Wound. With updates about travel restrictions and how to protect yourself. Coronavirus primetime special coverage on aljazeera. Italys coronavirus catastrophe the death toll is rising at an unprecedented level but government is taking more drastic measures that will reduce the number of people dying and what lessons can other countries learn from italy this is inside story. Hello welcome to the program im Bernard Smith hospitals and morgues overwhelmed bodies piling up in churches and just under 800 deaths in one single day thats the shocking reality in italy which is becoming the center of the coronavirus pandemic and a symbol of the enormous challenges facing europes Public Health systems but government is struggling to keep up with the spread of the virus it sent in the army to enforce the lockdown in long body the Northern Region at the center of the outbreak and its tightening already strict controls on daily life Prime Minister just happy conti has ordered all but the most essential businesses to close until april the 3rd hes described the situation as italys most difficult crisis since the 2nd world war. We are slowing down the productive engine of the country but we wont stop it its not an easy decision but it is a decision that prepares us to tackle the most severe moment of the contagion the decision is necessary today in order to contain the spreading of the epidemic as much as possible the Health Emergency as we foresaw is turning into a full economic emergency but i want to say to all of you that the state is here in the state is a person the government will take extraordinary measures that will allow us to stand up again and restart as soon as possible. Really knowing shit those sacrifices that today can look like a step backward it will allow us tomorrow to run up and to come back since into effect trees into our offices into our squares into the arms of relatives and friends we are giving up our most beloved habits because we love italy but we dont give up our confidence in the future united we will make it lets have a look at how italy got to where it is now its 1st cases were 2 visitors from the chinese city of will hand they were placed in isolation at a hospital in rome on january 31st the next day its only became the 1st european country to block all flights to and from china but the virus had already spread unnoticed a man known as patient one with severe flu like symptoms was only diagnosed on his 2nd visit to hospital hed been to dinner parties played football and gone running with friends. Northern italy which was at the center of the infections was sealed off within a few days the lockdown was extended to the entire country after a spike in cases and deaths. Lets introduce our panel from hours are no longer be in northern italy francesco bari shes a journalist who lives there from milan Rozelle Amaechi to shes the president of the italian nongovernmental medical Organization Emergency and from oxford in the United Kingdom dr peter drawback of physicians whos talk lobel Health Social medicine and clinical infections disease at Harvard Medical School welcome to you all thanks for joining us well start 1st of all with you peter from the outside looking in what is going wrong in italy why is it really struggling to cope with the number of coronavirus patients. Well i think you know we like so many other countries was really caught flat footed by this pandemic and really the speed at which it spreads and failure to take really aggressive action really put them behind the curve and its a cautionary tale for every other country about what happens when one doesnt act quickly and comprehensively enough to to contain this well its now reached a point of course which really overwhelms the Health System and unfortunately mortality rates are much higher than it otherwise would have been because of course the Health System cant cant cope and result your organization operates in iran eritrea sudan and italy of course what challenges are your teams on the ground facing in a city at the moment where many because we also have a lot of cleaning all around the country in the south and were trying also to have dealing with this outbreak in that region c. T. And. Both in terms of response for the vulnerable groups and in terms of supporting probably across the. Region so its that the system is there and be overstressed and. We its its a huge family care issue and then we really have to. Take care of everybody we cannot get anyone behind if not its going to be even more difficult than the disease thats why we decided to her it was initially under more noble groups like a Homeless People migrants and accompanied my as because if we must stay home people who do not have a whole lot not a doctor too poor and if you sick disease a disease a big issue for themselves and for the community and who are so these are where we are trying to to go with there and at the center and trying to. Not. There theyre not. Ask you about about that a little later a little later on but francesca youre there peter talked about people being caught flatfooted initially about the government being caught flatfooted were people paying enough attention attention to this where you are where they taking it seriously. No honestly im honestly no one now is. You know is so listening to whats going on that on these bubble of their best security am were just watching the dying to die and you know its its like here is like being 2 weeks a head off off the rest of italy and view iraq and so we are now to us of intensive care betsy while ago than when we ran out of oxygen tanks. Who are you know attending the torm and now we were even run out of flowers in the cemeteries and nothing i mean everyone is a dorm infected or with a family you know at around the who will be infected sooner and there is nothing to treat them nothing you just wait then the sherlock you survive through that it is our son and bottle now peter is you here i mean theres no positive news coming out of that part of italy spain france and the u. K. Have they got this to come is there anything they could be learning now from italy or if one has time run out. Yeah of course its so tragic whats happening in italy and it was one of the 1st places to get to experience it sophistic arena i think what that really means is that for other countries theres no excuse to follow the same path having said that i fear that spain france the u. K. And other countries are very much headed down that trajectory in at this point theres theres no reason to wait into not be more aggressive here in the u. K. Theres theres no discernible strategy anymore theres a trickle of measures being rolled out every day we need to do is act more quickly and from pretend simply to scale up testing in isolation where possible to much more aggressively implement social distancing in places where theres already widespread transmission like london should be shut down as much as it is safe to do and an obvious a lot of investments need to be made in preparing to Health System for the surge that is really already starting but will get worse in the days to come and result i see you nodding away that of course your concentration as well as on some of the most vulnerable in Society Migrants and the homeless ones who often other the back of the health care queue in the best of times how is this affecting the most vulnerable people. Well as i was saying before these people ringback lack the minimum standards of not medic of support they dont have safe places where to answer it in case that they develop symptoms so what were trying to do in milan we can have authorities enemys ability its to survey or these facilities where this shelter where these people are staying and trying to scale up you had 11 older just sticks up all the flow of the movements of people and also objects objects of things that the Food Distribution did sit ration between the bat and of course once. Possible symptoms are we start supporting them. With this without nurses and training. Staff that is working Reception Centers or for the hosts of people trying to enter. And weve also identified a building with a municipality here in milan. But not conserved. Fraction can be programmed. Into the choir there. Have a. Whole backwards we wouldnt have been. Put in this way we would thrive to review as much as possible the contagion and also to have. The Emergency Rooms of the. Brady over where we were patients from just going in the early days of this there was mixed messages from italys political leaders yes they counsel flights to and from china at the end of january but the Prime Minister played it down when the Italian Government decided to really crack down and impose these lock downs. Did people start taking it seriously where you were or were they confused by the mixed messages francesca to be honest i arrived here 17 days ago so before even before the passion looked down a bit early you know or because the 1st lockdown was only for nora that nicholas and here everyone was already respecting you know or you it was already a red zorn because it was a matter of survival but it was already too late and here really all of us i mean we were 2 pair of glasses of glass we were masks we use you know with this in fact really everything every every 5 minutes the point is when you reach this number of you know in fact it why you have Bessie Kelley seek everywhere and everywhere mean seen every every or when youre not this in fact im tucker is is in fact it how do you disinfect your hands there is no way not to get sick here and you know its just a matter of being a symptomatic or not when you reach this level there is nothing you can do so honestly my reporting from here is you know its not even for so long but of the in the more discreet early and for you look at for us slate peter are the governments in britain particularly in france and spain paying attention to the sort of thing that francesca is saying that the seems to been a reluctance from some political leaders made particularly you have noticed to make these painful decisions to really put the brakes on a functioning society have you seen a peter he felt that. Yes unfortunately and really over the last 8 weeks we could have been doing a lot more in terms of preparation from what i can understand of the Decision Making process here in the u. K. In recent weeks there was a lot of concern about whether the public would go along with measures to restrict movements in due to social distancing and their cause a lot of equivocating and really a bias towards inaction in that really allow the virus to spread silently over the last couple of weeks which puts us in a really difficult situation now i want to add one more important point that we heard a bit from the other guests around whats happening in italy right now and that is were starting to see that hospitals themselves are actually becoming little epicenters of transmission where patients and Health Workers are getting infected as well and when that happens even measures like lockdowns will necessarily help this is really important to emphasize how badly we need to make sure Health Workers have protective equipments now we have good protocols in place and where possible infected patients are being cared for in different parts of the hospital or in different facilities from other patients a result of what from your experience so far can you say to all the governments who come to you and say how can we stop it getting as bad as a silly. Well i definitely agree with what peter was saying before. What we are realizing here is. Perhaps a difference like for example well be able outbreak here if youre not really considered a hospital 3 or coronavirus 3 because patients can be contagious even when they are using to magic so perhaps you can add meet someone for a few more fracture and then you find out that he or she has a high risk there who are we really need to make sure the entire system is organized and if we are all. Infected and we can spread the virus of protection of everybody every. Race every segment covered partment with the hospitals must be must be respected movements. Be really be strictly control the flow of patients. Suffer not only of managers are doctors and nurses but also the cleaner the supporting star everybody has me. Think in these months i think that what i have to do that i have theres romance there. And this could be something that its its not easy to implement because of course you have to change completely the mindset that sometimes certain things of. Changing the. Who. Object to. Medical equipment. Or its a complex situation either. Were going to the. Facts. Saturns birth. Time. And discover that with. The. Pizza the way things are at the moment do you see whats happening now and its really playing out the same way in spain france the United Kingdom and then the United States well i think it already is weve seen many and ive spoken to many colleagues in hospitals and in london in scotland in the u. S. They reported their i. C. s are already full and theyre already really preparing for the serged you know the 2400 people that have tragically died in italy in the last 4 days were infected probably about 2 weeks ago when italy was in a very similar place to where we are in the u. K. And other places now so i think were headed down that trajectory quite unfortunately of course its still not too late to act and flatten the curve in trying to save as many lives as possible. Rizal of course your team is working very hard in italy but a lot of your work is focused in the developing world do you see any way you hit seeing any vulnerabilities to tackling the coronavirus in other countries that youre working at the moment are you worried about all the pot parts of the developing world very much worried honestly speaking because we know our weak. Systems in those countries are and we know that he has been a tragedy for europe recently. And we can count we can rely on a very well structure have. Really dont know whats going to happen if these take these dimension in countries like sierra leone saddam or afghanistan so we are definitely very much concerned and this is also why immediately. 2 weeks ago we started to share with our. Learning to be who are so we started to take. To implement i. P. C. Measures in all our facilities are regardless of the fact that the country has already or not yet reduced. My response in the case we wanted to as much as possible to mitigate the risk of spreading these are not it is and where we were unlucky can i ask of course were hearing in europe and the us there already short of respirators theyre running out of medic medical equipment gloves and masks so that puts the developing world again at the back of the queue for those sort of emergency supplies i guess that western countries might once have provided with provided to them. Yes i mean it said this is something im president and i think that may be the only comparison then we can make if we spend a few hours there were one. So its a its big challenge for everybody we try to. Send supply enough supplies to the hospital or to the hospitals in the countries where we were working in order to have the. Aft or for approximately 3 months of activities but we really dont know how this is going to develop and. The shortage of the protective material of medical equipment of drugs now we are also the spinning hearing that there is a shortage of the specific drugs for intensive care treatment thats. Something that should occur. Or i think very much so i hope that that would be the perfect we would learn to cope with the or. Mers and peter i know you played a key role in transforming rhondas Health System could and its a fairly advanced in terms of development in africa could rwanda cope with a coronavirus outbreak. We want to senator richard this far many other countries in the region have whats whats really ironic is that many countries in that part of the world acted quickly and aggressively to try to contain this they know that complacency kills because theyve been living with epidemic Infectious Diseases for a long time and so the early measures i think have helped to keep the number of cases down in many countries in africa the problem is of course is that if things do continue to spread in settings where it gets medical care for example ventilators in i. C. U. Beds or stream limits theres very much a risk that even the best Health Systems in places like rwanda nigeria etc could be overwhelmed but in those sorts of countries where youve got People Living often in very close quarters how do you impose the sort of social distancing measures or the extreme lockdowns that youre asking more Development Countries to more developed countries to impose one thing thats important to remember is there is there is a theres a lot that goes on between normal life and its total lockdown in places like singapore have showed us that with smart actions early on you dont necessarily need to go that far weve seen in rwanda for example things like closing of schools and places of worship of putting hand washing stations at bus stops of people wash their hands before and after getting on the bus a number of other things along with try to ensure Public Health measures aggressive certain lines isolation in Contact Tracing and thats what it takes to really keep this under control francesca we know we all know now theres going to be many many weeks probably many months of significant controls on peoples lives any sign of a team where you are the most any sign of people tiring of having these restrictions placed on them. Yes not about the restrictions. Psychological you honestly you know outside of the year you are speaking or whom we are dealing with the social distance well here is silly to be destroyed and the distance is the distance between you and your southern mother or son who seek a tall man so especially for me as a worker respondent the the main difference is you know. In war i mean after an air strikes you know you you run toward iran the danger or you can try to do something and here not only you can do anything because you dont even have an oxygen tank but when you have a 2 or someone who suddenly you know cant breath anymore and these are tense several times per day suddenly you know they cant breath anymore they have fever and the shortness of breath and you can do anything you cant even catch you know. Your father or your mother i mean there they are really dying in front of you and you cant catch them and the. Psychological it this is something that is serious carrying. Out some law in this residence and so for now you know all these issues about the restrictions some in. Everybodys strine to really trying to survive also because when you know everybody around you you see you really we cap in the morning and the 1st thing you do you check you know 1st of all you check your if you can still breathe. Then we check our troth then we check our here so i mean its like of you live in fear because you think that all of a sudden you know you will have a temperature are you dont think of anything else here well. Very sobering information from northern italy id like to thank all of our 3 guests francesca bari result and peter drawback thank you too for watching you can see the program again any time by visiting our website aljazeera dot com and for further discussion go to our Facebook Page thats facebook dot com for slash a. J. Inside story and you can also join the conversation on twitter our handle is at a. J. 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