea, according to the Organization world health.

Now that system has been unbalanced. The staff are brought to the emergency room and the emergency room, the holidays have been canceled and the doctors say they delay the non-urgent operations to free the ICU beds.

Pier Luigi Viale, head of the infectious diseases unit of the Sant’Orsola-Malpighi hospital in Bologna, works 24 hours a day, in three jobs. Her hospital is handling multiple coronavirus cases. Her doctors are moving to other hospitals and clinics in the area to lend their experience and help with cases. In addition, his doctors also need to look after patients with other contagious diseases that are struggling to survive.

“If it drags on for weeks or months we will need more reinforcements,” he told Reuters.

Last week, the mayor of Castiglione d´Adda, a city of about 5,000 people in the “red zone” of Lombardy, which was the first to be closed, launched an urgent online appeal for help. He said his small town had to shut down his hospital and was left with a doctor to treat over 100 coronavirus patients. Three of the city’s four doctors were sick or in quarantine.

“Doctors and nurses are on the edge,” said a nurse from the hospital where Mattia was hospitalized. “If you have to manage people in artificial respiration you have to constantly observe them, you can’t deal with the new cases that come in.”

Studies so far suggest that each positive case of coronavirus can infect two more people, so local authorities in Lombardy have warned that hospitals in the region face a serious crisis if the spread continues – not only for COVID-19 patients but also for others. whose treatment has been delayed or stopped. As the crisis spreads to Italy’s less prosperous south, the problems will be magnified.

Intensive care facilities face the most intense pressure. They require specialized personnel and expensive equipment and are not designed for mass epidemics. In total, Italy has around 5,000 intensive care beds. In the winter months, some of these are already occupied by patients with respiratory problems. Lombardy and Veneto have just over 1,800 intensive care beds between public and private systems, only a few of which can be reserved for COVID-19 patients.

The government asked regional authorities to increase the number of ICU places by 50% and double the number of beds for respiratory and contagious diseases, while rearranging staff shifts to ensure adequate staff. About 5,000 respirators have been purchased for intensive care stations, the first of which is expected to arrive on Friday, said Deputy Economy Minister Laura Castelli.

The region has already asked nursing institutions to allow students to pursue their degree to get more nurses into the system early. Groups of specialists in intensive care and anesthesiologists, including staff external to the most affected regions, will have to be set up.

To increase the burden, hospitals in Italy depend on medical personnel to try to trace the contacts that people who have proven positive have had with others. A doctor from Bologna, who asked not to be named, said he spent a 12-hour day tracking down people who had been in contact with only one positive patient, to make sure that people who needed further testing were found .

“You can do this if the number of cases remains from two to three,” said the doctor. “But if they grow up, something has to give. The system will implode if we continue to actively test everyone and therefore we must do all this. ”

“MAXIMUM POWER”

In South Korea as in Italy, a first case of COVID-19 was identified when a medical officer followed their intuition, rather than official guidelines, on tests.

The first case in the country was a 35-year-old Chinese woman who tested positive on January 20. But the biggest outbreak was detected after the 31st patient, a 61-year-old woman from the southeastern city of Daegu, South Korea, was diagnosed February 18.

Like the patient named Mattia in Italy, the woman had no known ties to Wuhan, the Chinese province where the disease was first identified. And as in Italy, doctors’ decision to recommend a test went against guidelines for testing people who had been to China or who had been in contact with a confirmed case, said Korea Medical Association’s Choi Jaewook.

“Patient 31”, as she became known, was a member of a secret church that deputy minister for health and well-being Kim Gang-lip has since linked to 61% of cases. The infections spread beyond the congregation after the funeral of a relative of the church founder was held in a nearby hospital and there were many other minor clusters across the country.

Once the church cluster was identified, South Korea opened approximately 50 drive-through test facilities across the country.

In empty parking lots, medical personnel in protective clothing lean into cars to check passengers for fever or breathing difficulties and, if necessary, to collect samples. The process usually takes about 10 minutes and people usually get the results in a text that reminds them to wash their hands regularly and wear face masks.

A total of 117 institutions in South Korea have testing equipment, according to the Korea Centers for Disease Control and Prevention (KCDC). The numbers vary daily, but an average of 12,000 is possible and the maximum capacity is 20,000 tests per day. The government pays for tests of people with symptoms, if directed by a doctor. Otherwise, people who want to be tested can pay up to 170,000 won ($ 140), said an official from a company called Seegene Inc, which supplies 80% of the country’s kits and says they can test 96 samples simultaneously.

There are also 130 quarantine officers like Kim Jeong-hwan, who focus on small details to track potential patients. The 28-year-old public health doctor spends the entire working day remotely checking people who have tested positive for COVID-19, the disease caused by the virus.

Kim, who is serving in the military, is part of a small army of quarantine officers who track the movements of any potential carriers of the disease by phone, app or signals sent from cell phones or black boxes from cars. Their goal: to trace all the contacts that people may have had, so they too can be tested.

“I haven’t seen anyone tell bad lies,” said Kim. “But many people generally don’t remember exactly what they did.”

Underlining their determination, quarantine officers told Reuters that they had identified five cases after a worker in a small town caught the virus and went to work in a “coin-operated karaoke machine,” a bar where a car allows people to sing some songs for a dollar. Initially, the woman, who was experiencing symptoms, did not tell the officers where she worked, local officials told Reuters. But they put the puzzle together after questioning his acquaintances and getting GPS locations on his mobile device.

“Now, quarantine officers have maximum power and authority,” said Kim Jun-geun, a Changnyeong county official who collects information from quarantine officers.

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The South Korean government also uses location data to personalize mass messages sent to cell phones, alerting all residents when and where a nearby case is confirmed.

Lee Hee-young, a preventive medicine expert who also runs the coronavirus response team in Gyeonggi province in South Korea, said South Korea has taken a step forward after MERS to increase its infrastructure to respond to infectious diseases. But he said that only 30% of the changes the country needs have happened. For example, he said, maintaining a skilled workforce and updated infrastructure in smaller hospitals is not easy.

“Until we solve this problem,” said Lee, “explosions like this can continue to explode anywhere.”

Recommended by Emilio Parodi, Stephen Jewkes, Angelo Amante, Sangmi Cha and Ju-min Park; Additional reports by James Mackenzie in Milan and Josh Smith in Seoul, Julie Steenhuysen in New York; Curated by Sara Ledwith and Jason Szep

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