Italian-style lockdown could be just weeks away in Britain
With travel suspended and public gatherings banned in Italy, experts warn that the country’s infection pattern and virus response mirrors that of the UK
WE KNOW, or we think we know, Italy as one of the most irrepressibly social and free-spirited nations on Earth. Yet today, 60million Italians will wake to find themselves under a quarantine not dissimilar to that put in place in central China in January.
With confirmed cases in Italy climbing by 2,000 a day, almost all travel has now been banned, along with public gatherings including sports, weddings and funerals.
Schools, universities, cinemas, theatres, libraries and museums are closed across the country.
Even Pope Francis abandoned his weekly St Peter’s Square appearance last weekend to deliver his message by video. He felt “caged” but “I see you and I am close to you,” he said.
As we watch events unfold in Italy, obvious questions arise: is Britain on the same epidemic trajectory, or did Italy make mistakes early on that we might avoid? And if we are on the same track, perhaps lagging by just a few weeks, can we expect to see a similar lockdown here in Britain?
There is not much evidence, despite stereotypes of Italian officialdom, that Italy got anything badly wrong.
It reported its first cases on Jan 30 when two Chinese tourists tested positive. Its health officials, supported by the European Centre for Disease Prevention and Control and the World Health Organisation (WHO) quickly implemented the measures the UK and all EU countries are following – most notably contact tracing.
However, “an Italian citizen with Chinese origins” who recently visited China is thought to have gone undetected. He came into contact with someone who then visited Codogno in Lombardy. It is that second contact who is thought to have spread the virus, causing the cluster in the north.
Susan Levenstein, a US doctor based in Rome, wrote last week that in her view “the authorities got their act together surprisingly fast”.
The WHO agrees. “The government and the people of Italy are taking bold, courageous steps aimed at slowing the spread of the coronavirus and protecting their country and the world,” director-general Tedros Adhanom Ghebreyesus posted online.
The Italians have tested more for the virus than others. In the early days, they tested all suspected cases, not just those who were symptomatic. In the UK and most other countries, only those with symptoms are checked because it is not clear if asymptomatic cases can spread the virus.
Some politicians are furious, saying the policy exaggerated the problem and damaged Italy’s reputation. Others are unapologetic. “Either you hide problems under a carpet, or you lift the carpet and you clean the floor,” Attilio Fontana, the Lombardy president, said last week.
So will we follow Italy’s path? Prof Francois Balloux, a professor of computational systems biology at University College London, thinks it likely the UK will follow the same trajectory over coming weeks.
“The trajectory of the epidemic in the UK is so far roughly comparable to the one in northern Italy, but with the epidemic in northern Italy two to three weeks ahead of the situation in the UK”, he said. “It is [also] possible that a lockdown strategy similar to the one imposed in northern Italy may be adopted by the UK and other countries at some point in the future.”
The UK, France, Germany and Italy all show a similar shaped curve as local case numbers mount. While lagging in total numbers, confirmed cases in the UK have doubled roughly once every three days in the last week.
But things can change; interventions do make a difference.
The reproductive number for the virus in Italy – the average number of people each new case infects – is said to be slowing as social measures bite. In Singapore and China, both of which were fast to put in place “social distancing”, the figures suggest they are slowing the outbreak too.
But will Britain bear such measures? And are they appropriate?
Prof Paul Hunter, a professor of Medicine at the University of East Anglia, said the pattern of infection appeared to be different in the UK.
“Personally, I do not think that such a large-scale lockdown would be appropriate in the UK. Compared to Italy and indeed China, cases in the UK seem to be spread throughout the country with no real concentration in one or two areas, so banning movement from one area to another would not necessarily achieve anything useful in the UK,” he said.
Nevertheless, the Government will not be taking chances. It has seen hospitals overwhelmed in northern Italy and knows the same could happen here.
Italian doctors warned European colleagues last week to “get ready” for coronavirus. In a letter they said up to 10 per cent of the infected would need an intensive care unit (ICU) admission.
It’s important to note that those countries implementing isolation measures appear to be carrying the great bulk of their populations with them. This is vital because the academic evidence suggests no amount of coercion will work in preventing an epidemic if the people to which it is subject are not brought in. So, will it work in Britain?
The best guess is that, like the Italians, we will comply. We are a law-abiding nation and one that values the lives of others, especially the elderly, who are at the greatest risk.
Prof Chris Whitty, the Government’s Chief Medical Officer, warned yesterday that anyone with just mild cold symptoms would soon be asked to self-isolate for seven days.
“We are now very close to the time, probably in the next 10 to 14 days, where we should say everybody who has even minor respiratory tract infections or a fever should be self-isolating for seven days.”
In a few weeks time he may be adding the words used by Luigi Di Maio, the Italian foreign minister, yesterday: “We must change our habits, the measures must be taken seriously and faced with responsibility. Let’s stay at home as much as we can.”
‘It is possible that a lockdown strategy similar to the one imposed in northern Italy may be adopted by the UK and other countries at some point in the future’