‘The cases are already there’
Wisconsin native in Italy predicts harrowing U.S. future
Deserted streets. Rationed health care. Shoppers lined up around corners at the few stores still open. Movement restricted between cities. And a death toll topping 4,000 and rising.
That’s the new reality in Italy — and a glimpse of what might be ahead for the United States if it fails to contain the spread of the coronavirus pandemic, said a Wisconsin native from his home in Rome where he works with the United Nations’ World Food Programme.
“You guys are going to be in for some serious situations in a fairly short manner of time,” Craig Arnold said via Skype from his apartment, where he is — like the rest of the country — on lockdown with his wife and two children.
“It’s unlike anything I’ve had to deal with on a population level,” said Arnold, who grew up in Appleton and has worked on public health issues and information systems in places like Bangladesh, Iraq, Myanmar and Afghanistan.
“It’s going to grow exponentially. The cases are already there.”
Italy has emerged as one of the countries hardest hit by the coronavirus, with more than 41,000 cases and a death toll that surged past 4,000 by Friday, overtaking that of China.
A number of factors are thought to play a role: an older population — nearly a quarter of its citizens are over 65 — high rates of smoking, health care rationing in the north, even the social custom of kissing cheeks when they greet one another.
Authorities have imposed a cordon
sanitaire, limiting movement into and out of the country and between cities and towns, except for those going to work or in emergencies. Not that there’s any place to go, really.
“The shops that open are only essential shops, for things like food and medicine,” he said. “And when you try to go into a shop, they have quotas, and you’re supposed to maintain a certain social distance.
“Oftentimes with grocery shopping, etc., the lines will be around the block.
They can only accept two to three people at a time . ... And you may be standing in line with people you don’t want to be.”
So, like everyone else there and many families in the states, they’re hunkered down at home. He’s juggling his work responsibilities, though that’s winding down, as they try to amuse two children, ages 4 and 9 months.
“When you called, we were in a hot game of Go Fish,” he said.
Arnold holds a master’s degree in public health from Tulane. But he stressed that he has no special insight into the virus or the pandemic.
He did know enough, based on his training, to pull his 4-year-old out of school a week before they were officially closed.
“That was when everything was going on in Carnival,” he said of the famed Venice celebration that was canceled in February because of an outbreak. “And my daughter won’t be going back to school (this year). That’s just not a risk we prefer to take.” Navigating the quarantine and cordon sanitaire have not been a hardship, he said. They’re used to working in countries where their movement has been restricted, in Iraq and Afghanistan, for example.
But watching the death toll soar has been unnerving, and pondering the unknowns — and the potential risk to himself and his family — unsettling.
“The pathology isn’t fully clear, how it spreads, none of this is exactly clear,” he said.
“There are so many unknowns around it. And the variation (in seriousness and outcomes) is so wide right now. Those are the kinds of things that are concerning. I think that weighs on everyone,” he said. “One of the biggest questions is: Is the health system able to treat you if the worst comes about.”
It’s very different than anything he’s encountered dealing with public health issues around the world.
“When I work on a polio program, the population might be concerned about (contracting) it, but I’m not. And that’s the difference,” he said. “It doesn’t affect me personally, except for my empathy, so it’s a whole different level of experience.”
Arnold has concerns about how the U.S., where he has family and friends, will manage the contagion and the burden it will place on the people who contract it, particularly those who are uninsured or under-insured.
“Here, in theory, if you get treated, you’re under a public service. You are not going to go broke from being treated and saving your life,” he said. “This is going to be very expensive in the U.S.”