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Between November 20 and 25, the autonomous province of Bolzano organized a massive test to isolate asymptomatic positives and block the transmission of the coronavirus. 3,619 positives were found, 1% of the 362,050 people who participated in the test. 530,000 people live in South Tyrol, so the membership was very high. However, a month later, the data shows that not everything went according to plan.
In Alto Adige the situation has improved, as in almost all regions of northern Italy after the restrictive measures adopted in November, but the R indext it is still above 1 and the autonomous province became a yellow zone only on Sunday December 20, along with Tuscany and Valle d’Aosta. To understand whether the mass test worked, it is important to explain what was predicted and what happened instead.
– Read also: South Tyrol goes alone
What were the predictions
The massive test was announced as the only way to reduce the number of new cases in a few weeks, reduce the pressure on intensive care units, improve all the indicators used by the technical-scientific committee to assess the progress of the epidemic. . Ultimately, the goal was to get out of the red area by Christmas. “It is the turning point to get out of the red zone and for a fairly quiet Christmas,” said the president of the autonomous province, Arno Kompatscher.
On the first day of testing, when it was already clear that adherence would be high, Tourism Councilor Arnold Schuler even raised the hypothesis of a reopening of the ski lifts in mid-December. The head of the mass testing project, Dr. Patrick Franzoni, had given precise figures: “The goal is to bring the R indext from 1.5 to 0.5 ».
According to the forecasts of the experts, the effects of the massive test would be comparable to those of a severe blockade, such as the total closure of March and April. Markus Falk, a biostatistician who collaborates with the Eurac research center, had published some forecasts. According to their estimates, a 70% stake would have lowered the R indext to 0.5 by December 8. However, without massive testing, the R indext it would have remained at 0.9 and a total or partial lock would have been required, at least until March. There were high expectations, and it’s the main reason so many South Tyrolese participated.
The Eurach Research Table with Expected Infection Clearance After Mass Testing
What happened instead
Many of the predictions made in mid-November did not come true. For example, the R index.t it is one of the indicators that has not dropped significantly. According to the latest bulletin of the Higher Institute of Health, in the week of December 7 to 13 the Rt punctual in the autonomous province of Bolzano is at 1.05. The value of the transmission index is higher than the 0.67 registered in the previous week, from November 30 to December 6.
In the first week of December, the Rt It came close to the estimates made before the test, but then rose again. It is no coincidence that the value, increasing in South Tyrol, was highlighted in bold in the latest ISS bulletin. Even the number of “currently positive” people did not have the expected decrease: on Sunday, December 20, there were 10,874 positive people in South Tyrol. On December 13, the “currently positives” were 10,599. Since Monday, December 21, however, there has been a problem with the data (let’s get back).
The number of people in home isolation is also growing: on Sunday, December 20, according to data published by Civil Protection, there were 10,684. This figure rose again after the drop in early December, ten days after the massive test.
This graph shows the evolution of the number of people in home isolation, in the autonomous province of Bolzano, from October 20 to Sunday December 20.
The situation in hospitals
In November, the test had been organized at a very difficult time for the hospitals in South Tyrol, in particular for the Bolzano hospital. The intensive care, in fact, was full of patients. New beds had been added, however, not enough to respond to the large influx of new critically ill patients. Doctors and nurses were under pressure and many health workers fell ill, compounding an already complex situation. At the moment it seems that the situation of a month ago is no longer there, but the emergency has not ended.
The latest update released by the South Tyrol health authority says 22 people are hospitalized in intensive care, two more than on Sunday, December 20. 179 patients are hospitalized in a non-critical area. According to the National Agency for Regional Health Services, 26% of ICU places are occupied by patients with Covid-19. The alert threshold is conventionally set at 30% and in the last twenty days the autonomous province of Bolzano has frequently exceeded 40%.
The trend of pressure on intensive care in South Tyrol (Agenas)
But there are also many problems related to the anomalous trend of this data, which shows sudden fluctuations. For example, the number of patients hospitalized in non-critical areas monitored by Agenas has reached 100%, so that for a few days more places than those available would have been occupied. In three days, the bed occupancy rate dropped to 45%. In the last week, even the daily data of the people cured and the currently positive cases have suffered anomalous variations: according to the data published by Civil Protection, 1,568 would have been cured on Monday alone. An unlikely figure, a sign of a collection or transmission problem.
The graph showing the anomalous trend of employment percentages in departments of non-critical areas in South Tyrol (Agenas)
On December 11, ASL health director Pierpaolo Bertoli said that hospital stays have been reduced by 20% and cases of intensive care by 24%. The general manager of the South Tyrol health company, Florian Zerzer, explained that finding 3,619 asymptomatic positives with the mass test prevented more serious consequences. “We know that 5% of the positives need hospital care, so thanks to the massive tests we avoided 180 hospital admissions and 18 admissions to the ICU,” said Zerzer. “With an approximate calculation, we can say that these 3,619 positive people would have infected about 75 thousand people.”
Some possible explanations
It is difficult to find a precise explanation for the failure to comply with the forecasts for new infections. The coronavirus cannot be explained by numbers alone, and the factors that affect the transmission of the infection are many. According to Markus Falk, the decline in the Rt in the two weeks after the massive test it may have been an optical illusion. In other words, the number of new infected could have decreased “artificially”, because the positives of the massive tests have been quarantined without the confirmation of the classic molecular swab. Therefore, by not making the positives flow to the official monitoring of the data and by altering the calculation of the R indext. «At the beginning the index Rt it fell almost vertically, then the fall continued, but not as steep as we expected, ”explains Falk. “By adding the cases detected with the antigen test and the molecular swab, we can see that the R indext it was unchanged before and after the massive test. We have managed to reduce the pressure on hospitals, but not eliminate the contagious potential.
The reopening of restaurants, bars and shops, since last December 4, has not helped. In fact, one of the recommendations made before the massive test was the need to continue with preventive measures, such as distancing, to allow the campaign to have positive long-term effects. “But I think the effect of the massive test is over,” says Falk.
People waiting for the first day of testing in Bolzano (Il Post)
The new ordinance
In South Tyrol, Christmas will not go out of the red zone, as expected a month ago. The reaction to the non-reduction of infections came with a new provincial ordinance, signed on Monday, December 21, which provides different norms from the national ones. Some measures are stricter than those approved by Prime Minister Giuseppe Conte, others are less restrictive. For example, in the province of Bolzano all stores will be closed from January 24 to 6. The only exceptions: grocery stores, pharmacies, hairdressers. Bars and restaurants will also be closed, but takeout and home delivery services are always possible.
However, compared to the rest of Italy, South Tyrolese will be able to move freely within the provincial borders, without being banned from leaving the municipality. “We want to allow a healthy freedom of movement and therefore people must be able to move freely within the provincial borders during the holiday period,” said the president of the autonomous province Arno Kompatscher. It is important to move outdoors, take a trip and be able to enjoy the winter landscape, because it is good for the body and the spirit, of course always complying with current safety and hygiene regulations ”.
Unified rules should apply in South Tyrol from December 24 to January 6. Shops, bars and restaurants closed throughout the period. More freedom of movement than the rest of Italy.
➡️https: //t.co/O2bFAcGPfI pic.twitter.com/hSFsK2pAkj– ProvinceBolzano (@ProvinciaBZ) December 19, 2020
The path of mass testing has not been abandoned, although it will continue in a different form. In fact, “phase 2” started two weeks ago, that is, a new screening campaign. This time, the entire population is not analyzed, but four thousand people drawn and summoned to undergo an antigen test once a week for four weeks. “With the project ‘Rapid tests in South Tyrol’ we have obtained a global vision of the progress of infections; now, in the next four months, we are going to test more than 20,000 people ”, explained the provincial health councilor Thomas Widmann at the press conference called for the presentation of the project.
The objective of the autonomous province is to have new data to keep the transmission of the infection under control in real time and to quickly understand if the positive curve grows rapidly again. In that case, new massive tests will be organized locally to identify asymptomatic positives and isolate them.
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