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Italy has reported more than 12,000 coronavirus cases. Photo: Carlo Hermann/AFP via Getty Images

The coronavirus outbreak in Italy has gotten so bad so quickly that some doctors are now forced to practice "catastrophe medicine" — determining which severely ill patients should, and should not, get care based on the resources available.

Between the lines: The U.S. is not at that point — but a week ago, neither was Italy. The rapid deterioration there underlines the importance of taking preventive measures seriously, and the need for political and health leaders to start thinking about hard ethical questions.

Where it stands: The rapid spread has forced Italian leaders to quarantine the entire country and close all shops except for pharmacies and grocery stores. The Italian health care system, which many experts hold in high regard, is overworked.

  • The severity of the virus in Italy contributed to the Trump administration's travel ban, but it was not the sole catalyst, administration officials told my colleague Alayna Treene.

What's next: There are several theories as to why cases exploded so dramatically in Italy, but the answers aren't clear right now. In the meantime, experts say the biggest lesson for Americans is that trying to limit the virus' spread — mainly by limiting contact with potentially infected people — really is important.

  • "When you have a real hot spot like [Italy], nobody has the time to do anything but cope with what's in front of them," said Arnold Monto, an infectious disease doctor and epidemiologist at the University of Michigan. "The only thing we can do, and the only rational thing to do, is social distancing."

Yes, but: The U.S. has no national plan for how to ration care if intensive care units and ventilators are all in use. State leaders and hospitals would need to write down actual policies now to avoid making those decisions on the fly, like Italian officials have had to.

  • "You cannot have that conversation in the midst of the crisis," said Alan Regenberg, a bioethicist at Johns Hopkins. "That is absolutely not the right time."

The bottom line: Shutting down schools, closing cultural spots, suspending sports and staying at home will upend people's lives in the short term, and hypothesizing who should get lifesaving care is an ethical nightmare.

  • But these decisions are likely the best shot the U.S. has to prevent out own outbreak from turning into Italy's dire situation.

Go deeper

Mike Allen, author of AM
1 hour ago - Economy & Business

Charted: GOP surged as Biden slumped

Expand chart
Reproduced from Gallup. (Independents were asked their party leaning.) Chart: Axios Visuals

Gallup polling found a huge shift in party preference over the course of 2021, from a 9-point Democratic advantage in the first quarter to a 5-point Republican edge in the fourth quarter.

Why it matters: It's the biggest swing in one calendar year for Gallup's 30 years of tracking.

Miriam Kramer, author of Space
1 hour ago - Science

A new NASA astronaut corps for the next era in space

Illustration: Aïda Amer/Axios

NASA's next crewed missions to the Moon will need a larger, differently-trained and multi-skilled astronaut corps to deliver on the agency's ambitions.

Why it matters: NASA has plans to fly astronauts to the surface of the Moon in 2025 and ultimately establish a long-term presence there. That goal requires a robust corps with new, specialized training in what it takes to live and work on the Moon — and NASA needs to start planning now.

China builds its own movie empire

Expand chart
Data: Gower Street citing Comscore; Chart: Kavya Beheraj/Axios

China blocked all four of Disney's Marvel movies from being released in its theaters last year, a grim sign for U.S. film giants being squeezed out of the world's fastest-growing box office.

Why it matters: The Chinese Communist Party is using domestic films as a key conduit for mass messaging aimed at achieving political goals, leaving little room for foreign views.