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While much is being made of the course of COVID-19 in Italy, it is worth remembering a couple of things as we focus our efforts in the United States. It appears that the same disease which we are now encountering found a very different population and medical readiness in Italy.
1. Italy has been committing demographic suicide for decades. Italy is down to 1.3 live births per woman. A major author wrote a decade ago that the big Italian family was a myth today, that an Italian child is most likely to grow up with no siblings and only one first cousin. So, it should be no surprise that Italy’s median age is already over 47. That is, Italy was already vulnerable to a disease that especially threatens the elderly because that is where their population has been shifting. The same holds for much of Europe.
2. Before this latest pandemic, Italy was ranked behind Mexico on the Global Health Security Index, rating nations’ readiness to prevent, contain, and treat infectious disease outbreaks. So let’s not hear too much about 1st world medical systems in Italy.
In comparison, the U.S. median age is 38. We rank 1 on the GHS index, to Mexico’s 28 and Italy’s 31. So, yes, we should expect to see the disease run a somewhat less lethal course here. However, words matter. The real experts warned repeatedly that it is not just the elderly with underlying conditions, rather it is people with compromised immune or respiratory systems who face serious, life-threatening danger from COVID-19.
That brings us right back to Dr. Drew’s warnings for the past year, and it validates his call for a significant portion of the COVID-19 Congressional slush fund to get put directly to use in attacking the public health crisis of the homeless in Los Angeles, San Francisco, and Seattle. Dr. Drew’s comment was that he would completely change his assessment of the disease if it got loose in the Los Angeles homeless population: immunocompromised, already lacking basic immunizations, malnourished, living in close, crowded quarters, with no sanitation.
But, would that only mean more deaths of street people, who are already vulnerable to other sources of early death? No. If an infectious respiratory ailment gets into the homeless populations of major cities, then all the other people living and working in the area suddenly face much greater exposure. If it is time to deploy a public health army of sorts, this is where it needs to go.Published in