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On January 7 we return to the color system of Regions decided on the basis of the 21 indicators that assess the progress of the epidemic of SARS-CoV-2. The “special period” ends, with the red and orange days the same for everyone during the Christmas holidays. But how do we start over? With the lowest level of yellow everywhere, unless the control room meeting is anticipated, scheduled for Friday, January 8, when the new report cards will be written and the new colors decided. Finally, on January 15, the government regulation that regulates the system expires and the 21 indicators could be revised. Not just in the direction requested by the Regions, which are also pushing to insert fast buffers when evaluating the ability to track. The Ministry of Health realized that having set the minimum level of RT (the virus transmission index) at 1.25 to enter stage 3 with a possible transition to the orange band and 1.50 for stage 4 and red band, may be ineffective. There is a risk of intervening late, when a region is now in trouble. The Veneto case, after all, demonstrates the limits of the mechanism.
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RESILIENCE
The Zaia region has experienced a very intense spread of the virus, however, precisely because of the RT system, but also because of a good response from the local health system, it has always remained yellow and this may not have helped it. In the last report on December 31st, the point RT was at 1.07, certainly alarming because it was above the critical level of 1, but not enough to trigger the orange band. The evolution of the situation will be evaluated on January 8, but the procedure will be reviewed in the coming weeks. The technicians propose the hypothesis of lowering the value of RT that provides the countermeasures to 1.1, but balancing this figure with that of the incidence, that is, the number of new positive cases per 100,000 inhabitants in the last 14 days. The virtuous value is expected to remain below 50, today Italy is at 305, Veneto at 968, Lazio at 285, Abruzzo at 168, Umbria at 196, Marche at 293, Campania at 179 and Emilia-Romagna at 412, to give a few examples. .
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CIRCULAR
In summary: the color system, to face the delicate months until spring, will be made more rigid, making the use of orange and red bands more appropriate for regions in difficulty. In parallel, between tomorrow and the day after tomorrow, the Ministry of Health will issue a circular ordering the system of rapid antigenic buffers. At this point, the assessment of the positivity rate, over the total of cases analyzed, is totally unequal from one Region to another, because it does not take into account, in the calculations, only the rapid ones. Some examples: Lazio and Veneto are among the regions with the highest yields per day, respectively 40,000 and 60,000. The Ministry of Health will be involved: antigens will be inserted, along with molecular ones, among the daily data; they will be regulated because not all antigenic products have the same level of reliability. And there will also be a line on a debated topic: when a person tests positive for the antigen, the molecular verification follows; It has been shown that, if it is a quantitative quick swab and the emerged value is very high, confirmation of the positivity of the molecular is not necessary.
However, a massive information campaign will also be designed in light of the cases, also registered in Rome, of people who had a negative antigenic swab, after this they were less cautious and later found positive. The quick swab, which can now also be made in pharmacies in various regions, including Lazio, is a useful filter, but not decisive. There is always a margin of error, but above all it is the photograph of that moment, a person can be infected five minutes later (or perhaps the virus was still incubating). Moral: even after a negative antigenic swab (but also after a molecular one) you must remain very, very cautious.
SCRIPT
But what will happen on January 8? What regions are at risk? Lazio has a low Rt for now, despite the recent increase in cases, so much so that on December 31 it was at 0.84. It shouldn’t turn orange, although there are signs of an increase in hospitalizations; Veneto is under special surveillance along with Calabria, Puglia and Liguria. Abruzzo, for its part, seems to have come out of the most difficult phase and the 7 will be immediately yellow. Lombardy and Emilia-Romagna have a high incidence of new cases, while Campania, at least according to the latest report, does not appear to be at risk for now, given that the RT is at 0.78.
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