What the world can learn from Italy about Covid-19 virus?

The International Institute for Middle-East and Balkan Studies (IFIMES) in Ljubljana, Slovenia, regularly analyses events in the Middle East and the Balkans. Dejan Azeski is Macedonian historian, journalist and publicist, member of the IFIMES International Institute, who at the moment lives and works in Trieste in Northern Italy. In his article entitled “What the world can learn from Italy about Covid-19 virus?” he is analyzing the outbreak of the pandemic of Coronavirus Covid-19 as he sees it first-hand in Italy and what the world will be like after the crisis. The article is published here in its full version.

● Dejan Azeski

Member of the IFIMES International Institute


What the world can learn from Italy about Covid-19 virus?


The Apennine Peninsula is geographically far from the Balkans, but basically judging by the mentality they are very similar to us. That is why intense socializing in small closed places (such as most of the Italian cafes and pubs) and in times of imminent danger of the virus contributed to its spread too quickly.


Italians as well as Balkans did not pay too much attention to appeals from the authorities not to go to bars every day after work - and thankfully during work. The local police have a fine and cultural problem with imposing restrictive measures and their authority. So, quarantine, although it has long been announced in practice, is difficult to apply.


And that's why we got to this massive scale disaster.


My fear is that given all these mental similarities and all the disrespect of the recommendations that I read about these days will quickly bring it whole Balkan in the same or at least similar state. Because the carriers of the virus are not just those we do not know, and it is not only those who think badly of us. On the contrary, most of the infected cases are taken by their closest and dearest relatives and friends.


Good and bad experiences from the quarantine


In whole Italy every movement has been restricted for a whole month. The initial idea of the authorities was to close the residents' homes without the possibility of leaving our apartments for food and medicine, and the army should cover all this with home delivery. But when they calculated how many hundreds of thousands of soldiers, and perhaps millions, were needed to supply the gates of 60 million people in this vast country, the idea was abandoned. But that's why residents are limited to going to the nearest supermarket or the nearest pharmacy. If the police find you far from your home and if you do not use the services of the nearest supermarket, you will also be fined. So walking out is not officially allowed.


But regardless of that, there are violations of quarantine every day and everywhere. This means that no matter how great the danger and fear - quarantine is difficult to sustain in the long run, and especially throughout the country equally. Therefore, it is necessary for other countries to accurately calculate when is the best and most necessary possible period for complete isolation.


The positive example of the small Italian town of Vo, which until recently was one of the centres of the epidemic, gives some hope, and at the moment it almost does not face new patients.


So by testing and testing all 3,300 residents of the city of Vo, near Venice, regardless of whether they showed symptoms but also with rigorous quarantine of the people they contacted when the infection was confirmed, the health authorities managed to stop completely the spread of the disease there.


Vo success tell us about the importance of testing and isolating otherwise healthy carriers, an approach that has been praised by the World Health Organization (WHO). They have recently urged all countries to test aggressively. South Korea and Taiwan have succeeded in limiting the number of people infected through testing.


This approach was originally planned to be applied in all the Veneto Area of Italy, where at least 11,000 swabs were planned to be taken daily.


But this is only theoretical. Because neither Italy neither any other western country has so many state resources to conduct such intensive testing and isolation measures throughout the territory.


Only China and possibly Russia, which still have active millions of people in their armies, can do this.


The Balkan states and armies do not have such opportunities. Therefore, the only thing left for us to do is to rely on the awareness of the population and as soon as possible an understanding of the simple meaning of the terms self-isolation and responsibility towards the environment.


Italy is before social uprising


This is the second most serious problem that the local media is writing about more and more. For the lack of money that definitely dominates the population and the dangers it poses.


Police reports of attacked supermarkets and even organized groups are becoming more common. Authorities have urgently adopted express measures to distribute 450 million euros in social assistance, which should be supplemented by more than 4 billion euros in other types of social benefits. But the big question is whether this money in such conditions when the administration is barely functioning will be able to reach those who need it the most.


Such images from Italy should probably be a warning to Balkan leaders that with each day of quarantine, the fire of social discontent will only ignite. And that vulnerable categories who are really hungry right now need to be cared for an hour early before it's too late.


Balkan leaders have taken the measures on time, but that is not guarantee at all


When comparative analyses are made between the situation in China, Italy and the Balkans, one question inevitably arises, “whether our authorities have taken the necessary measures in a timely manner so as not to repeat the tragedy of this scale in Northern Italy.” The chronology of events tells the following:


China placed Wuhan and other affected cities across the country in full quarantine on January 23, when only 25 deaths were reported. It has been three weeks since the announcement of the strict quarantine until the peak of the disease.


Italy began similar measures as Wuhan on March 11, when 827 deaths were reported, eight days after the first 79 deaths were registered and nineteen days after the outbreak of the country's epidemic.


Due to all this, Italy, although it has almost 20,000 registered cases less than China, has twice as many deaths as the world.


This comparison speaks volumes about the importance of timely and responsible access to the danger of the Covid-19 virus.


Most of the Balkan countries, unlike Italy, introduced quarantine measures and a curfew when there were no casualties and only a few dozen was infected.


This gives us a good basis for hope that we will avoid a catastrophe of this magnitude like in Lombardy and Veneto.


But we must know that despite the timely measures taken, the Balkans have several limiting factors in relation to Italy, and especially in relation to China.


● The mass return of the diaspora to the country - which we will surely pay dearly for. These are mostly people who have been left without income and are unable to service their expensive regime expenses in the west and have therefore expressly returned.

● Mass disregard for quarantine measures after returning home - which is evident to every quarter.

● Lack of staff and appropriate medical equipment - facts that with the passage of time and increase in the number of patients in particular will come to the fore.

● The mentality and the essential need for socialization that is the same or worse for the Balkans as well as for the Italians.

● Tendency to spread false news and panic that will surely be reflected during the peak of the disease that arrives in about a month.


Fast immunisation is not an option- prepare yourself for a long distance lockdown


Finally, the good news about coronavirus came to us from the United States. Jennifer Haller is the brave 43-year-old mother of two who first received the test vaccine against this malignancy. This means that the first phase of immunization to protect against cowboy-19 has officially begun.


The vaccine, codenamed MRNA-1273, is being developed in collaboration with the National Institutes of Health and the modern biotechnology company “Moderna”. Ink from Massachusetts. The new vaccine does not cause Covid-19 in those who have received it, but it does contain a small amount of genetic code that is copied from the virus and that causes the disease - which is actually a basic requirement for a vaccine to work. But the people in charge are clear enough: for this to start to be applied in  masse, it will take more than a year and a half.


Such views of the American scientific community related to the long period that will be necessary to start vaccination have recently been confirmed by the analysis of the BBC, which mentions the same long period of a year and a half. An even more extensive analysis of this topic was made by the famous magazine from the USA – “New Yorker”. It literally says:


Developing, licensing and producing a vaccine for Covid-19 in 12 months would be an incredible, unprecedented revolutionary achievement. No other vaccine has developed so quickly.”


It is known that the fastest development of a vaccine so far was recorded in 2015 during the Zika virus when the vaccine was ready for testing in seven months, but the epidemic disappeared before vaccination samples were sent to clinics around the world.


Such scepticism about the extra rapid development of the vaccine was also personally conveyed to US President Donald Trump by John Shiver, head of research and development at the multinational pharmaceutical company Sanofi.


"There is definitely a misunderstanding. It is not the same as testing several people and putting the vaccine into mass use. So clinical testing is done on healthy people, and when it comes to mass vaccination, all categories of the population get it, and a lot of things can go wrong. We certainly do not want to use a vaccine that can worsen the condition. Throughout history, there have been examples of vaccines that, instead of reducing it, have triggered the disease.”


His other colleagues, top world scientists, agree that even in the case of the most urgent need, it is almost impossible to expect mass vaccination in less than a year and a half.


So far, vaccines have been developed in Belgium, Germany, Italy, Belgium and even Hong Kong, but no team of scientists working on them has been able to promise that we will have anything useful in less than a year.


The three possible exit scenarios


Since we have already determined that vaccination will not magically save us from the Corona virus and all its side effects that we feel every day, we need to look at the other two possible variants.


We mentioned above that the Zika virus epidemic of five years ago disappeared or subsided on its own before mass vaccination was needed. The question now is, can this happen with the Corona virus? Probably YES because that's exactly what's happening in China right now. After several months of quarantine, the disease has stopped progressing and spreading, and now medical records are being kept under control. Simply speaking, this means that people in the most affected areas are already returning to their jobs and starting to live better. But that doesn't mean that restaurants, airports and all other high-risk areas will open soon. So what the Chinese authorities have managed to do with their draconian measures is to slow down the disease to the point where it will not cause too many casualties before the vaccine arrives. And after what we see, probably Italy and all the European countries that follow it are trying to copy the same seemingly successful model.


The second approach, currently used by the United Kingdom, and in part the Netherlands and several other northern countries, is the model of natural immunization. This means leaving the young and healthy and sometimes even stimulated to get the virus as soon as possible and gain immunity to it. This targets a figure of 50% of the population who should become immune within a year, which according to medical theories is enough for the country to declare victory over this dangerous disease.


But according to experts, this model obviously carries a lot of risks. Despite recommendations for young people not to socialize too much with their older relatives, the question is how realistic it can be. So, it is true that young and healthy Britons will soon become immune to the disease from their peers around the world, but it is also possible that the UK will face massive deaths from the vulnerable and old categories of patients.


Plus, this scenario leaves open the possibility of a massive influx of patients to health care facilities in just one moment that they probably can't stand.


In summary, what is already being done in the Balkans and in most countries of the world is the only real solution that is available to us so far. Given that the vaccine will not arrive any time soon - citizens should prepare for a few months quarantine following the example of China, and in the period after that to learn to function only within their city and without excessive socialization. And all this will last until one of the three things happens: mass vaccination (not earlier than a year and a half), gaining natural immunity of 50% of the population (which will also take several months) or alleviation of the disease itself as in the case of the Zika virus, which in our case will probably come with the summer and the hot weather that should kill the virus.


As a historian Ihave never heard of catastrophe of this magnitude


In almost fifteen years of active study and practice of history, I do not remember meeting a catastrophe of this magnitude.


Now the critics will immediately say that history remembers the Black Dead and the Spanish flu and that's all true. But they were not in Shanghai, Milan, Los Angeles and Peru at the same time.


Last week I read with disbelief the confession of one of our Macedonian sailors on a cruiser in the western Pacific who says that they sailed unsuccessfully from Chile to the United States and no port wanted to receive them to unload the passengers. This in itself proves how widespread this catastrophe is.


I don't even want to talk about the volume of quarantine. Even in the fiercest days of World War II, so many people around the world were not forced to stay indoors. That fact must be taken into account.


To be clear, I have never been and will never be a supporter of conspiracy theories. So I won't believe that someone did this on purpose to do or use something in the background.


But that now that the disaster has come, this could be the ideal time for greater economic, demographic, military and territorial change, I can guarantee.


So once again, history has not recorded a global tragedy and danger of such magnitude. This can only be compared to the ancient stories of Atlantis and the biblical Old Testament to Sodom and Gomorrah.


So in both cases, the greed and curiosity of the people caused nature to return them in the worst possible way.


Those from Atlantis dug too deep looking for crystals and then drowned in the sea with their city. In Sodom and Gomorrah, they were adulterous to see the forbidden, and God or nature returned them with complete destruction.


We have both of these elements today. We, as a generation, have been digging too deep into chemistry and science, so the virus has escaped us from the laboratory. And with our incomprehensible greed and curiosity about too many trips in less than a month, we managed to infect almost the whole world.


And finally, this virus, by attacking only the weak old ones and those that cannot be defended unequivocally, reminds me of the realistic concepts of natural selection and purification of humanity.


How will the normalization look like?


The second positive news I've heard these days is that boutiques and other stores will soon open in Austria. Let me just explain - Trieste has been under the jurisdiction of Vienna and the events in Austria for hundreds of years and is still closely monitored here today. So the local media, based on the Austrian example, have already started making scenarios and assessments as to how Italy would emerge from the crisis.


It is definitely clear that nothing can be expected before the Catholic Easter (April 12). But two days later, on the 14th or 15th at the latest, the authorities are expected to implement the first measures to loosen the quarantine. It will certainly be a free movement permit in certain parts of the day as a basis for returning people to their jobs.


The second step we will probably see by the end of this month is the opening of some of the other stores and the permission of the restaurants to prepare food for home delivery. But that doesn't mean we'll soon have lunch and dinner together in the famous Italian restaurants. The authorities here are aware that due to the mentality of the population - the cafes should not be opened until the end of the whole epidemic, which means that it is possible to be left without cafes, bars and restaurants all summer.


According to the columnists of the local newspaper “Il Piccolo” from Trieste, the citizens should not be overwhelmed by the euphoria of the expectations for after Easter.


Citing the Chinese example, they say no one can guarantee that the quarantine will not be returned again and again.


Yes, we will soon have loosened measures and the opportunity to move more freely. But if the number of new patients starts to grow at least minimally - again we will all be locked in a new and new quarantine


The second problem is that no one is saying when public transport will be restarted inside and outside the lodge. We all know that Trieste is as much Italian as it is ex-Yugoslav with tens of thousands of Slovenes, Serbs and Croats living here. They are not used to being cut off from their home countries for so long, they say, referring to their ancestors that even in World War II the city was not so cut off from the world.


So Italy still has a long way to go.


In what kind of World we’ll live after Covid 19?


Based on all the analysis I have been following closely in the world's most important media these days, I can conclude that:


● First of all, until then, there will be so much habit and creativity in working from home that neither the bosses will want to spend huge sums on offices nor the employees will have the desire to leave the warmth and comfort of their home - normally in those sectors where possible.

● In that way, the labour will become much more portable because you will go and pay for the task performed. The principle swing the door - take a salary with small exceptions we will probably leave it behind - because after this crisis no one will have excess money to throw away.

● The principle and correctness of the travel-consumer society in which we previously lived will be reconsidered. First of all, there will be no money for such a walk around the world unnecessarily, and secondly, people will be afraid to use airports, buses and their meager space for a long time to come.

● The need for a strong state instead of independent corporations and businessmen will be seen again. Because in the crisis it was clear that countries with a stronger public sector were much easier to overcome this situation. This will inevitably lead to the strengthening of movements and political parties that advocate a fairer distribution of wealth, which means that even in the United States, the sustainability of capitalism in its raw form will be deeply questioned.

● Military and its massification will once again become a topic of conversation and an important factor in society. First of all, in the crisis it was clear that countries that have a large and organized army can much more easily conduct police hours and quarantine and food deliveries and help the sick. Secondly, we are entering a period when due to the lack of money - the conflicts within the country but also between the two countries will become relevant again, which means that you will need a device that can protect you and guarantee you peace. This is likely to mean abandoning the quest for a global world and returning to the fight for national interests.


In short: the world we will live in after the crisis, at least in the short term, will be much more like the one our grandparents lived in in the 1950s and 1960s than our world we left behind just a month ago.


Ljubljana/Trieste 10 April 2020