Week 1: State of the Health Crisis and public measures for the management of the coronavirus: Italy, France, Monaco and data on other countries

For more than a week now, the coronavirus has left China, entered in Italy, then it reached Monaco, France, the U.S.A, the U.K, and 76 others countries of the world. Many things are said regarding the propagation of the virus and obviously, the information differs depending on which organizations speak: the scientists, the medical people, the politicians, the health facilities, the businesses, the finance sector, the medical laboratories…
The speeches differ because each actor follows different interests: public, economic, health, social… That’s mainly the issue and why the whole management of this health crisis is difficult and not understood enough by all. One thing is sure. The public safety measures for the health plan on coronavirus must be only taken in the interest of the populations.

The truth is that this coronavirus brings a shadow on the world and underlines how difficult it is for the countries to undertake the safest actions of prevention considering what the WHO says in terms of risk of world contamination. The professor Marc Lipsitch in Epidemiology in Harvard School of Public Health, the Head of Communication on Disease Dynamics said on the 14th of February 2020: “I think it is likely we will see a global pandemic. If a pandemic happens, 40% to 70% of people world-wide are likely to be infected in the upcoming year.

The declaration of this professor of Harvard reveals that, in the worst case scenario, up to 40% to 70% of the total world population could be infected. Everybody is in accord for an estimation of a 2% rate of death. Based on approximately 7 billions of people on earth and the worst case scenario data, it would mean a risk of deaths in number between 56 million and 98 million.
It means that each measure of prevention taken by the countries, the businesses and the people + the researches on a vaccine are tools to limit the impact of the propagation of the disease and the number of deaths at the world scale.

About the IMEDD
The IMEDD, is a neutral organization specialized in sustainable development. The IMEDD acts in the field of risks, analyzing the public and independent data, information and communications, following the goal of providing support to the concerned organizations to make their Health and Prevention Plans clearer and more visible to the populations and businesses.
The IMEDD works beside the governments helping them to spread their public plans of health and safety for their populations.
The IMEDD has the liberty, with a given trust, to share with the governments its perception and analysis of the crisis and propose measures of prevention that could be applied on a voluntary basis in order to reduce the impact of the crisis.
The IMEDD is neutral: its goal is to bring clarity and visibility on the facts in order to propose the governments to apply the safest measures, free to the public organizations to listen… or not to the IMEDD’s recommendations in terms of initiatives to limit the propagation of the effects of the virus, meaning limiting the number of deaths.

The following analysis proposed by the IMEDD is a weekly report of the coronavirus crisis management that started last week in Italy, France and Monaco and spreads all over Europe (76 countries are concerned at the world scale on the 2nd of March).

Point 1: the children and the schools

Since the very first beginning of the coronavirus in Italy, the public authorities took straight away the right measure: the closing of the schools in several regionsIn Monaco and France, the children were on holidays, so the schools were closed and the children kept with the parents. Regarding the children’s risks of infection, the situation is not clear enough. Though it is said that very few or no deaths or contamination reach the children, there are some reports published by the official media that show the contrary.

At this stage of the global study of the virus (which is new and not enough studied yet due to its recent appearance), it can’t be assumed with full certainty that the children are not at risk. Maybe, the children don’t develop the disease in the same proportion and effects than the adults do, though the children can transmit the virus to the people who surround them. No country has enough distance objectively at this stage of the epidemic considering this ultra-rapid outbreak of the virus, especially in Italy that revealed 901 new cases in the past two days reaching a total number of 2036 cases on the 2nd of March, meaning that the number of cases doubled in two days at the country scale.

On the other hand, all public and health organizations in each country of the world know that, even regarding the flu or other kinds of regular disease, the schools are considered as a place of transmission between the children, then in their families, as the children bring the disease back home. Once the virus enters in a school, the spreading could be huge with some unmastered consequences for both the children and families. It could increase the risks of congestion in the healthcare structures and the over-passing of the whole system that would be unable to respond to the health needs of the population. That would potentially cause an effect of panic and a dizorganization that would lead to a lack of response of the system.
Is that the risk to be taken for the upcoming weeks and maybe months, considering that nobody on earth, nor the public authorities, nor anyone, can say in true honesty, in full responsibility, certainty and enough distance in time, that there is no risk of propagation nor transmission at all for the children?

Even when encouraged by the adults, the children are not able by themselves to maintain the prevention measures, they touch their hands, give kisses, talk in the ear or mouth of their friends, share the phone or the snack, drink with the same bottle. Many parents are worried.

Regarding those facts and the public global incapacity in all countries today to affirm in full certainty, the risk zero of contamination and tranmission for/by the children, the IMEDD advises the countries to implement a proposal of measure of prevention, meaning that:

  • it should be proposed to the parents who wish it to keep the children at home while doing online homework with the support of the schools.
  • the schools could provide a minimum service for the parents who would need to keep their children go to school.
  • this system should be continued until the epidemic is totally mastered in full certainty, when no new case is found in each country.

Point 2: developing the on-line school

For all the children and students of all grades, developing the on-line school using the support of the parents is an adapted measure, so the children do their homework and continue their education in the most normal way as possible during the solving of this health crisis:

  • Planning a weekly programme of homework that the children send back by email to the teachers.
  • Focalizing on maths, science, the mother tongue and languages.
  • The countries can follow the educational methods used by the International Schools that teach the children how to work on-line through Google Docs, Google Sheets, Webminar, Whatsapp…
  • Most of the children have access to the Internet, they have their own computer or phone, or their parents have a computer or phone that the children can borrow.
  • This measure of on-line school commits both the families and the public education system around the children’s education.

This sanitary crisis is an opportunity for the countries to implement the on-line school for this concern of precaution in order to limit the propagation of the virus.

This video below explains how France could intend to do the on-line school: https://youtu.be/SII0yJvQf9o

Point 3: implementing telework 

In order to reduce the speed of propagation of the virus in the countries, telework should be proposed to those who can do it and who wish to do it.
All technologies can easily be used to implement telework. It needs a bit of adaptation for the computer services in the businesses that need to provide an access to their server so their employees can connect and work from home. Most of the researchers, media people, analysts, communication people and services jobs can easily do telework with the use of the technologies.
As most of those jobs work with goals to reach in a period of time, no matter that they stay at home as long as their work is given back for the due date. Those people are easily adaptable as they already work with the technologies.
Therefore, to reduce the speed of propagation of the virus, the countries should already start to implement this measure of telework, that will ease by the way, the management of the children in this period of crisis.

Point 4: sanitary risks for the people of the sector of waste treatments

The people and organizations of the waste treatments sectors (on the public territories or in businesses) should take the safest precautions when emptying the bins (in the streets or in the offices). Those people of the waste management are the first who risk to be exposed to tissues with alive mucus from potentially ill people.
The security rules already plan the use of gloves when managing the waste. Regarding the risk of propagation of the virus, the people of the waste management (both for the public place and in businesses) should be equipped with masks to make sure that they don’t expose themselves to the virus. Even in places like airports, train stations, etc…, the people in charge of the waste public bins should always be equipped with gloves and masks when empyting the bins, then follow their company and public prescriptions in terms of health and safety.

Point 5: management of the risks in the offices

  • The management of the unique use tissues:
    The period of incubation varies from 2 days to 14 days, but there was an unusual case, a man in China, who developed the disease after a period of 27 days of incubation. It means that some people could be infected by the virus without knowing it. A unique use tissue, that contains mucus, thrown in an office bin, can be a source of contamination, as the mucus in the tissue stays alive for a while until it dries. Some recyclabe bags (like for the dogs excrements) can be used in this period of virus spreading. Once the tissue is used, it should be put in a recyclable bag with a knot to close it. At the end of the day, the bags of tissues should be taken and thrown in a big public waste container.
  • The door handles, lifts buttons
    Sharing space in offices increases the risk of propagation. The attention must be focused on the door handles and lift buttons that everybody uses, even if a desinfection is done on a daily basis. A solution is to prefer the use of the stairs and for the door handles, some gloves or even a unique usage tissue can be used not to put the hand in contact with the button or the handle of the door.

Point 6: Public transports

Many public transport undertake desinfection measures.
It is known by all that the public transports represent a place of concentration for people that increases the risk of propagation of the virus. In the exposed areas, the use of gloves and masks should be advised in the public transports and some prevention information should be given to those who use the public transports.
A measure that would also reduce the use of the public transports is telework. All the people able to work from home don’t need to use the transports anymore then they contribute to the management of the risks and limit the propagation of the virus. This measure contributes both to health and environment as it allows to reschedule/adapt, in time, the offer of public transport.
The lockdown and the management of the crisis in China also shows a decrease of the CO2 emissions due to the health crisis and it also shows that the lockdown was the good tool to master an even bigger diffusion of the virus than they actually have in China.
Indeed, NASA confirmed the information and stated on saturday that the resulting factory closures and fall in motor traffic in China has meant a sustained drop in noxious nitrogen dioxide. Fei Liu, an air quality researcher at NASA, said regarding the CO2 emissions in China since the outbreak of the coronavirus: “This is the first time I have seen such a dramatic drop-off over such a wide area for a specific event.”

Point 7: the countries and all the public organizations should provide full transparency on the data of the propagation of the coronavirus

To help all the concerned organizations and in order to bring full transparency to the study of the growth of the disease, the WHO, the countries and all the public organizations, must join together, to create a unique database showing the public detailed data, including the historic, and not only the countries, also the cities and the villages.
The goal is to make the situation visible for everyone to see in details where the virus has spread and the scale. Those detailed data should be provided and made public through an Excel file and also on a World Google Map that would give details on each city and villages. Those data would allow some other institutes specialized in data analysis to bring support to the crisis management and propose ideas of measures, in order to always ensure the safest situation for the populations.
This tool, WorldoMeter is useful to follow the situation, though it only presents the data at the country scale: 
https://www.worldometers.info/coronavirus/#countries.
Most of the tools provided on the Internet are like WorldoMeter, with no detailed data within the countries. Some finer details are needed, the same tables for each country including the cities and the villages.

Point 8: Iinformation and communication

In the past week, the IMEDD followed the health and prevention information of three countries: Monaco, Italy and France.
Here is below the sum up, guidelines and pieces of advices for the upcoming weeks.
The common message of the countries is to master and slow the propagation of the virus.

  • Monaco: 1 case, 02/03/2020
    Last week, Monaco was the country that most provided transparency and information to the health and safety measures for the coronavirus outbreak, by largely informing the population and the organizations. Monaco is known to be a very reactive country in all fields of actions. The whole sanitary system in Monaco is mobilized to deal with this issue.
    Monaco provides full transparency on its data and has already adopted some measures of prevention, such as the possibility of telework for the people who come from the zones at risk.
    The Monaco Parliament actively follows the situation and stands beside the Government regarding the measures taken in Monaco.
    As only one case was reported in the country until today, the Monaco schools opened on March the 2nd, with some special health and security measures. The Monaco Prime Minister was with the children to bring support, he accompagnied the teachers and reassured the families. The Monaco Prime Minister also explained the content of the measures taken for the children and the system of response available in Monaco for the management of this health crisis which has no border.
    Video of the Monaco Prime Minister’s visit in a school of Monaco on the 02/03/2020.
    https://www.facebook.com/GvtMonaco/videos/275745390071735/
    In this second post published by the Government, Monaco shows full transparency on the situation annoucing a rate of 20% of children who didn’t attend school on the 2nd of March and a rate of 5% for the teachers:
    https://www.facebook.com/GvtMonaco/photos/
    a.1443278289296473/2373799019577724/
    .
    The message of Monaco is serene but clear: “we are ready and mobilized to face the epidemic. But the State can’t do everything. It is also the responsibility of each of us. Through our behaviours, we can master or slow the spread of the virus”.
    Later during the day, H.S.H Prince Albert II of Monaco participated in a meeting with the Government to discuss the advancements of the coronavirus crisis management. Some more information should be released by the Monaco authorities by the end of the week:  https://www.facebook.com/286449344700945/posts/3217103798302137/
  • Italy: 2036 cases – 52 deaths, 02/03/2020
    Since the beginning of the crisis, the Italian Government took straight away the measures of a lockdown in the areas in which the coronavirus emerged (Lombardia, Veneto, Emilia-Romagna). Some local lockdown were made too in other regions such as in Liguria (the border region with France). The schools were closed straight away after the Italian Government informed the population. It was asked to keep the children at home, though many people didn’t really believe in the spreading of the virus and many children were left in the streets hanging around, during this first week of contamination of Italy.
    During the first week, the public authorities were quite directive with a good coherence in their information plan, explaining the urgency of investigating on the chain of contamination in Italy, which is justified. Then, for the preparation of the measures for the second week, it differs regarding the people and the regions. Though between saturday 29th of February and sunday 1st of March, Italy revealed 566 new cases (a third more in one day). On the 2nd of March, 335 news cases were reported. Those two days made the total number of cases double, showing that Italy has entered the phase of an early growth for the spreading of the disease. At the national level, 2036 cases at total are reported in Italy on the 2nd of March, which is the highest rate of contamination in Europe, that leads to 52 deaths. Most cases in Italy are in Lombardia, Emilia-Romagna, Veneto, Piemonte, Marche and Liguria with 25 cases on the 2nd of March.
    The Liguria region announced that, with a desinfection of the schools and the appropriate sanitary products and health behaviours, the school could open on wednesday 4th of March, though the final decision is not taken yet.
    The Italians remain perplex. The number of cases of coronavirus increases in Italy and the actual plan would be to re-open the schools in the week.
    The IMEDD advises the Italian authorities to take the biggest measures of precaution regarding the children (including Liguria), by keeping the schools closed until it is surely known that the coronavirus doesn’t expand in the country, which is not the case today. The IMEDD also advises the Italian authorities to bring more attention to what is said by the people on social media. Many people in Italy think that the coronavirus is a fake news and they don’t seriously take into account the public measures (the more the official information is shared, the more the people will adopt the prevention behaviours). On the contrary, the parents and the grand-parents in Italy are very aware and concerned about the spreading and the risks of the virus (especially for the elderly populations, the probability of death if infected by the virus could reach: 4% betwen 60 and 69 years old, 8% between 70 and 79 years old and 14,8% over 80 years old – WorldoMeter Data).
    In Italy, many grand-parents look after the children when the parents work. Most of the elderly people and parents support that the school stay closed. They see the schools as a possible risk of clusters for the virus that could be brought home by the children, that would expose their parents and grand-parents. In Italy, the organization of the on-line school is possible, sending the homework to the parents through whatsapp school groups (each Italian uses whatsapp), then if the parents keep working, the grand-parents can help the children do their school work at home.
    Italy should take the opportunity of this crisis for the implementation of the on-line school.
    The number of declared cases in Italy has doubled in the past two days, reaching already more 2036 persons. The safest measures of prevention should be implemented to ensure the children’s safety.
    The IMEDD finally advises the Italian authorities to provide both a public Excel file of the data and a Google Map available on-line and updated each evening, regarding the location of the cases in order to bring full transparency (showing the public data by regions, provinces, cities, villages, using the IStat detailed geographical nomenclature).
  • France: 191 cases – 3 deaths, 02/03/2020
    Last week, the French Government was the last of the three countries to take action as it was the last to announce a case of coronavirus. France was called for action by the national and international community when the first cases emerged in Italy. The French public decision makers of the bordering regions of Italy took measures in their own cities straight away (such as Nice that canceled the Carnival, or in Menton, la Fête du Citron). The first phase of the plan in France was to limit the entrance of the coronavirus within the territory, so a quarantine was asked for the people who came from the zones at risk (mostly Italy, China, South Korea, Japan).
    Though, the virus entered in France. Within a few days, on the 2nd of March, France reached the number of a 191 cases with different places concerned in the department of Oise, a village in the department of Savoie. Some cases were reported in the cities of Nice, Lyon, Nantes, and it seems that there is a new cluster of the virus in the North West of France, in the department of Morbihan.
    In the places where France has cases, the schools are closed. Though, on the rest of the territory, the schools stay opened.
    Apart from the children, France has to think about all the teachers who are also certainly very concerned about the propagation of the virus in schools. Those teachers often have themselves young children. The teachers can’t be put in a situation of health risks either, because they are needed for the continuity of education (especially if the epidemic goes on, a system of on-line school has to be developed). Therefore, the real challenge for France for this new week is to act in bright awareness and implement the closing of the schools by precaution in order to master and slow the speed of the contamination while implementing on-line school at global scale. In the same time, regarding the parents, for those who can and who have children, telework should be proposed, so the whole families remain safe at home, while continuing learning or working on-line.
    In the past day (from March 1 to March 2), the number of cases in France nearly doubled, showing that France could maybe follow the trend of Italy in the upcoming days and weeks. The numbers of cases in France need to be carefully followed.
    The French Government insisted on the fact that the health infrastructures are ready to face the needs of the population regarding the disease
    .
    The French Government insisted as well on the fact that the researchers worldwide work as fast as they can to study and develop a vaccine against the virus.
    It also advised that the French Government brings more clarity to its plan for the events. In certain countries, the events over 1000 persons are cancelled whereas in France, the events to cancel concern a number over 5000 persons. In all scenarios, the events represent a threat in terms of mass contamination, no matter the number of people. The health situation of an event is not controlable enough. None of the origin of the visitors can be traced with full certainty and as the virus has quite a long time of incubation, nobody can know for sure that he/she is not infected.
    The IMEDD finally advises the French authorities to provide both a detailed Excel file and a Google Map available on-line and updated each evening, regarding the location of the cases in France in order to bring full transparency (showing the public data by regions, provinces, cities, villages, using the INSEE detailed geographical nomenclature).

Conclusion of week 1: coronavirus spreading Italy, France, Monaco

For the moment, the coronavirus crisis is quite well managed in the reporting of the data, information and communication, though Italy and France need to challenge themselves during this week 2 to achieve the safest goals of precaution for the children and families, while encouraging telework for those who can and closing the schools while implementing the on-line school, some measures that would allow to slow the rate of propagation of the virus within the countries.
Regarding the exchange of the populations between Italy, France and Monaco in the border region due to the economic and social relations of the three countries, a global management should be done (the PACA region in France, Monaco and the Liguria Region in Italy).

  • There are some French Children and workers in Italy (Liguria) that go to school or work in France (Alpes Maritimes) or Monaco: situation of a border region.  
  • There are some Italian workers from Italy (Liguria) who go to France (Alpes Maritimes) or Monaco for work.
  • The Monaco people also move in the the bordering regions of France and Italy.

The proximity of the three countries with the many exchanges of population each day increases the risk of mass contamination. Some special measures of prevention, such as telework and the on-line school should be implemented straight away for the prevention and the safety of all during the time of this diffusion of the virus.

For this next week, the IMEDD encourages those three countries to go on with their full transparency on the data, information and communication, encourages the safest initiatives and a style of information/communication as “the safest parent of the family”, the one who doesn’t take risks for the children.
Missing a few days of school doesn’t count. The important is not to risk the lives of people.

Focus on the United States and the United Kingdom

  • United States: (99 cases, 6 deaths, 02/03/2020)  
    The President of the United States decided to take special measures to protect the American people, such as urging the Americans not to go in certain countries. Delta and American Airlines canceled the flights to Asia and the flights between the U.S.A and Milan were canceled on the 1st of March. The American Government announced that the researchers are on their way to find a vaccine and that all possible action is undertaken. The U.S Department of Defense informed in the press conference of the 2/03/2020 from Arlington County, that they have been working on the issue of the coronavirus for 6 weeks and took all the measures to be ready for all kinds of scenarios, with short and long terms measures. The U.S Department of Defense’s goal is to make the forces and their families safe and sustain the work of the forces in the country and at international. The U.S Army, based in Italy, follows the Italian and the U.S plans regarding the spreading of the virus. They adapted everything on line, the school, the information, and even the mass on sunday. The U.S Army in Italy is very active on social media for the spreading of prevention information to the American soldiers and citizens and to a larger community of Italians or foreigners who live in Italy.
  • United Kingdom: (40 cases, 02/03/2020)
    The United Kingdom are prepared for the outbreak of the virus within the country.
    Some news have been published saying that there could be a closing of the schools during two months, but the decision is under consideration. Though, this announcement show that the UK public authorities don’t want to take any risks for the children in case of outbreak in the country. The country prepares. It doesn’t mean that the closing will be effective, but the measure is in the thoughts of all.

​Focus on other countries (2/03/2020)

  • ​China: 80 151 cases => 2944 deaths
  • South Korea: 4335 cases => 28 deaths
  • Iran: 1501 cases => 66 deaths
  • Japan: 274 cases => 6 deaths
  • Germany: 165 cases  => no death at this date​
  • Spain: 120 cases  => no death at this date​
  • Canada: 27 cases ​ => no death at this date​
  • Switzerland: 24 cases  => no death at this date​
  • Austria: ​18 cases => no death at this date​
  • Netherlands​: 1​8  cases​​ ​=> no death at this date​ ​
  • Belgium: ​8 cases ​​=> no death at this date​ ​​
  • Luxembourg: ​​1 case​  ​=> no death at this date​
  • Ireland: 1 case​  ​=> no death at this date​

The list of the 76 countries affected by the coronavirus on this date of the 2nd of March 2020 is available here: https://www.worldometers.info/coronavirus/#countries

The position of the EU

​The EU raises ​the corona​virus risk level as the ​world and European ​cases grow from moderate to high. The whole situation is explained in the video below made by the BBC​: https://youtu.be/CMUQIlvv1to

Links to connect to be informed of the latest news.  

————————–

Read all the IMEDD’s articles since the beginning of the covid19’s crisis in Italy:
http://www.imedd-group.com/en/category/who/