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The first Minister Giuseppe ConteDuring his communications to the Chamber on Monday, November 2, he explained that the government intends to launch a new Dpcm (Decree of the Presidency of the Council of Ministers) to combat the pandemic.
Within this Dpcm, it should take effect for Wednesday (and therefore, it must be reiterated, not yet officially released), Conte described a new rule system which will be based on a classification of the Regions in three risk scenarios, with increasingly restrictive measures.
How will the risk areas mechanism work?
The premise from which to start is that, according to what was reported by the Prime Minister, the epidemiological framework in which Italy is in transition to scenario 4.
What is scenario 4?
Define the different scenarios – the 4 most serious – the Covid-19 Prevention and Response Plan prepared by the Higher Institute of Health: a document that provides, in fact, different scenarios and the related measures to be implemented based on the progress of the epidemic. Scenario 4 is presented in cases of uncontrolled transmissibility with criticality in the stability of the health system in the short term.
What is the definition of who we are in scenario 4?
One of the parameters that is taken into account is the Rt contagion index, which is evaluated Region by Region: the alert is activated when the level of 1.5 is exceeded, and there are 13 – at this moment – the Regions that The Iss are above the threshold: Calabria (1.66), Emilia Romagna (1.63), Friuli Venezia Giulia (1.5), Lazio (1.51), Liguria (1.54), Molise (1.86) , Province of Bolzano (1.96), Province of Trento (1.5), Puglia (1.65), Umbria (1.67) and Valle d’Aosta (1.89).
Two Regions even exceed 2: Piedmont, at 2.16, and Lombardy, at 2.09.
The index It is not by the only criteria: To determine entry to scenario 4, a high incidence of cases and clinical severity must be registered, with sustained pressure on the prevention and health services departments in the different regions. Conte explained for example: There is another probability that 15 regions will exceed critical thresholds in ICU and medical areas in the next month.
What does scenario 4 imply? What are the areas?
Scenario 4, again within the ISS document, is divided into three bands or risk areas:
– moderate (we will call it green for convenience: the term is not in the ISS document);
– high / very high for less than three consecutive weeks (orange);
– high / very high for more than three consecutive weeks, and unmanageable situation (rossa).
On the basis of what is a Region included in one of these three areas?
To define the classification of a Region in one of these areas / bands are, said the Prime Minister, 21 criteria, which will define a risk ratio: among these, said the premier, the number of symptomatic cases, hospitalizations, cases in RSA, the percentage of positive swabs, the average time between symptoms and diagnosis, the number of new outbreaks, the occupation of beds on the basis of availability real.
Who will establish a Region in one band or another?
It will be determined by the Ministry of Health – The inclusion of a Region in one of the three areas, with the consequent automatic activation of the planned measures, will be carried out by order of the Minister of Health.– Conte said – on the basis of a weekly follow-up, in coordination with the president of the Region himself.
How long will a region stay in an area, for example red or orange?
It will depend on the data: the input and output mechanism in one category or another – said Conte – it will be automatic. Therefore, the activation of the measures that will be triggered, progressively, at the entrance of a Region in a band will also be automatic.
What will be the measures that will be initiated in the different bands?
We don’t know yet: the government will have to discuss it with the Regions.
What can be deduced from what Conte said is that for the Regions in the green category, the measures adopted at the national level will be valid (for example: the limits to the movement of people in the afternoon – the so-called curfew -, the closing of shopping centers on holidays and weekends, the closure of playrooms and bingo and gods museums, the 50% reduction in public transport capacity, etc: all measures not yet officially confirmed, but talked about by the Prime Minister in Parliament).
If the Region falls into the orange category, the more restrictive measures will automatically take effect; if it then went to the red category, the measurements would be even more rigid.
In the latter case, the ISS document spoke, for example, of generalized restrictions with extension and duration to be defined with respect to the epidemiological scenario, together with mobility limitations to / from the affected areas, but also the closure of school / university structures , always for the extension and duration that the advance of the epidemic requires, and activation of distance education whenever possible.
Conte specifically spoke, in the House, of a Limitation of the movement of people to and from the Regions considered at greatest risk..
In the last hours, hypotheses have circulated regarding other regulations related to the belonging of a Region to the zones / bands with the highest risk: among others, the possibility of extending distance education to middle schools, the closure of stores and commercial activities (except for essential activities such as pharmacies, food, kiosks), the closing of bars and restaurants also for lunch.
These measures, it bears repeating, have yet to be confirmed.
When will each Region know which band it is in each week?
The data will arrive weekly, along with the monitoring of the Higher Institute of Health (which is usually published every Friday afternoon).
If a region meets the criteria to enter risk areas, the ordinance of the Ministry of Health and the Governor of the Region would take effect immediately, automatically.
The permanence of a Region in one or another band will be established weekly: in short, a Region can be red one week, orange the next, or vice versa.
It should be noted that the two groups with the highest risk: high / very high for less than three consecutive weeks me high / very high for more than three consecutive weeks – they are also determined on the basis of a time variable: to enter the red area, a Region will need to have highly negative data for more than three weeks in a row and therefore restrictive measures should not be completely unexpected.
At the moment, as it does not have the 21 criteria from which the risk factor will be determined, nor the weight that will be attributed to each criterion, the Messenger Service not being able to independently determine if there are already Regions that would fall within the red band, or if very negative values have already been recorded for two weeks, which would take – in case of confirmation of the data next Friday – automatic entry in the Red zone.
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