Will the coronavirus crisis in California be as fast as Italy?

It begins every afternoon: the patient has a fever, shivering, chills and difficulty breathing, and flows into the hospital. In Italy, the latest country hit by the latest coronavirus, it seems like a clockwork.

"It's hard to see so many people getting sick at the same time," Roberto CosentiniA doctor near the northern city of Bergamo near Milan says Emergency Room Doctor Podcast. "It's like a regular daily earthquake."

Is this a California store?

More than 3,000 cases of COVID-19 have been confirmed in Golden State, of which 67 already dead Respiratory diseases. This is a far cry from the 69,000 deaths and 6,820 deaths reported in Italy.

But health officials here hint that this is possible.

"We are in a serious crisis," warned Scott Morrow, San Mateo County Health Officer. "Unless everyone does their part and adheres to the county's in-situ refuge order and the governor's" safer at home "order, we will soon face an Italian disaster," he said. statement Released Monday night.

In nearby San Francisco, Dr. Grant Colfax, director of public health, is working Cheer up In patients who are hospitalized within the next week or two. "The worst moment has not yet come," he said.

The first coronavirus infection in California was confirmed in late January, and the number of COVID-19 cases and deaths has increased exponentially since early March.

On Tuesday, county officials in California announced 395 new cases of coronavirus infection. On the previous Tuesday, there were only 158 new cases. Similarly, on Tuesday, 11 new deaths were reported across the state. Three people died last Tuesday.

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No one is sure what the future holds for California. Illnesses and deaths can be avoided or delayed if residents follow the orders of Governor Gavin Newsom as much as possible. On the other hand, if a person with no symptoms enters the state and becomes a super communicator (transmitting the virus to many people), he or she may trigger a new outbreak.

Either way, there are good reasons to expect the worst to happen suddenly, just like in Italy.

For several weeks, King County, Washington and the San Francisco Bay Area were the hardest hit areas in the United States. Then New York Gov. Andrew Cuomo seemed to be everywhere 5,707 new coronavirus cases announced On Monday night. One the next day 4,790 additional casesThis brings the total number of Empire States to 25,665.

"This is happening in New York," he said George RutherfordAn epidemiologist and infectious disease specialist at the University of California, San Francisco. "They oppose it."

Rutherford said the sudden rise in deaths in Italy could be due to bad luck and inability to act quickly.

In fact, although China's population is 23 times that of China, Italy has more than twice as many deaths as China, the source of the pandemic.

The first sign of the problem appeared on February 20, when he was a healthy 30-year-old man with a rare case of pneumonia and needed intensive care. Although he has not been to Chinese history, he is in Codno Hospital According to a Milan report, the province of Lodi, about 30 miles southeast of Milan report In the Journal of the American Medical Association.

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On the second day, another 36 cases of coronavirus were found. To make matters worse, the virus spread quickly among hospital staff. Maurizio CecconiElected President of the European Society of Intensive Care Medicine and co-author of the JAMA report.

"Don't underestimate this. It's not normal flu. It's serious," Cecconi Said in a Interview Editor-in-chief of a medical journal. "The percentage of patients needing intensive care is high."

The public health response has worsened the situation. Codano area Fast closing business Many people stay at home, but Other neighborhoods nearby Not so decisively acting until March 8-more than two weeks-instructions to stay in place Ordered Serving approximately 16 million people in northern Italy, the region includes Venice and Milan.

The delay proved fatal. Bergamo SlammedThe church in the city cemetery must be Into a morgue Deal with the dead.

Italy is particularly vulnerable to COVID-19 because of its large population SkewRutherford said. According to the World Bank, 23% of the Italian population is at least 65 years old. Only Japan's population is older. (In the United States, 16% of the population is over 65; in China, only 11%.)

According to a study of 803 people who died in Italy, about 88% of them were at least 70 years old Cecconi shared the data.

Elderly people and those with health conditions are at the highest risk of major illness and death if they are infected with coronavirus (formally known as SARS-CoV-2). If the virus settles deep in the lungs, it can prevent victims from breathing on their own and cause septic shock and multiple organ failure. The immune system's response to the infection may drown tiny air sacs that deliver oxygen to the lungs, making the situation worse.

Medical staff in protective clothing looks after a COVID-19 patient in the intensive care unit of a hospital near Rome.

Medical staff in protective clothing looks after a COVID-19 patient in the intensive care unit of a hospital near Rome.

(Alberto Pizzoli / AFP / Getty Images)

In addition, Italy is stuck in a problem familiar to the United States-unable to conduct extensive testing. Cecconi and his colleagues wrote that this affected doctors' "ability to make accurate diagnoses and allocate patients appropriately."

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The authors say that in this case, adding more ICU beds is not enough. They wrote that the measures left at home "may be the only way to curb the spread of infection and allow the development of time-related diseases."

Health workers in California have been following podcasts from Italy as they prepare to respond to surprise attacks from COVID-19 patients. Cosentini's podcast described the condition so seriously that medical staff needed help from a staff psychologist.

On a particularly bad day, Cosentini's emergency department admitted 80 pneumonia patients. Cosentini said patients had to wait in the emergency room because there were no beds available in the 800-bed hospital.

It takes time to treat COVID-19 patients. Patients who cannot breathe on their own may need to stay on the ventilator for three to 20 days. One the study Of patients in Wuhan, China reported a median time from onset to discharge of 22 days. (Those who died after symptoms first appeared lasted 18.5 days.)

"Not only do we fill the bed for people with the disease and people suspected of having the disease, but we can't move them out until we determine whether they are negative."

The Times staff writers Harriet Ryan and Sean Greene contributed to this report.

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