🇮🇹 The Corona Virus in Turin, Italy
I'm an American expat currently living in Turin, Italy. The headlines about the Corona virus' spread in Italy are pretty scary. I put this notebook together so family, friends, and curious people can get a little insight into what's actually happening.
The first section offers a statistical overview. I'll update this every day. The second section has some of my anecdotal observations and tracks a few headlines. The third section has a little bit more on the importance of evidence-based storytelling.
Overview of the Problem
I'm pulling data from Italy's Civil Protection Department. I think they are doing a great job of providing the public with accurate information. Here are the latest figures from Piedmont. The total cases are the total number of diagnosed cases of COVID-19 in the region.
Turin is the regional seat of Piedmont. The city has about 875,000 residents. It's a quirky city situated at the foot of the Alps. Piedmont is a beautiful region with over 4 million people.
Here are the total number of Corona cases in Piedmont starting from February 24th. Rollover the bars for more detailed information.
It's hard to understand the scope of the problem in any Italian province without comparing it against the epicenter of the outbreak, Lombardy. Lombardy is right next to Piedmont. Both Lombardy and its capital Milan are much more populous regions. Here is the comparative growth of the virus in raw numbers.
Looking at the data on a logarithmic scale makes it easier to see the relative change over time. The important takeaway is the shape of each slope. I'm particularly interested in seeing the change in the slope after March 8th, the date of the original ban on regional movement (indicated in red).
A slowing of the growth rates outside of Lombardy gives credibility to Prime Minister Giuseppe Conte's decision to order a limited lockdown.
Testing seems to be a component of South Korea's relative success (see the section Comparing 🇮🇹 Italy and 🇰🇷 South Korea). The number of daily fatalities must level off before the disease can be considered "contained." The rates are below.
Daily Log From Turin, Italy
A daily log of anecdotes from living in Turin.
A New Required Lockdown Form Has Been Released
From the Dipartimento della Protezione Civile:
The new declaration form, to show to the police in case of movement, includes a list of possible emergency situations that justify the citizen's movement.
A Report From the Rivoli Public Hospital in Turin
What he and his colleagues have been witnessing in the “Isolation Ward” of the hospital over the past few weeks is no less than a nightmare. “We have 30 beds in our ward and all are almost continuously occupied. If a bed gets unoccupied, more often for a death than a discharge, it gets reoccupied within an hour or two,” [Madhu Hemegowda] tells the DH over phone from Turin.
~ Anirban Bhaumik. "Coronavirus: Karnataka nurse does his bit amid dance of death in Italy." Deccan Herald". 24-March-2020.
On the Churches in Turin
Cocks co-founded The Art Newspaper and is currently in lockdown in Turin. She observes:
There is still one place where you can see real art: the doors of the churches are open, and they count as a place where you may go for “health reasons”.
This lockdown could be seen as the most extraordinary social experiment. Nothing like it has happened before, so I hope someone is keeping notes. Everything public is shut, from schools to bars to shops. No congregating is allowed anywhere for any reason. The church has obeyed the state and no public masses or other liturgies are being celebrated; I am awestruck at the thought that this must be for the first time since Christianity came to the peninsula in the days of Emperor Nero.
~ Anna Somers Cocks. "Letter from Italy: the churches—open, but without services—are the only place to see art". The Art Newspaper. 23-March-2020.
Prime Minister Giuseppe Conte announces the closure of all factories and production that is not absolutely essential.
The Military Arrives in Nearby Lombardy
And Chinese medical experts helping Italy deal with the crisis have said the restrictions imposed in Lombardy are "not strict enough."
The government has now agreed that the military can be used to help enforce the lockdown, the president of the Lombardy region, Attilio Fontana, told a news conference on Friday.
"(The request to use the army) has been accepted... and 114 soldiers will be on the ground throughout Lombardy... it is still too little, but it is positive," Fontana said. "Unfortunately we are not seeing a change of trend in the numbers, which are rising."
The soldiers had until now been deployed in the region to ensure general security in the streets.
~ Valentina Di Donato, Nicola Ruotolo and Laura Smith-Spark. "Italy calls in military to enforce coronavirus lockdown as 627 people die in 24 hours". CNN. 20-March-2020.
Corona Virus' Impact on Internet Traffic in Turin
In the Turin area, where I am based, Internet traffic doubled last week [...] Thierry Breton, the EU Commissioner for Internal Market, said that working from home and streaming put pressure on digital infrastructures.
Consequently, Breton asked Netflix to move to a lower video definition to reduce the bandwidth absorption, even creating a dedicated hashtag, #SwitchToStandard. Netflix, in response, announced it will reduce the bit rate in Europe for a month to reduce bandwidth usage by a fourth.
~ Luca Ciferri. "Day 9: Internet gridlock." 20-March-2020.
Calling the Consulate
My sister contacted me, concerned with this excerpt from The Seattle Times: "The State Department on Thursday issued a new alert urging Americans not to travel abroad under any circumstances and to return home if they are already abroad unless they plan to remain overseas." Emphasis mine.
So I called the U.S. Consulate General in Milan today. They forwarded me to an emergency help center that is inundated with calls. I waited on hold for about 25 minutes.
The friendly individual on the other end suggested I enroll in the Smart Traveler Enrollment Program (STEP) today. The purpose of STEP "is to notify U.S. nationals in the event of a disaster, emergency or other crisis, and for evacuation coordination."
The State Department is currently issuing a Global Level 4 Health Advisory – Do Not Travel, which is not a travel ban for American citizens but a strong caution against unnecessary travel. The person on the phone said if I feel safe and have food and water then there is no immanent reason to leave.
Traveling at this point would make me more exposed to COVID-19.
Italy Sends Tests to the United States
3D Printed Parts
[Nunzia Vallini] explained that the hospital in Brescia (near one of the hardest-hit regions for coronavirus infections) urgently needed valves (in the photo) for an intensive care device and that the supplier could not provide them in a short time. Running out of the valves would have been dramatic and some people might have lost their lives. [...] At the time of writing, 10 patients are accompanied in breathing by a machine that uses a 3D printed valve.
~ Davide Sher "Italian hospital saves Covid-19 patients lives by 3D printing valves for reanimation devices" 14 March 2020
Medical Supplies Arrive in Turin From China
About 26.4 tonnes of medical materials raised by eastern China's Zhejiang Province have arrived in the northern Italian city of Turin.
~ "Medical supplies from China handed over to Italy" 15 March 2010
Italy's Initial Problem
Interesting analysis by Angela Dewan of CNN.
Italy's initial problem was that it simply couldn't identify the person who first brought the virus into the country, known as Patient Zero. That made tracing who that person had come into contact with impossible.
The first confirmed case, or Patient 1, came in a hospital in the northern region of Lombardy. Italian Prime Minister Giuseppe Conte admitted that the hospital there did not follow procedure and inadvertently helped the virus spread.
Comparing 🇮🇹 Italy and 🇰🇷 South Korea
Generally speaking, Italy has imposed a more restrictive lockdown than South Korea; South Korea has been testing and tracking more aggressively.
Today, South Korea records a minuscule death rate of less than 1%, according to World Health Organization figures, while Italy's reached over 14% on Friday [13-March], as the country reported another 250 deaths in just 24 hours. More than 1,200 people have died in Italy, which has more than 17,600 cases, officials there say. The global average death rate is currently between 3-4%.
Dewan suggests that testing and tracking might be the difference:
[Korea] has the resources to run about 15,000 diagnostic tests per day and has conducted more than 200,000 tests nationwide. Anyone referred to by a doctor or who has encountered an infected person gets that test for free.
Parts of the country have even set up drive-through testing booths, which limits face-to-face contact but makes getting tested an easy and low-risk affair.
While I am generally concerned about how all this citizen tracking may impact individual privacy in the future, the South Korean Foreign Minister Kang Kyung-wha shared a wonderful sentiment on the value of openness and international interdependence:
The New European published another account of the city by the British student Georgia Flynn: A city under siege from coronavirus: My life in locked-down Italy.
Singing From the Balconies
Yesterday, from my balcony:
Music Across Italy
The spontaneous concerts and singing were happening all around Italy. The Independent, picked up a similar story in Siena. They highlighted a particularly interesting parallel with China:
Reminiscent of the chants from Wuhan high-rise apartments early in the epidemic there. Stay strong Italy. Praying for you guys.
Northern Italy, especially Lombardy and Piedmont, is the nation's manufacturing hub. Auto production has come to a near-complete halt.
For the second consecutive day very few vehicles are being produced in Italy. Only Ferrari is still building its supercars, but the staff at its plants in Maranello and Modena plants has been reduced to a minimum, the company said. Volkswagen Group's Lamborghini plant has halted production for nearly two weeks. Fiat Chrysler Automobiles' four assembly plants stopped regular production on Wednesday.
~ Luca Ciferri "Day 2: Production Paused" Automotive News 13-March-2020
New Prime Ministerial Decree
The measure provides for the suspension of further categories of services and commercial activities, apart from those involving the sale of food and basic needs, newsstands, tobacconists, pharmacies and parapharmacies. In any case, the interpersonal safety distance of one meter (three feet) must be guaranteed.
~ Coronavirus emergency: new Prime Ministerial Decree suspended additional categories of services and commercial activities Protezione Civile 12-March-2020
On Wednesday, Prime Minister Giuseppe Conte announced the latest step in a process that has progressively turned Italy into a fully quarantined country. [...] People who still go to the office are requested to prove the absolute necessity to do so by signing a certificate that must be submitted and vetted by the police. Transgressors face up to three months in jail and a fine. Going out for physical activity is permitted, provided it’s short and solitary. Schools and universities — which have been shut down since March 4 — will be closed at least until April 3, but the date will likely be extended.
~ Mattia Ferraresi "A coronavirus cautionary tale from Italy: Don’t do what we did" 13 March 2020
Testing and Travel Restrictions
Italy is aggressively testing for the virus, which could help explain why its total confirmed cases are higher than some other countries in Europe. On Tuesday, more than 60,000 tests had been performed, more than twice as many tests as the United Kingdom had done.
In contrast to most other countries, South Korea’s reports of new cases have begun to slow — at least for now. Unlike other countries with major outbreaks, South Korea, with a population of 50 million, has not outright restricted the movement of its citizens and has instead focused on aggressively monitoring for infections. [...] More than 235,000 people have been tested, and health officials carefully track down people who may have symptoms, testing more than 10,000 people each day.
Singhvi, Anjali, Allison Mccann, Jin Wu, and Blacki Migliozzi. “How the World's Largest Coronavirus Outbreaks Are Growing.” The New York Times. The New York Times, March 12, 2020.
Red Zone Quarantines
Italy red zones 11 towns with police and military checkpoints. Many in the Lombardy (Milan) region.
Annalisa Malara tests positive for COVID-19 after being admitted to intensive care on 20-February. His activity between the 14th and the 20th likely spread it to hundreds of people including medical staff at the Codogno hospital.
Annalisa Malara, 38 years old, checks into an emergency room in Codogno in Lombardy with pneumonia. He had the flu since 14-February. ~ la Repubblica
The Importance of Open Science and Computational Notebooks
Open Science in the Pandemic
I pulled in the latest data on March 17th and immediately noticed something was wrong. The employee at the government's Dipartimento della Protezione Civile (Department of Civil Protection) had made a simple error inputting the dates. I cloned the data in the official repository, fixed the information, and requested they pull my (correct) data back into the official repository.
It wasn't a big deal, but it's a reminder of the importance of keeping source data open and in the the public. Thousands of people are auditing the data every day. In the West, our diversity is our strength.
On Computational Notebooks
Why a computational notebook on Nextjournal? Because the internet is more than a facsimile of 20th century technologies. It is larger than shareholder owned "public squares." It is a place for human authorship, not algorithmic curation.
Notebooks make it possible to take raw data and build a narrative with 21st century media. This notebook is re-runnable at any point in the future with the latest data, it is easily shared, and a starting point for conversation. Dr. Craig Spencer said it best: people need clear, concise evidence-based messaging. Notebooks are the perfect format for this effort.
If you'd like to know more about how exponential growth affects the spread of epidemics, this video is a great start. The video will help you understand why it's important to curb the spread of COVID-19 early.
This repo is mounted by: Python