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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

3 hours ago - World

India records its deadliest day of the pandemic

A health worker moving an oxygen cylinder in a coronavirus ward of a hospital in New Delhi on May 8. Photo: Raj K Raj/Hindustan Times via Getty Images

India saw its deadliest day of the pandemic yet with more than 4,180 confirmed COVID-19 deaths reported Saturday.

Why it matters: The country has recorded more than 21.8 million coronavirus cases and 238,270 deaths since the pandemic began. The true numbers, however, are likely much higher, experts say, as the country battles a continued surge in cases that has left hospitals and health workers overwhelmed.

Updated 3 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Annelise Capossela/Axios

  1. Health: The end of quarantine — CDC updates guidance on airborne COVID-19.
  2. Politics: Oklahoma secures $2.6 million refund for hydroxychloroquine purchase — Why Biden's latest vaccine goal is his hardest yet.
  3. Vaccines: Pfizer begins application for full FDA approval of COVID-19 vaccine — Moderna says its COVID booster shot shows promise against variants.
  4. Economy: U.S. adds just 266,000 jobs in April, far below expectations.
  5. World: Asia faces massive new COVID surgeIndia records its deadliest day of the pandemic.
  6. Variant tracker: Where different strains are spreading.
Updated 4 hours ago - Energy & Environment

Ransomware attack forces shutdown of major U.S. fuel pipeline

A police officer stands guard inside the gate to the Colonial Pipeline Co. Pelham junction and tank farm in Pelham, Alabama, in 2016. Photo: Luke Sharrett/Bloomberg via Getty Images

A major U.S. fuel pipeline running from Texas to New York has been taken offline by its operator because of a ransomware attack, Colonial Pipeline said Saturday.

Why it matters: It's a significant breach of critical infrastructure and comes on the heels of multiple other major cyberattacks on both U.S. companies and the federal government.