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Like many, Saverio Stranges has had some long days in recent weeks.
With a brother and other family back home in the Lombardy Region of Italy – one of the hardest hit areas from the COVID-19 virus – the Schulich School of Medicine & Dentistry professor has seen his professional and personal worlds collide.
“It has been a major adjustment. I’ve been emotionally upset with what’s happening in Italy, being concerned about family and friends, although they’re OK,” said the Chair of the Department of Epidemiology and Biostatistics. “Professionally, this is kind of my field. So early on, when I got a sense of what was happening, it was shocking to me.”
Italy, a country of 60 million, registered 3,405 deaths on Thursday after another 427 people died. Given that Italy has been averaging more than 350 deaths a day since March 15, it’s now overtaken China in terms of deaths caused by COVID-19. The current number of deaths in China stands at 3,242 dead after today’s figures were released.
Experts have blamed Italy’s high death rate, in part, on the almost total collapse of the health system in some parts of the country. “Then people die who wouldn’t have died with timely intervention,” Jonas Schmidt-Chanasit, a virologist at Germany’s Bernhard Nocht Institute for Tropical Medicine, told Al Jazeera News. “That’s what happens when the health system collapses.”
Stranges remains in contact with his family and other colleagues and public-health officials in Italy at least four or five times a day.
— Ryan Meilak (@RyanMeilak) March 15, 2020
“I remember when I got home one evening, I told my wife this was going to be a unique event in our lifetime,” he recalled, speaking of the days prior to the World Health Organization’s (WHO) declaration of a global pandemic. “The first week for me was difficult in terms of anxiety, but now my mindset is more stable and I’ve been engaged more with my work.”
While Stranges admits the number of cases and deaths in Italy are shocking, the percentage of new cases lowering day-to-day keeps him optimistic – maybe required isolation and social distancing initiatives are doing their job.
“This is not something you curb in a few days,” Stranges said.
A week ago, the number of new cases in Italy was increasing by nearly 30 per cent a day. That increase has slowed to 12.6 per cent yesterday.
“There is an expectation the peak will be reached in perhaps a week to 10 days. You can expect numbers to increase, and not just in Italy, but to assess its progress it’s the percentage change we need to pay attention to,” Stranges said.
Beyond age, the variation in mortality is influenced by different factors, like geography, social structure and population density. Italy is three times smaller in area than Ontario, but has a population of 60 million compared to Ontario’s 15 million.
United Nations and Italian health authorities have cited a variety of reasons for Italy’s high toll – primarily its large elderly population that is particularly susceptible to developing serious complications from the virus. Italy has the world’s second-oldest population (after Japan). The vast majority of Italy’s dead (87 per cent) were over age 70.
“We need to consider demographics of those dying,” Stranges said, adding Italy has the oldest population in Europe, with about 23 per cent of residents 65 or older. “The vast majority of people dying are elderly, so a high proportion are vulnerable people.”
— John Nichols (@NicholsUprising) March 13, 2020
Stranges added that countries like Canada – and cities like London – can learn from Italy by being proactive in the measures taken to lessen the impact in the community.
“This is something comparable only to the Spanish Flu,” he said, referring to the 1918 influenza outbreak than infected 500 million people, or almost of the 30 per cent of the world’s population.
“High-income countries are not necessarily prepared to face such exceptional pandemics. In learning from Italy, Western countries, such as Canada, need to move fast. By doing that, by anticipating what can happen, you can buy time, slow down the spread and avoid the tremendous burden around the health-care capacity issue. We need to contain.”
While models show Italy should reach its peak in the next couple weeks, Stranges feels it will take until the end of May, perhaps into the summer, before life returns to “normal.”
With more interactive partnerships and better coordinated policies globally, Stranges would like to see more investment when it comes to public-health strategies in the future.
“As a public-health physician and epidemiologist, I know it’s important we keep investing in public health and epidemic preparedness – even in high-income countries,” he said, adding more emphasis on infectious disease control and surveillance is key.
“We also need to recognize we are in and highly interconnected global world – what happens in Wuhan (China) can, and is likely, to have an impact in London or Lombardy. There are many lessons to be learned. With the challenges we are facing come opportunities.”
If there can be a silver lining, the events of recent weeks have demonstrated that communities can help communities, neighbours can help neighbours, said Stranges.
“It helps us to recognize the simple things in life. We tend to take a lot for granted,” Stranges said. “Perhaps we can use this time as a way to rearrange our priorities and enjoy family. When we go back to ‘normal life,’ we should really be grateful for everything we have, but also be aware we are in uncertain times. We will come out of this in a better direction, rebuild our society and our economy. I’m optimistic.”
Al Jazeera News contributed to this report.