„In Einzelfällen werden nur noch Patienten mit Überlebenschancen beatmet“(11. 3.)
Official guidance to doctors in Italy, seen by The Independent,, have said only patients “deemed worthy of intensive care” should get it and decisions based on a “distributive justice” approach balancing the demand for care versus available resources.
Laut dem Robert Koch-Institut sind 10 bis 15 Prozent der Erkrankungen mit dem COVIT-19 Coronavirus schwere Fälle und erfordern stationäre Behandlung.
Falls sich das Virus, wie generell erwartet wird, pandemisch ausbreitet, die gesamte Bevölkerung infiziert und sich dauerhaft etabliert, dann müssten demnach 8 bis 12 Millionen Deutsche stationär behandelt werden.
Bundes-Gesundheitsminister Jens Spahn glaubt, es stünden in Deutschland 30.000 Betten in Isolierstationen zur Verfügung.
30.000 für 8-12 Millionen?
In Grossbritannien spricht man über die Notwendigkeit, unter den die Hausärzte und Krankenhäuser aufsuchenden Patienten eine Auswahl zu treffen.
Triage heisst das bei Epidemien und in Nothilfeaufnahmen übliche Verfahren, bei beschränkter Kapazität die “wichtigsten”oder "dringendsten" unter den angebotenen Patienten auszusuchen und den “weniger wichtigen” Rest zu vertrösten oder abzuweisen.
Unangenehmerweise gibt es für Triage (Begriff aus dem Französischen) keine anerkannten, zu befolgenden Regeln, auf die sich Krankenhäuser berufen könnten. Was werden die abgewiesenen Patienten tun? Werden sie das Krankenhaus verzweifelt belagern, wie in Wuhan geschehen, oder gar Selbstmord begehen? Oder werden sie versuchen, wie eine Zombie-Armee mit Gewalt das Krankenhaus zu stürmen?
Erschreckende Perspektiven.
In Italien, von den Alpen bis zur Südküste Siziliens stellen die Krankenhäuser in diesen Tagen sogenannte "Triage-Zelte" auf. Sinn der Zelte ist es, die hilfesuchenden potentiellen Patienten am Ansturm auf die Nothilfestationen zu hindern. Im Zelt sollen sie Rat und erste Diagnose erhalten. Das ist schwierig, denn knapp die Hälfte der am Virus Erkrankten ist asymptomatisch: zeigt noch keine Symptome, ist aber ansteckend.
Wie würde Triage in Deutschland aussehen? Zunächst würden wohl Kinder unter 10 Jahren und Jugendliche nachhause geschickt, denn in den unteren Alterskohorten gilt das Virus als ungefährlich. Den über 65-Jährigen und den bereits mit einer Vorkrankheit Belasteten würde man wahrscheinlich die stationäre Behandlung wegen ihrer kurzen Lebenserwartung und niedrigen Heilungschancen verweigern um die begrenzte Kapazität Jenen zu gewähren, die schnelle Heilung und lange Restlebenszeit versprechen.
Soweit die Theorie. Aber in der deutschen Praxis dürfte Triage anders aussehen. Krankenhäuser sind keine Wohlfahrtsanstalten sondern Erwerbsbetriebe in der einen oder anderen Form. Das heisst: bei der Triage würden wie so häufig Privatpatienten vor dem Gros der Kassenpatienten bevorzugt werden. Würde ein privat zahlender Greis einer jungen Kassen-Alleinerziehenden vorgezogen werden?
Eins ist jedenfalls sicher: will man die nach Abzug aller harmloseren Fälle übrig bleibenden Millionen Deutsche, die als schwere Fälle gelten müssen, versorgen, dann kann nur ein Faktor helfen: Zeit.
Je langsamer die Epidemie verläuft, desto eher wird das (von Infektionen stark dezimierte) Krankenhauspersonal angesichts der geringen Bettenzahl fähig sein, den Ansturm der Verzweifelten ohne allzu grausame Triage zu bewältigen.
China und Italien versuchen derzeit, durch Entwarnung und teilweise Wiederöffnung der Schulen und Arbeitsstätten die Volksmassen zu beruhigen, die sie zuerst durch rabiate Methoden und grossflächige Verbote in die Seuchenpsychose gejagt hatten. Ruhe und Zeit gewinnen, das ist die Losung der Gegenwart. Zeit ist das wertvollste Gut.
"This represents a new phase of the outbreak, Kim argues, and authorities must adapt their response to it. At first they were focused on tracking suspected cases and quarantining them. But, Kim says, "at this point, tracing how the infection spread is meaningless." Tracing takes up too many resources, he says. He adds that the city doesn't have enough epidemiological investigators and that the virus is so widespread that investigators can no longer sort out who infected whom in Daegu.
Kim Hyeonggab, president of the Korean Association of Public Health Doctors and a medical volunteer in Daegu, says he's seeing a shift in tactics from health authorities from trying to contain and trace the virus to trying to mitigate its impact and prevent deaths. This has been done nationwide and involves a range of actions, from canceling schools to calling off K-pop concerts.
Since last Saturday, I've seen government efforts shift to securing more hospital beds and building a triaging system," says Kim — prioritizing patients with severe symptoms at health facilities."
The coronavirus epidemic in the UK will last until next spring and could lead to 7.9 million people being hospitalised, a secret Public Health England (PHE) briefing for senior NHS officials reveals.
The document, seen by the Guardian, is the first time health chiefs tackling the virus have admitted that they expect it to circulate for another 12 months and lead to huge extra strain on an already overstretched NHS.
It also suggests that health chiefs are braced for as many as 80% of Britons becoming infected with the coronavirus over that time.
Alzano Lombardo ist eine Ortschaft mit etwa 14.000 Einwohnern. Ein später verstorbener Patient hat das Corona-Virus in die Nothilfestation des lokalen Krankenhauses gebracht. Ärzte und Personal steckten sich an, und mit ihnen die Bevölkerung. Schon am 23. Februar wollte der Bürgermeister den ganzen Ort vorsorglich in Quarantäne schicken. Doch ein Ukas des Innenministeriums in Rom verbat Bürgermeistern, individuelle Entscheidungen zu treffen. Also wurde in Alzano gestorben, jeden Tag mehr
Wer Italien kennt, weiss was passiert ist. Die Nothilfestation, der Pronto Soccorso, ist eine italienische Institution wie der Espresso und das Rubbellos. Wenn immer man ein gesundheitliches Problem hat, geht man lieber zum Pronto Soccorso als zum Arzt, denn die erste Hilfe ist in der Regel schnell, kompetent und gratis.
Kein Wunder, dass der Pronto Soccorso von Alzano zur Virenschleuder mutierte. Die Lage mit dem tückischen Corona-Virus erinnert an die Pestzeiten noch im 18. Jahrhundert, als ein Besuch im Hospital als beste Chance galt, sich den Schwarzen Tod zu holen. Wer die Ansteckung mit dem Virus vermeiden will, bleibt Krankenhäusern und Arztpraxen möglichst fern. Aber das wussten die armen Lombarden von Alzano nicht.
“Non è giusto che papà sia morto così. Muoiono tutti come dei cani, come dei porci. Ancora oggi la gente dice che erano vecchi, erano malati: era mio padre c***o, non era vecchio e non era malato. Vaff*****o”. È questo lo sfogo di Roberta Zaninoni, figlia di Giuseppe, morto ad Alzano Lombardo (Bergamo) e risultato positivo al Coronavirus.
“Faccio più di 10 condoglianze al giorno ad amici e conoscenti su Facebook e le pompe funebri sono costrette ad ammassare le bare nelle chiese, come se i corpi fossero numeri. Per mio papà dovremo aspettare almeno tre settimane”, prosegue la donna.
"Es ist nicht fair, dass Papa so gestorben ist. Sie alle sterben wie Hunde, wie Schweine. Auch heute noch sagen die Leute, sie seien alt, sie seien krank. Er war mein .... Vater, er war nicht alt und er war nicht krank.". Dies ist der Wutausbruch von Roberta Zaninoni, der Tochter von Giuseppe, der in Alzano Lombardo (Bergamo) starb und positiv auf das Coronavirus getestet wurde.
"Ich spreche Freunden und Bekannten auf Facebook mehr als 10 Beileide pro Tag aus, und die Bestatter sind gezwungen, Särge in Kirchen zu stapeln, als wären die Leichen Nummern. Wir werden mindestens drei Wochen auf meinen Vater warten müssen", fährt die Frau fort.
Update IV
Scientists tracking the spread of the coronavirus reported on Monday that, for every confirmed case, there are most likely another five to 10 people in the community with undetected infections. These often-milder cases are, on average, about half as infectious as confirmed ones, but are responsible for nearly 80 percent of new cases, according to the report, which was based on data from China. (New York Times).
Update V
Der Bürgermeister von Bergamo, Giorgio Gori, sagt in einem Interview mit Huffpost:
In questa provincia il numero dei decessi a causa del virus è di gran lunga superiore a quello delle statistiche ufficiali. Molti malati anziani muoiono di polmonite a casa loro, o nelle case di riposo, senza che nessuno abbia fatto loro un tampone, né prima né dopo il decesso. Ho chiamato una dozzina di sindaci, per farmi un’idea: in quei comuni il numero dei decessi attribuibili all’epidemia è all’incirca quattro volte quello ufficiale.
In dieser Provinz ist die Zahl der durch das Virus verursachten Todesfälle viel höher als die offizielle Statistik. Viele ältere Patienten sterben zu Hause oder in Altersheimen an Lungenentzündung, ohne dass jemand vor oder nach dem Tod einen Abstrich gemacht hat. Ich habe ein Dutzend Bürgermeister angerufen, um mir eine Vorstellung davon zu geben: In diesen Gemeinden ist die Zahl der Todesfälle, die auf die Epidemie zurückzuführen sind, etwa viermal so hoch wie die offizielle Zahl.
Update VI
“Unfortunately we can’t contain the situation in Lombardy. There’s a high level of contagion and we’re not even counting the dead any more,” she (hospital nurse Daniela Confalonieri) said..
Leider können wir die Lage in der Lombardei nicht unter Kontrolle bringen. Der Umfang der Ansteckungen ist groß, und wir zählen nicht einmal mehr die Toten", sagte sie (Krankenhausschwester Daniela Confalonieri).
Update VII
«The real death toll for Covid-19 is at least 4 times the official numbers»
Nembro, one of the municipalities most affected by Covid-19, should have had - under normal conditions - about 35 deaths. 158 people were registered dead this year by the municipal offices. But the number of deaths officially attributed to the virus is 31.
Une entreprise bretonne, la société NG Biotech, lance un test de diagnostic rapide du coronavirus. En quelques minutes, il analyse une goutte de sang. Pour savoir si on a été contaminé dans le passé par le coronavirus, même sans présenter de symptômes, il existe une solution ; le test sérologique. En effet, les tests actuels réalisés avec un écouvillon dans le nez peuvent seulement faire état d’une contamination sur le moment. Grâce à une goutte de sang, le test sérologique permet lui de détecter les anticorps développés si le patient a été en contact avec le virus.
Eine bretonische Firma, NG Biotech, hat einen Schnelldiagnosetest für Coronaviren entwickelt. In wenigen Minuten wird ein Tropfen Blut analysiert. Um herauszufinden, ob man in der Vergangenheit mit dem Coronavirus kontaminiert wurde, auch wenn man keine Symptome zeigt, gibt es eine Lösung: den serologischen Test. Die derzeit durchgeführten Tests mit einem Abstrich in der Nase können nur Infektionen zu diesem Zeitpunkt nachweisen. Mit einem Tropfen Blut kann der serologische Test Antikörper nachweisen, die sich entwickeln, wenn der Patient mit dem Virus in Kontakt gekommen ist.
The Food and Drug Administration has approved a coronavirus testing kit from Bodysphere, one that can detect antibodies related to the virus in only two minutes. The test will be deployed in states around the country, enabling healthcare facilities to test for signs that the patient had contracted the virus at some point. The testing kit is only intended for use by medical professionals, however.
Update IX
So geht es auch...vielleicht Brief aus einem zentralamerikanischen Land
Hier haben die Leute keine Lust mehr auf Corona-Vorsichtsmaßnahmen: Ärzte behandeln Corona- Patienten ohne Schutzkleidung und für das sonstige Personal gibt es auch keine. Die Menschen sind draußen unterwegs, feiern Partys und halten kaum noch Abstand. Dennoch steigt die Zahl der Neuerkrankungen (offiziell) nur langsam. Schwere Fälle und Tote gibt es nur wenige.... Die Einheimischen sind der festen Meinung, dass nach Ostern die Sonderregelungen außer Kraft gesetzt werden. Wir hoffen also darauf, dass wir nur die leichte Corona-Variante bekommen, dass es wenige/keine Todesfälle geben wird und dass die Variante mit dem “Schutzwall“ klappt...
Ein Hauptgrund, warum SF mit seiner Viruskampagne so viel besser als NY abschneidet dürfte sein, dass SF kein öffentliches Massenverkehrsmittel besitzt, während das New Yorker Massen-Transportwesen Ansteckungen enorm fördert.
Written on .
Citing a report published by Chinese scientists,... a Chinese-language newspaper published in Hong Kong, Ming Pao, and the British daily, The Mirror, explained Sunday that the Wuhan Center for Disease Control, or WHCDC, could have spawned the contagion in Hubei Province.
According to the report penned by Botao Xiao and Lei Xiao of the South China University of Technology,... the research lab, which is only 280 meters away from the Huanan seafood market,... kept disease-ridden animals including more than 600 bats. It stated that while it's plausible the virus was leaked from the lab and contaminated initial patients in this epidemic,... more solid evidence is required through future study. The report also raised the possibility that theWuhan Institute of Virologycould have leaked the virus while it was carrying out tests involving Chinese horseshoe bats.
Against such a background,... an article published by the Washington Times late last month is garnering attention, as it raised the possibility that the disastrous outbreak could be the accidental result of biological weapons research.
This comes as a renowned law professor at Tsinghua University in Beijing, Xu Zhangrun, is known to be missing after publicly condemning Chinese President Xi Jinping for failing to contain the spread of the virus at an early stage. He even added the condemnation could be the last message of his life.
Now, a team of scientists from Xishuangbanna Tropical Botanical Garden of Chinese Academy of Sciences, South China Agricultural University, and Chinese Institute for Brain Research wrote in a paper published on ChinaXiv, about an alternative source of the coronavirus that is currently spreading across the globe.
The scientists say they have found genomic evidence that the seafood market is not the actual source of the outbreak. Instead, they point the source of the virus outbreak to a laboratory that studies potent viruses.
The Wuhan Virology Institute researches some of the world's most dangerous pathogens. It is China's first Biosafety Level 4 laboratory, the highest security level needed to isolate dangerous biological agents in an enclosed facility.
The novel SARS-CoV-2 coronavirus that emerged in the city of Wuhan, China, last year and has since caused a large scale COVID-19 epidemic and spread to more than 70 other countries is the product of natural evolution, according to findings published today in the journal Nature Medicine.
The analysis of public genome sequence data from SARS-CoV-2 and related viruses found no evidence that the virus was made in a laboratory or otherwise engineered.
“By comparing the available genome sequence data for known coronavirus strains, we can firmly determine that SARS-CoV-2 originated through natural processes,” said Kristian Andersen, PhD, an associate professor of immunology and microbiology at Scripps Research and corresponding author on the paper.
Chinese government researchers isolated more than 2,000 new viruses, including deadly bat coronaviruses, and carried out scientific work on them just three miles from a wild animal market identified as the epicenter of the COVID-19 pandemic.
Several Chinese state media outlets in recent months touted the virus research and lionized in particular a key researcher in Wuhan, Tian Junhua, as a leader in bat virus work.
The coronavirus strain now infecting hundreds of thousands of people globally mutated from bats believed to have infected animals and people at a wild animal market in Wuhan. The exact origin of the virus, however, remains a mystery.
"As China fights to prevent a second wave of COVID-19, two experimental vaccines will be trialed on humans, state media Xinhuareported on Tuesday.
The experimental vaccines are being developed by a Beijing-based unit of Nasdaq-listed Sinovac Biotech (SVA.O), and by the Wuhan Institute of Biological Products, an affiliate of state-owned China National Pharmaceutical Group"
Update V
"There is increasing confidence that the COVID-19 outbreak likely originated in a Wuhan laboratory,....
U.S. Embassy officials warned in January 2018 about inadequate safety at the Wuhan Institute of Virology lab and passed on information about scientists conducting risky research on coronavirus from bats, The Washington Post reported Tuesday."
"The Wuhan wet market initially identified as a possible point of origin never sold bats, and the sources tell Fox News that blaming the wet market was an effort by China to deflect blame from the laboratory"
Dass Ungarn das korrupteste EU-Land ist, bekommen wir mal wieder amtlich. Es steht im 2018er OLAF-Bericht, der EU-Antikorruptionsbehörde. Konsequenzen hat das keine, OLAF kann die Akten nur weiterreichen, Ungarns Generalanwalt Péter Polt hält für sie mehrere Schredder-Anlagen (finanziert mit EU-Geldern) bereit. Die lobenswerte Initiative einer EU-Generalanwaltschaft (EPPO) mit nationalen Durchgriffsrechten kommt indes nicht voran.
2018 hat OLAF 167 Untersuchungen durchgeführt und mit 256 Empfehlungen abgeschlossen, 9 davon fielen auf Ungarn, bei 7 davon wurde eine Anklage empfohlen. Insgesamt empfhielt man der EU, von Ungarn 371 Millionen gestohlene Euros zurückzufordern, eine bescheidene Summe, wir haben für die betreffende Periode von 2014-2019 rund das Zehnfache kalkuliert - pro Jahr. WIE DIE EU DEN MAFIA-STAAT UNGARN FINANZIERT.
OLAF selbst hat offenbar aufgegeben, der Chef spricht von "Dialog und Kooperation" als die Mittel der Wahl, um gegen den Missbrauch von EU-Mitteln vorzugehen. Ein netter Versuch.
Die ungarische Regierung bedankte sich artig für den Bericht von OLAF, der belege, wie schlimm die Korruption unter den sozialistischen Vorgängern gewesen sei (bis 2010 an der Macht). Alles, was man der jetzigen Regierung vorwerfen wolle, seien "Racheakte der Wahlverlierer", so Tamás Deutsch oder eben eine "Einmischung in ungarische Angelegenheiten".
Fazit: Die EU ist nicht gewillt, Korruption und Betrug seitens ihrer Mitgliedsländer zu ahnden, auch nicht die strukturelle Kleptokratie eines Orbán. OLAF ist so sinnlos, die EU macht sich lächerlich und verliert weiter an Autorität. Auch die rechtsstaatlichen Verfahren (Sargentini-Bericht, Artikel 7) kommen nicht voran, unter Von der Leyen und ihrem Team ist das auch nicht vorgesehen. Orbán gewinnt.
L’Italia non cresce perché il sistema è schiacciato dalla burocrazia e dall’inefficienza dell’amministrazione pubblica? O le cause sono altre? Un libro di Paolo Sestito e Roberto Torrini cerca di rispondere a queste domande. Ne pubblichiamo un estratto.
Un’industria poco innovativa
[…] Sarebbe semplicistico e sbagliato identificare nel (mal) funzionamento del mercato del lavoro la ragione principale della bassa crescita italiana. […] Il fattore di sviluppo più rilevante nel lungo periodo è la crescita della produttività del lavoro, che dipende soprattutto dalla capacità innovativa delle imprese e dal sostegno che il sistema istituzionale di un paese è in grado di offrire a quelle più dinamiche, anche penalizzando le posizioni di rendita che scoraggiano l’innovazione. […]
La dinamica fiacca della produttività dipende innanzitutto da scelte organizzative e manageriali delle imprese e degli imprenditori ed è quindi da ascrivere ai loro comportamenti e al modo in cui il contesto economico li condiziona. Da questo punto di vista, va ricordata quella che è forse la caratteristica più peculiare del nostro sistema produttivo, ovvero la sua estrema frammentazione in imprese di piccola e piccolissima dimensione, a cui si associa una quota di lavoratori autonomi che è la più elevata tra i paesi avanzati (doppia rispetto al dato medio europeo). Le imprese italiane nel settore privato non finanziario hanno una dimensione media di appena 3,9 addetti contro i 6,9 dell’Unione Europea; quelle con meno di 10 addetti impiegano il 47 per cento degli occupati contro il 29 per cento medio dell’Unione. Specularmente, le imprese sopra i 250 addetti sono molto poche e relativamente piccole, con una quota di occupati di poco superiore al 20 per cento contro valori superiori al 30 nei principali paesi europei.
A lungo questa specificità nazionale non è stata percepita come un ostacolo allo sviluppo, o almeno si è ritenuto che la peculiare organizzazione produttiva dei distretti industriali italiani potesse controbilanciare i vantaggi derivanti dalle economie di scala, e non solo, goduti dalle grandi imprese. Il quadro è mutato però radicalmente sul finire degli anni Novanta, quando le difficoltà crescenti del sistema produttivo nell’affrontare la rivoluzione tecnologica dell’Ict e la globalizzazione hanno messo sempre più in luce i limiti di un modello basato sulla piccola impresa. […]
Lo scarso dinamismo d’impresa in Italia non è principalmente legato al numero delle nuove imprese che entrano nel mercato. Rispetto ad altre economie avanzate, le nuove iniziative imprenditoriali, pur numerose, sono però caratterizzate da una scala produttiva più ridotta e da una minor propensione a crescere nel tempo […]. Inoltre, le nuove imprese mostrano una minor probabilità di uscita nel caso l’iniziativa imprenditoriale si riveli poco redditizia. […] Sembra quindi che il problema più rilevante non sia costituito dagli ostacoli all’ingresso nel mercato, anche se gli oneri burocratici che gravano sulle nuove iniziative imprenditoriali non devono essere sottovalutati, quanto piuttosto di qualità delle nuove imprese e di efficacia dei processi di mercato che dovrebbero favorire la sopravvivenza e l’ascesa di quelle migliori. […]
Le iniziative dei governi
[…] Sono tre le aree in cui i governi si sono impegnati nell’ultimo decennio, da un lato per migliorare direttamente la performance delle imprese e dall’altro per costruire un ambiente più favorevole alle attività economiche.
[…] Le iniziative che hanno tentato di sollecitare l’innovazione nelle imprese italiane sono motivate dall’idea che, se queste da sole non garantiscono un adeguato livello di innovazione, il sostegno pubblico, anche a mezzo di generosi incentivi, possa dare una scossa positiva al sistema. La letteratura teorica offre una giustificazione a incentivi rivolti agli investimenti in innovazione, in quanto si ritiene che questi abbiano significative ricadute positive sull’intero sistema: nei casi in cui i benefici collettivi sono superiori a quelli percepiti dai singoli investitori, gli esiti spontanei di mercato non garantiscono il raggiungimento dei livelli ottimali di investimento, giustificando così l’intervento pubblico. Questo spiega, ad esempio, perché l’Unione Europea autorizzi gli stati membri a sostenere l’attività innovativa delle imprese in deroga alle restrizioni sugli aiuti di stato. Ma ovviamente, non fosse altro per il fatto che la disponibilità di fondi pubblici è per definizione sempre limitata, occorre interrogarsi sull’efficacia e sull’efficienza di questo tipo di incentivi: i sussidi in questione innescano meccanismi autopropulsivi o finiscono per coprire spese che sarebbero state comunque effettuate dalle imprese beneficiarie?
[…] Altre misure intervengono sull’ambiente in cui operano le imprese, senza in linea teorica richiedere aggravi di spesa. Si tratta delle misure di semplificazione e snellimento delle procedure amministrative, autorizzative e di altro tipo […]. L’idea sottostante è che gli oneri burocratici siano un peso che grava sulle attività produttive e che ne scoraggia gli investimenti. […] Anche in questo caso la valutazione degli interventi non è facile. Da un lato, infatti, il costo implicito per le imprese può essere molto diverso a seconda della modalità di intervento della pubblica amministrazione; dall’altro, alcune regole sono comunque necessarie per salvaguardare interessi rilevanti e i problemi non derivano tanto dalla loro esistenza quanto dagli extra-costi e dall’incertezza generata da regole farraginose e da amministrazioni inefficienti nella gestione dei processi amministrativi. […] La questione della burocrazia deve quindi essere vista come un problema di efficienza delle amministrazioni e, ancora più a monte, come un problema di qualità della regolamentazione.
[…] Le riforme della pubblica amministrazione si sono spesso focalizzate sul tentativo di rivedere il regime del pubblico impiego […]. In particolare, si è a più riprese intervenuti sulla relazione tra Pa (in primis i loro vertici amministrativi) e decisore politico, pensando che questo fosse lo snodo chiave per imprimere un cambiamento sostanziale. Gli interventi in questo campo sono stati spesso intrapresi con l’idea che si potessero ottenere grandi risultati senza costi per le finanze pubbliche o addirittura che da questi potesse derivare un risparmio di spesa – incrociando così il dibattito della riforma della Pa con l’annosa questione della spending review. Tuttavia, […] il tentativo di riformare a costo zero e per via prevalentemente normativa la Pa si è per molti aspetti rivelato velleitario. Sprechi e inefficienze sono certamente presenti, ma per conseguire significative riduzioni di costo e aumenti di efficienza sono comunque necessari importanti processi di riorganizzazione e magari sostanziosi investimenti (dall’adozione di nuove tecnologie allo svecchiamento e formazione del personale), senza i quali è difficile immaginare di ottenere risultati.
Some time ago, our predecessor magazine german.pages.de -- Deutsche Rundschau wondered what life would be like in the still distant year 2020. Staff author John Wantock, writing under his pen name J.P. Eckermann, summarized his expectations in a letter to his old friend John W. Goethe.
Johann P. Eckermann to John W. Goethe
February 29, 2020
Dear W,
A brief update on our life in poor old Germany where all forces of nature seem to combine to make us more miserable. However, let me assure you that we don't pity ourselves; instead we remain cheerful and continue enjoying life to the fullest!
Our new house is now almost finished; we are already occupying the ground floor. I am so glad my son and my granddaughters agreed to share servicing the 70-year mortgage of 4 million euro. That's what it costs today to build a small passive house even though the land is provided free by the city as a subsidy to modern home construction.
The contractor assures me that the insulation of our passive house will be so perfect that not only we don't need any heating but that we will be able to sell energy to the city circuit resulting from cooking and our body heat radiation. Selling up to 10,000 calories/day to the city will nicely help pay the mortgage.
I am again mobile because I managed to purchase a second hand diesel Vespa which consumes about one liter (1 quart) of rapeseed diesel per 100 kilometres (about 55 miles). I am confident we can make ends meet because I have applied for a garden plot on the former Munich-Garmisch autobahn where we can grow some rapeseed.
Sorry, I forgot to mention that one track of the autobahn is being removed because there is not enough traffic anymore. Instead, they are putting in an underground pipeline to bring rapeseed oil from the countryside to Munich. Since truck transport of oil has become too costly, Europe is now criss-crossed by pipelines put underground to prevent theft. The land above the pipeline is leased out as private gardens to single parents, former industrial workers and other needy people like me.
This will be a tremendous blessing for us because the overpopulation of Germany starts threatening our bare survival. Don't forget that after the dykes broke due to the recent fast rise in ocean levels, Germany lost some 20 percent of its territory to the North Sea and the Baltic. All those refugees from the densely populated sea shores are now living in slums circling the cities. In addition to the Germans there are millions of poor wretched Dutch who lost the entirety of their country. Flemish from former Belgium, Danes, Poles and lots of Russians from former St. Petersburg are also living here.
You blessed Americans with your vast oil reserves in West Africa and the southern Caucasus (sorry for the victims of the recent Chechen ambush on the Batum pipeline) cannot possibly imagine what it means if most land must be used for energy production rather than food. Our forests are being slashed at high speed; a new coal mine is opened every month. Despite burning all these primitive fuels we have no environmental problem anymore because of the virtual disappearance of industry, automobile and air traffic. Also, modern railroad coal engines and home coal furnaces are much more efficient than the 20th century types. Most of the remaining trucks are now wood-powered, a World War II invention which generates gas from wood pellets to run a combustion engine.
In many areas of Germany there are still plenty of old windmill electricity generators which are now being restored to serve local communities. Many more of the wind generators, unfortunately, were lost to the rising seas. People lucky to own such a windmill have adapted to living during doldrum periods. New types of fridges can store cold for up to seven days without being recharged. Supermarkets are also selling rechargeable 48-volt batteries which can provide xenon lamp lighting for a home for about a week.
As you can see, most of this is relatively manageable. What is really hard for us is the shortage of food. Since rapeseed oil is the most profitable crop, most farmers are growing food only for domestic and local consumption. A lot of oats is also grown for the horses now poisoning our city streets with their repugnant odors, not to mention of the noise of their hooves on the tarmac.
Lucky those who own a small garden. Compost is the fertilizer of choice since mineral fertilizers, pesticides and the like have virtually disappeared as a consequence of the energy squeeze and the resultant de-industrialization. In the absence of mineral fertilizers, the nutrients stored in the soil have been consumed in a few years and farm yields returned to 19th century levels. People have nostalgic dreams of the old days when food was plentiful and Germany seemed to be in danger of over-aging and depopulation because of its low birth rates.
With a larger than our present population of 65 million in the remaining territory, Germany could never have absorbed the 25 million environmental refugees. And, imagine, 5 million Italians from Padania are said to be on their way northbound. They think Bavaria is an Italian province. If they really come, then buona notte, dear W.
Next time I shall report to you on progress at the Cologne wharves in building a modern wind powered ocean liner which promises to make trans-Atlantic travel again possible at reasonable rates. Maybe I could visit you and remain there.
