L'Italo-Americano

THURSDAY, APRIL 30, 2020 www.italoamericano.org 16 L'Italo-Americano LIFE PEOPLE PLACES HERITAGE C oViD-19 pan- demic as of 25 A p r i l 2 0 2 0 (Italy's Feast of the Liberation from the Nazi-Fascist occu- p a t i o n [ L i b e r a z i o n e : 2 5 aprile 1945]): World: 2,9+ million con- firmed cases (373 per mil- lion); 202,660 deaths (26 per million). I t a l y : 1 9 5 , 0 0 0 + c o n - firmed cases (3,231 per mil- lion); 26,384 deaths (436 per million) US: 953,000+ confirmed cases (2,879 per million); 53,745 deaths (162 per mil- lion) California: 41,400+ con- firmed cases (1,057 per mil- lion); 1,618 deaths (41 per million) L o s A n g e l e s C o u n t y : 18,520+ confirmed cases; 8 5 0 d e a t h s ; S u n V a l l e y , w h e r e V i l l a S c a l a b r i n i i s located, has 89 confirmed c a s e s ; a n d C h i n a t o w n , w h e r e o u r c h u r c h o f S t . Peter is located, reports 7 confirmed cases. (for individual cities and neighborhoods within LA, c h e c k a t : publichealth.lacounty.gov) Infectious diseases, like C o V i D - 1 9 , m o v e l i k e waves: the number of infect- ed patient initially swells, then flattens eventually to fall. The rate of infection, that is the steepness of the wave, reflects the number of people each infected patient can infect at any moment ( R 0 ) . W h e n R 0 i s l a r g e r than 1, one infected patient infects more than one other person, and the wave grows: t h e i n f e c t i o u s d i s e a s e i s g r o w i n g o u t o f c o n t r o l . W h e n R 0 i s a b o u t 1 , o n e i n f e c t e d p a t i e n t i n f e c t s about one other person, and the infection flattens out and i s g e t t i n g u n d e r c o n t r o l . W h e n i t i s b e l o w 1 , e a c h infected patient infects less than one other person, and the infectious process is con- tained, and the curve falls. C o V i D - 1 9 , l i k e o t h e r infectious diseases, spreads via this balance between the people at-risk who have not been infected with SARS- C o v 2 , a n d t h o s e w h o g o t infected, survived and have recovered. This balance, when plotted out, looks like …a wave. T o c o n t a i n t h i s w a v e medically, we need a vac- cine to prevent infections, a n d a n e f f e c t i v e t r e a t - m e n t t o t r e a t i n f e c t e d patients. For CoViD-19, we have neither. To contain this wave with no available vaccine or treat- ment, we can only decrease t h e r i s k o f i n f e c t i o n b y physical distancing and quarantine. If we do not, the wave will be a tsunami – it is that simple. Even when we stay away from each other, we must a l l o w s u f f i c i e n t t i m e f o r infected patients to recover. They, in time, will protect all r e m a i n i n g a t - r i s k p e o p l e ( i . e . , " h e r d i m m u n i t y " ) . Time is of the essence here because, for herd immunity to be effective, over 60% of any social group must be recovered patients with still active immunity - meaning, still having circulating anti- bodies - against the virus. It is difficult to estimate t h a t t i m e w i t h C o V i D - 1 9 because we do not yet know how long antibodies against SARS-Cov2 remain circulat- ing in recovered patients. We also do not know how long we must be in this "stay away" mode (i.e., physical distancing and quarantine). We are all impatient to return to our routines, our f r i e n d s a n d o u r f a m i l i e s . B u t , i f w e b r e a k " s t a y away" too soon, we will again lose control over CoViD-19, and the wave will rise again. As of now, in some places, l i k e t h e B a y A r e a , w h i c h a c t e d f a s t t o e n a c t " s t a y away," the wave is decreas- ing: meaning that we are controlling CoViD-19. If we "re-open" the Bay Area too soon or too fast, we will lose control and the wave will o v e r c o m e t h e h e a l t h c a r e s y s t e m a g a i n : a " s e c o n d wave" will form, as we have seen it happen in China and in Singapore just recently. In other places, like LA County, the wave is barely r e a c h i n g i t s p l a t e a u . T o b r e a k " s t a y a w a y " n o w would be irresponsible: we will undoubtedly lose con- trol over CoViD-19, and the wave will sharply rise again, no doubt. They are having this very d e b a t e i n I t a l y : i n t h e South, Sicily for example has done a great job in control- l i n g C o V i D - 1 9 a n d c o u l d begin to "re-open" cautious- ly; in the North, Lombardy h a s h a d a t e r r i b l e b o u t against CoViD-19, as we all know, and they are not yet ready to "re-open," scientists say. But Italians are impa- t i e n t , a n d c o u n t r y - w i d e , Italy wants to re-opening. W h a t s e c o n d w a v e w i l l afflict Italy in the next 10-14 Per Saperne Di Più: CoViD-19, a word with Francesco Chiappelli Issue 3, Dott. Francesco Chiappelli, Prof. Emerito UCLA Center for the Health Sciences days is everyone's fear and guess. The principle of the sec- ond wave is simple. If I have not yet been infected, break- ing "stay away" too soon in the absence of a vaccine and of a treatment, will increase m y r i s k o f i n f e c t i o n b y someone infected I get in close contact with. If I am infected but show no signs or symptoms – as do, appar- ently, close to 40% of people infected with SARS-Cov2 – and dismiss "stay away" too soon, I increase the risk of infecting someone close to me, who might eventually end up in the hospital and could die. To be clear, this week's issue of the Journal o f t h e A m e r i c a n M e d i c a l A s s o c i a t i o n p u b l i s h e d a paper by Gandhi and collab- orators, in which they stated in no uncertain terms that "…[A]symptomatic trans- mission of SARS-CoV2 is the Achilles' heel of CoViD-19 pandemic control through the public health strategies… ". In brief, loosening "stay away" as a society increases the risk of R 0 to rise again, thus engendering a second wave of CoViD-19. We know this can happen, because it has. T h e 1 9 1 8 i n f l u e n z a pandemic had three waves: in the Summer of 1918, in Fall/early Winter 1918/1919, and in April 1919. The sec- ond wave, a real tsunami, killed millions worldwide. B u t , C o V i D - 1 9 i s n o t influenza. Corona viruses differ from Influenza virus- es, and it is a fallacy to pre- dict a possible second wave of the former based on what w e k n o w o f t h e l a t t e r . Influenza viruses typically infect us when our immune s y s t e m i s a t t h e w e a k e s t , such as in the colder Winter months when we are bat- tling the common cold and o t h e r i n f e c t i o n s . C o r o n a viruses attack our tissues and physiological organs, Continued to page 18

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