Intensive care and Rt index: Lombardy problem

“The decline in intensive care admissions in Lombardy is slower than expected and than we expected: we expected to reach 500 beds by Christmas (the December 10 figure indicates a total of 748 intensive care hospitalizations, ed), but with this trend we will need more time ”. To tell HuffPost is Antonio Pesenti, head of anesthesia and resuscitation at the Policlinico di Milano and coordinator of intensive care in Lombardy.

“Contrary to what happened in April when, in total confinement, the decline was faster – emphasizes Pesenti – today the numbers are slowly decreasing. My concern is what will happen with the arrival of Christmas and that will depend to a large extent on the behavior of the citizens ”.

A situation, that of Lombardy, which attracts attention especially on the eve of the “color change” in the Region and the consequent relaxation of restrictions. “As of Sunday (December 13, ed) Lombardy will officially be the yellow zone. Minister Speranza informed me that, as in previous times, he will sign the ordinance on Friday, on Saturday it will be published and on Sunday it will come into force, ”the president of the Attilio Fontana Region anticipated in the last hours.

“If the measures of the yellow zone are respected and strictly enforced by our fellow citizens, they could be enough to avoid what happened in October, after we had a summer in which we were a little too liberated,” Governor Fontana said today. “The third wave? This – Fontana explained on the sidelines of a press conference in the Region – is a question that should be addressed to the experts. I believe these decisions have been made wisely and carefully by people involved in fighting the epidemic. The yellow zone that maintains the limitations is close to the ordinance that I signed on October 22 that determined a stabilization “of the contagion curve.”

Professor Antonio Pesenti, who coordinates intensive care in Lombardy, emphasizes: “We know that the less strict the measures are, the greater the number of patients. It is about understanding where common sense will choose to place us: it is clear that we will not be able to reach zero infections, unless we opt for a total closure such as that of March and April, but it is necessary to obtain a reasonable contagion rate. Also for the good health of the medical-health system ”. “One element to draw attention to is that recent restrictions have reduced the number of new infections relatively little: this may be due to the choices and behavior of individuals, who do not always respect the rules,” continues Pesenti.

On the new wave of Covid-19, the head of anesthesia and resuscitation of the Milan Polyclinic states: “The high probability of a third wave, which has already started in many countries of the world, is widely recognized. I trust that Italians understand that, during the Christmas holidays, it will be good to opt for sobriety while remaining as restricted as possible ”.

Therefore, the next few weeks will be decisive in determining and understanding the trend in the first days of 2021. It is not only the number of intensive care units that is modestly improving in Lombardy. The Rt index is also paralyzed: today Arturo Artom, engineer and founder of Confapri and physicist Roberto Battiston reported it in the pages of the Corriere della Sera.

For about ten days, experts point out, in the region the Rt index, a number that indicates how many people are infected by a single person, on average and over a certain period of time, has stopped falling. After reaching its low since early fall around Nov 25 (below 0.7), the Rt index continues to fluctuate around 0.8. A number in stasis that fortunately remains below 1 but which, according to experts, represents an element to be analyzed.

“If we consider that the number of infected represents the effect of social dynamics dating back about ten days before, we understand how the rapid resumption of infection since the beginning of October and that we identify as the ‘second wave’ is not due to summer behavior , but to what has happened in our cities since mid-September, that is, the reopening of offices and the resumption of school activity “, write Battiston and Artom in Corriere.

The RT then declined again around October 23, in Lombardy and throughout Italy. “If we look at the cause of this sudden change of course, we discover that ten days earlier, on October 13, the Dpcm had entered into force with new restrictive measures,” the experts emphasize.

In the future, on November 6 the country was divided into red, orange and yellow zones. “The effects of this measure that introduces very severe measures in the red regions – say Battiston and Artom – do not seem to lead to major improvements in the rate of descent of Rt.

And as of November 27, the RT stops, never goes down. But what is the reason? Scientists put forward the hypothesis: “it cannot be ruled out that the new measures have had counterproductive effects: forcing the inhabitants of medium-large cities within the limits of their municipalities may have in some way favored new contacts or encounters to determine the resumption of contagion “.

Today, December 10, 2,093 cases of coronavirus and 172 deaths were recorded in Lombardy. Deaths have risen to 23,449 since the start of the epidemic. The swabs performed were 24,229, in total 4,350,769. Yesterday, compared to 14,174 swabs performed, there were 1,233 positives and 69 deaths.