Ravaged by first wave, Italy ill-prepared as second COVID assault hits

By Giselda Vagnoni, Elvira Pollina and Emilio Parodi

a man and a woman standing in a room: Medical staff in Rome hospital treating Covid patients fear surge in infection numbers

© Reuters/YARA NARDI
Medical staff in Rome hospital treating Covid patients fear surge in infection numbers

ROME (Reuters) – One month ago, the World Health Organization posted a video praising Italians’ “strong and effective response” to the coronavirus pandemic.

At the time, Italy had one of the lowest infection rates in the Western world and appeared to have learnt the lessons of the first wave, which killed more people than anywhere else in Europe except Britain.

Now it appears that Italy, ahead of the rest of Europe when COVID-19 arrived, was simply behind the curve when it roared back as summer ended. New cases are rising at record rates, hitting 31,758 on Oct. 31 against around 2,500 at the start of the month, while deaths are up tenfold to more than 200 a day.

To be sure, many northern hemisphere countries are also facing a coronavirus resurgence. But just as Italy became a symbol of the perils of the virus, so its inability to protect against a second wave has underscored Europe’s failure to use the summer lull to bolster its defences, notably in tracing and testing.

a group of people standing in front of a crowd: FILE PHOTO: People protest against the government's measures to combat the coronavirus disease (COVID-19) in Turin

FILE PHOTO: People protest against the government’s measures to combat the coronavirus disease (COVID-19) in Turin

“It is a monumental debacle. The fact that Italy is in the same situation as other countries in Europe is no comfort to me,” virologist Andrea Crisanti told Reuters. “We had five months to strengthen our surveillance, tracking and prevention systems and instead we are heading towards a new lockdown.”

a person wearing a helmet: FILE PHOTO: Italian restaurant and bar workers protest against the government's COVID-19 rules, in Rome

© Reuters/YARA NARDI
FILE PHOTO: Italian restaurant and bar workers protest against the government’s COVID-19 rules, in Rome

The government says it wants to avoid another national lockdown and denies failing to anticipate a second wave.

“There may have been mistakes, you can always do better but we have not underestimated the situation. We have worked on all fronts,” Prime Minister Giuseppe Conte said last week.

Crisanti, who has become a celebrity with his dogged demands for more testing, published a letter with nine colleagues on Friday listing what they said were the government’s failings, along with recommendations.

One shortcoming, they said, was the system Italy had adopted to trace those who had contact with COVID sufferers and make sure they were tested.

In June, the government employed 9,000 people for this. That has risen to just 9,200, a third of the number Germany employs. The state placed adverts last week to recruit another 2,000.

“We warned the authorities from the very beginning that we would have needed much more people, and people professionally trained, for tracing COVID-19,” said Miria De Santis, head of the national association of health assistants.

“I think the authorities overlooked the risk of the second wave,” she told Reuters.


Franco Locatelli, a leading member of the scientific committee that advises the government, denies the state lowered its guard, but acknowledges that the tracing system has been overwhelmed.

“COVID-19 tracking

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‘Eat out to help out’ offer contributed to UK second COVID wave

By Andrew MacAskill

LONDON (Reuters) – The British government’s “Eat out to help out” discount scheme to boost spending at restaurants, cafes and pubs over the summer helped spread the coronavirus and contributed to a second wave of infections, according to a new study.

For the month of August, the government offered diners up a 50% discount of up to 10 pounds ($13.03) per head on meals between Mondays and Wednesdays to kick-start the economy and encourage people to spend money again after the pandemic lockdown.

Between 8% and 17% of newly detected infection clusters could be linked to the scheme during that period, according to the study by the University of Warwick. Areas where there was a high uptake of the scheme saw an increase in new infections about a week after it started, the study found.

Watch: Lab tests show there’s a massive difference in the effectiveness of the best and worst face masks

Meanwhile, the research said those same areas saw a decline in new infections a week the discount offer finished.

Britain’s finance ministry said it did not recognise the findings of the study.

“Many other European counterparts have experienced an uptick in cases – irrespective of whether similar measures for the hospitality industry have been introduced,” a spokesman for Treasury said.

Thiemo Fetzer, a professor of economics who published the study, said: “The Eat-Out-to-Help-out scheme, hailed as an economic cure for the ailing sector, may have substantially worsened the disease.”

The research highlights the difficult challenge balancing public health and economic growth during this crisis. The government subsidised about 100 million meals in August and the scheme was so effective some businesses continued offering the half-price discounts even after the government funding ended.

Prime Minister Boris Johnson earlier this month defended the scheme for helping to protect millions of jobs in the hospitality industry but conceded that it may have had an impact on infections.

Watch: UK death toll rises to 45,675

(Reporting by Andrew MacAskill, Editing by William Maclean)

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Eat Out to Help Out ‘accelerated’ COVID-19 second wave

An Eat Out To Help Out poster in a restaurant window. Photo: Mark Kerrison/In Pictures via Getty Images
An Eat Out To Help Out poster in a restaurant window. Photo: Mark Kerrison/In Pictures via Getty Images

The Eat Out to Help Out scheme has had a “large causal impact in accelerating” second wave COVID-19 infections, a Warwick University study has suggested.

According to the research, the “significant” rise in coronavirus infection clusters emerged a week after the scheme started.

It also suggests that between 8% and 17% of newly detected COVID-19 clusters could be linked to the scheme during that time period.

Regions where there was a high uptake of Eat Out to Help Out also saw a decline in new infections a week after the scheme drew to a close.

There were lower infection rates in places that experienced high rainfall around lunch and dinner-time than in areas that enjoyed nicer weather.

While restaurants that participated in the scheme saw an increase in visits of between 10% and 200% compared with the same period in 2019.

Academics concluded that the economic benefits of Eat Out to Help Out were short lived.

READ MORE: Record increase in UK store closures as more COVID-19 lockdowns loom

The month-long scheme was launched as part of chancellor Rishi Sunak’s Plan for Jobs to kickstart the UK economy after the coronavirus pandemic forced businesses to close during lockdowns. The government offered to cover up to 50% from customers’ bills, with firms able to reclaim the government’s payment through a HMRC portal.

Around 84,000 restaurants have signed up to the scheme, which offers a maximum discount of £10 ($14) per customer on Mondays, Tuesdays and Wednesdays throughout August.

Brits enjoyed more than 64 million meals, in the programme’s first three weeks, according to government data.

Yahoo Finance has reached out to the Treasury for comment.

Watch: Why tax rises may be inevitable in Britain

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Second Wave ‘Critical Stage’, Hospital Transmission Report

These are the UK coronavirus stories you need to know about today.

Second Wave ‘Critical Stage’

Imperial’s REACT continuing community COVID-19 swab testing study estimates 96,000 people a day in England are becoming infected. The latest swabs were collected on Sunday and the data are published in a preprint.

  • Infections are doubling every 9 days with infections increasing across all age groups and areas of the country.

  • An estimated 128 people per 10,000 now has the virus compared to 60 in 10,000 as of 5 October.

  • R is estimated to have risen to 1.6.

The authors conclude: “The co-occurrence of high prevalence and rapid growth means that the second wave of the epidemic in England has now reached a critical stage. Whether via regional or national measures, it is now time-critical to control the virus and turn R below 1 if further hospital admissions and deaths from COVID-19 are to be avoided.”

Experts have commented via the Science Media Centre.

Professor Igor Rudan, joint director of the Centre for Global Health and WHO Collaborating Centre, University of Edinburgh, said: “This study should be considered very accurate and reliable scientific evidence that shows that a very large second wave of COVID-19 pandemic is underway.  It will inevitably lead to a very large number of infections, severe episodes and deaths in the coming weeks and months.  Efforts will be required to reduce the national reproduction number below 1.0 again.  The measures that were in place over the past 2 months across most of Europe were clearly insufficient to prevent the new large growth of infected cases and fast spread of the virus.” 

Paul Hunter, professor in medicine, UEA, said: “Although we do not know for certain what the prevalence of infection was at the April peak, it is likely that infection rates now are very similar to and maybe even higher than at the peak in April.”

Dr Simon Clarke, associate professor of cellular microbiology at the University of Reading, said: “We can expect this situation to continue to deteriorate if authorities remain slow to react.”

Nowcast and Forecast

Also published today is the Cambridge MRC Biostatistics Unit’s weekly Nowcast and Forecast.

It estimates:

  • 55,600 daily infections in England with cases “particularly high” in the North West, and the North East and Yorkshire

  • The number of daily deaths is likely to be between 237 and 422 by 5 November

  • London, followed by the North West, continues to have the highest attack rate

Lead researcher, Professor Daniela De Angelis, commented: “The estimated trends in R values and growth rates show signs that the epidemic is growing at a slower pace in most regions. However, the rising number of infections and the R values remaining above 1 clearly indicate continued transmission, leading to the prediction of a steep rise in the number of COVID-19 deaths.

“Curtailing this transmission will require sustained social distancing interventions.”

PHE Data

Meanwhile Public Health England’s weekly national flu and COVID-19 surveillance reports showed case rates increased in every age

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Building wave of ransomware attacks strike U.S. hospitals

By Christopher Bing and Joseph Menn

WASHINGTON/SAN FRANCISCO (Reuters) – Eastern European criminals are targeting dozens of U.S. hospitals with ransomware, and federal officials on Wednesday urged healthcare facilities to beef up preparations rapidly in case they are next.

The FBI is investigating the recent attacks, which include incidents in Oregon, California and New York made public just this week, according to three cybersecurity consultants familiar with the matter.

A doctor at one hospital told Reuters that the facility was functioning on paper after an attack and unable to transfer patients because the nearest alternative was an hour away. The doctor declined to be named because staff were not authorized to speak with reporters.

“We can still watch vitals and getting imaging done, but all results are being communicated via paper only,” the doctor said. Staff could see historic records but not update those files.

Experts said the likely group behind the attacks was known as Wizard Spider or UNC 1878. They warned that such attacks can disrupt hospital operations and lead to loss of life.

The attacks prompted a teleconference call on Wednesday led by FBI and Homeland Security officials for hospital administrators and cybersecurity experts.

A participant told Reuters that government officials warned hospitals to make sure their backup systems were in order, disconnect systems from the internet where possible, and avoid using personal email accounts.

The FBI did not immediately respond to a request for comment.

“This appears to have been a coordinated attack designed to disrupt hospitals specifically all around the country,” said Allan Liska, a threat intelligence analyst with U.S. cybersecurity firm Recorded Future.

“While multiple ransomware attacks against healthcare providers each week have been commonplace, this is the first time we have seen six hospitals targeted in the same day by the same ransomware actor.”

In the past, ransomware infections at hospitals have downed patient record-keeping databases, which critically store up-to-date medical information, affecting hospitals’ ability to provide healthcare.

Ransomware attacks have jumped 50% over the past three months, security firm Check Point said Wednesday, with the proportion of polled healthcare organizations impacted jumping to 4% in the third quarter from 2.3% in the previous quarter.

Two of the three consultants familiar with the attacks said the cyber criminals were commonly using a type of ransomware known as “Ryuk,” which locks up a victim’s computer until a payment is received.

The teleconference call participant said government officials disclosed that the attackers used Ryuk and another trojan, known as Trickbot, against the hospitals.

“UNC1878 is one of the most brazen, heartless, and disruptive threat actors I’ve observed over my career,” said Charles Carmakal, senior vice president for U.S. cyber incident response firm Mandiant.

“Multiple hospitals have already been significantly impacted by Ryuk ransomware and their networks have been taken offline.”

Experts say the deployment of Trickbot is significant after efforts by Microsoft <MSFT.O> to disrupt the hacking network earlier this month.

That initiative was designed to handicap the cyber criminals, but they seem

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‘Overwhelming’ COVID second wave floods Swiss hospitals

By Cecile Mantovani

GENEVA (Reuters) – Swiss hospitals are scrambling to cope with a surge in new COVID-19 patients, bringing back retired staff to replace sick frontline workers and closing other wards as officials warn they could reach breaking point in about 10 days.

Case numbers in Switzerland have risen to record levels this month, with infection rates far exceeding those in neighbours Germany and Italy.

The government is expected to announce new measures on Wednesday but has been criticised by medics and scientists for being too reluctant to impose strict nationwide rules.

At Geneva’s University Hospital (HUG), in one of the worst-hit cantons, cases have increased more than six-fold in three weeks to 350 patients.

“Everyone expected a second wave, but no one to my knowledge expected it to be so wild and so severe,” director Bertrand Levrat told Reuters.

“Today, this wave is going to be probably bigger, maybe much bigger than the first wave,” he said, describing a strained situation with exhausted medics and more than 400 COVID infections among staff.

To cope, his facility is cutting elective surgeries, moving patients to private clinics and has called on retired workers even though they would be in the age bracket more vulnerable to the virus.

Nationally, about a third of intensive care units remain available but will be filled in the next ten days if the current infection rate persists, government delegate for the Coordinated Medical Services Andreas Stettbacher said on Tuesday.

Similar warnings were issued earlier this year during the first outbreak, but then hospitals, propped up by army reservists, largely coped and many had spare capacity.

The situation is different this time around, doctors say.

Marie Assouline Reinmann, a doctor at HUG, is concerned that complacency and scepticism about restrictions could lead to a spike in the number of infections.

“I fear that people take the situation less seriously and that it gets worse and worse here at the hospital,” she said.

“I would like people to realize that this second wave is here and it is already overwhelming us.”

Confirmed cases in Switzerland and neighbouring Liechtenstein have surpassed 127,000, with a death toll above 1,900.

(Additional reporting by Silke Koltrowitz; Writing by Emma Farge; Editing by Raissa Kasolowsky)

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India Near 8 Million Cases; Europe Wave Resurgence: Virus Update

(Bloomberg) — India’s confirmed cases reached just under 8 million as virus infections spread across the country. Europe’s resurgent coronavirus outbreak intensified, with Italy’s new cases reaching a record and France reporting the most deaths since April as stricter measures are weighed on the continent.

Japan passes a bill to offer a free vaccine. In a rare admission, U.S. President Donald Trump acknowledged that coronavirus cases are rising in “certain areas” of the Midwest. Covid-19 hospitalizations have risen at least 10% in the past week in 32 states and the nation’s capital as the month-old viral surge increasingly weighs on America’s health-care system.

Pfizer Inc. CEO Albert Bourla said the company may know by the end of October whether its vaccine is effective. Russia has begun production of a second vaccine that hasn’t completed trials.

Key Developments:

Global Tracker: Cases top 43.9 million; deaths exceed 1.16 millionEast Europe fights for its life against virus it thought crushedCity locked down for three months has bleak lesson for the worldCan you get Covid twice? What reinfection cases mean: QuickTakeSlow Covid recovery stalks health industry as new cases surgeEuropean governments running out of options to avoid lockdownsVaccine Tracker: Vaccine trials restart, providing hope

Subscribe to a daily update on the virus from Bloomberg’s Prognosis team here. Click CVID on the terminal for global data on coronavirus cases and deaths.

chart, histogram: Seven-day average of U.S. death toll is at 800 again

© Bloomberg
Seven-day average of U.S. death toll is at 800 again

India Virus Cases Reach Almost 8 Million (12:22 p.m. HK)

India’s total confirmed virus cases reached 7.99 million on Wednesday, according to government data. The nation added 43,893 cases in a day. Coronavirus-related deaths rose to 120,010.

India trails only the U.S. as the nation with the most number of cases. The U.S. has 8.77 million cases, according to data collected by Johns Hopkins University.

Iran’s Parliament Speaker Tests Positive (11.26 a.m. HK)

Iranian parliament speaker Mohammad Baqer Qalibaf has tested positive for coronavirus and is currently in self-isolation, the state-run Islamic Republic News Agency reported. Earlier this month, IRNA reported the country’s nuclear energy chief Ali Akbar Salehi as well as Mohammad Bagher Nobakht, a deputy president and top aide to President Hassan Rouhani, had also tested positive for the virus.

Trump Says Midwest ‘Heated Up’ With Cases (10:41 a.m. HK)

President Donald Trump on Tuesday night acknowledged that coronavirus cases are rising in “certain areas” of the Midwest, a rare admission during the final week of the presidential campaign.

“Certain areas that are heated up right now,” Trump said at a rally in Omaha, Nebraska. “They’ll go down. They’ll go down very quickly. They’ll be down within two weeks, they’re figuring.”

Trump has routinely downplayed the virus while making his closing argument to voters, who have rated his pandemic response poorly, according to opinion polls. The president said again on Tuesday that the country is “turning that corner.”

South Korea’s Moon Says Virus Contained, Seeks to Revive Economy (9:34 a.m. HK)

Video: Health panel proposes colon cancer tests start

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Britain’s Health Workers Face 2nd Virus Wave, but This Time With Less Support

People have also begun complaining about long wait times.

“There is some disbelief that you’ve had six months to prepare for this and why haven’t you been training more nurses,” said Dr. Tamás Szakmany, an intensive care doctor in Newport, Wales. But, he said, “it’s not just like you’ve got a car factory and you suddenly need more transmissions, so you train the factory workers to build more transmissions. It’s just not that simple.”

Among doctors and nurses, a sense of battle fatigue has set in. Extra weekend shifts that were intended to be temporary have lasted through the summer, especially in northern cities where coronavirus wards remained busy even as a national lockdown was lifted in the summer. Health workers are calling in sick, many of them with anxiety and depression.

Rapid testing remains scarce for doctors and nurses. And health workers on coronavirus wards are supplied only with basic surgical masks, not the heavier-duty N-95 masks reserved for intensive care units.

“The first time around, it’s almost like a once-in-a-lifetime kind of medical challenge,” said Paul Whitaker, a respiratory doctor in Bradford, in northern England, where the number of coronavirus patients has returned to its early May peak.

“The hospital provided packed lunches for us all,” Dr. Whitaker added. “People were sending good luck messages. But the prospect of going into another six months, which is almost certainly what it’s going to be, is relatively frightening. How are you going to maintain the morale, the focus and the energy of all these people?”

In the ex-mining and manufacturing towns in England’s north that have been hit hardest by the latest surge of infections, doctors are especially harried. Nearly 40 percent of critically ill patients are now classified as the country’s most deprived, compared to a quarter of such patients in the spring and early summer.

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Europe’s Second Wave of COVID-19 is Being Driven by Two Countries. Here’s Why

covid prague
covid prague

Employees of Czech hospital beds maker Linet check beds to be used in the Covid-19 field hospital on October 20, 2020 in the Linet factory in the village Zelevcice, 30km south-east of Prague. Credit – Michal Cizep/AFP—Getty Images

Europe is clearly in the grip of a second wave of the coronavirus pandemic. In the past week, countries throughout Europe—including Belgium, Croatia, the Czech Republic, France, Germany, Hungary, Poland, Portugal, Slovakia, the U.K, and Ukraine—have all recorded their highest daily caseloads since the pandemic started.

But two of these stand out. As of Oct. 25, Belgium and the Czech Republic are currently reporting about 146 and 115 new daily cases per 100,000 people, respectively, according to TIME’s coronavirus tracker, which compiles data from Johns Hopkins University. That’s dramatically higher than the E.U. average of 33 per 100,000.

The Czech Republic hit a new daily record of 15,258 new infections on Oct. 23; a day later, Belgium set its own record with 17,709 new daily cases. Belgium is now the epicenter of the E.U’s second wave, with the continent’s highest per-capita case rate (besides tiny Andorra). The country also has the world’s third highest number of COVID-19-related deaths per capita after Peru and tiny San Marino.

Experts speaking to TIME say they can’t point to anything specific that has made the Czech Republic or Belgium unique among E.U. states in their handling of the pandemic, instead attributing the rise in cases to a combination of factors, and the relatively arbitrary nature by which a virus spreads through populations.

Increased testing doesn’t fully explain the rise in case numbers

Marc Van Ranst, a virologist from the University of Leuven in Belgium, says the rise in cases can be partly explained by the increase in testing in his country. The number of daily tests has increased from about two out per 1,000 people each day in September to nearly six in recent days.

Testing has also increased in the Czech Republic over the same period, from about one per 1,000 people to around 3.5.

However, that cannot entirely account for the overall rise in cases, because the positivity rate—the share of tests that come back positive—rose in Belgium from around 2% in mid-September to over 18% in late October.

In the Czech Republic, that number soared from around 4% in to nearly 30% in the same period.

Population density may be a factor

Another potential factor for the situations in Belgium and the Czech Republic is their relatively high population densities. “You have to look at Belgium as one big city,” says Ranst. “That’s why in Brussels, where the population density is particularly high, the problem is acute.” For every square kilometer of land in Belgium there are 377 people; in the Czech Republic that number is 137. Compare those to the E.U. average of 112.

Pierre Van Damme, an epidemiologist in Belgium, said the reopening of universities at the end of September, in particular, has been a driver of

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How Melbourne’s long lockdown crushed a second wave

a bus on a city street: Melbourne residents have endured one of the world's longest lockdowns

© Getty Images
Melbourne residents have endured one of the world’s longest lockdowns

Melbourne’s grinding second coronavirus lockdown began in the chill of winter.

In early July, the nights were long and dark, and Australia’s cultural capital was confronting the terrifying reality of another deadly wave of infections.

More than 110 days later, experts say it is emerging as a world leader in disease suppression alongside places including Singapore, Vietnam, South Korea, New Zealand and Hong Kong.

Raina McIntyre, a biosecurity professor at the University of New South Wales’ Kirby Institute, told the BBC that Australia’s response had been “light years ahead” of the US and the UK.

“It is just thoroughly shocking. When we think of pandemics we don’t think that well-resourced, high-income countries are going to fall apart at the seams, but that is exactly what we have seen,” she said.

At the end of Tuesday, Melbourne’s five million residents will see an end to strict stay-home orders that put an entire city into a type of protective custody.

When the restrictions are lifted, Melburnians will have endured one of the world’s longest and toughest lockdowns.

It’s been controversial, calamitous for jobs and crushingly hard for many, but health specialists believe it has worked.

There is cautious optimism that with very low case numbers, the worst is over.

chart, histogram: Victoria's daily cases. Entered lockdown 7 July. .

© Provided by BBC News
Victoria’s daily cases. Entered lockdown 7 July. .

“I’m pretty proud of what we have achieved here,” said Professor Sharon Lewin, director of the Doherty Institute in Melbourne. “The outcome has been extraordinary – not without its pain, though.”

On Monday, Melbourne reported no new daily cases for the first time since June. In early August, it was recording more than 700 daily, and dozens of people were dying.

The Victorian state capital was at the heart of an unfolding public health crisis, and in other parts of Australia, which had mostly contained Covid-19, people held their breath.

“Europe and the US are facing enormously high numbers. In Victoria, we had an isolated outbreak pretty much just in Melbourne, and the rest of the country had extremely low, and in many states zero, numbers,” Prof Lewin told the BBC.

“We had absolutely no choice but to go into a significant lockdown if we were going to rejoin the rest of the country, and that gave us motivation.”

Face coverings became mandatory in Victoria, and a night-time curfew blanketed Melbourne.

Life retreated indoors, while on the front-line of an invisible war, a growing number of casualties included health care workers and nursing home residents. The true impact on mental health may never be known.

More on Melbourne’s lockdown:

“We understand why the government has taken that approach and it has worked, but we do feel that the government could move quicker to start easing the restrictions. They are taking an overly cautious approach,” explained Adel Salman, vice-president of the Islamic Council of Victoria, last week.

“The strain on families, the rise in domestic violence – these

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