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Florence, May 9, 2020 – After almost a week from the start of the so-called phase 2, Ars Toscana (Regional Health Agency) takes stock of the situation in thetrend of the epidemic in Tuscany, also read through the lenses of some of the monitoring indicators planned at the end of the Dpcm of April 27, through which the Ministry of Health will decide in the future whether to adopt restrictive measures in those areas of the country that could be subject to a strong appearance of new cases.
We come from a week during which the the number of cases was constantly less than 40 people. Compared to the average for the last week of March, the date from which social distancing measures are estimated to have had their effect, there has been a 85% decrease in new cases compared to the Italian average of 70% (Lombardy 60%, Piedmont 50%). A single territorial area still seems to “drain” most of the cases, and that is the province of Florence. Recalling that the data transmitted to Civil Protection every day is related to the province of notification, the highest concentration in Florence is mainly due to the population density of the territory and the greatest attraction of Covid hospitals in the Florentine area.
The contagion rate in the Region has been consistently below 1 for about a month.
As for the clinical conditions, more and more often we are in the presence of asymptomatic cases, symptomatic pauci and in a mild condition (see Figure). Consequently, the composition by age group and gender has been gradually changing in recent weeks: since the fourth week of the epidemic (last week of March) there is a reversal in the gender ratiowho was previously in favor of the male sex (proportion of 40-60%) and who since the first week of April, the same proportions have been invested in favor of women. Contagion sites have seen the The male gender is more frequently infected in the family and in the workplace, while the female gender is found among health workers and health care residences.
The average age of cases decreases significantly during the week., barely reaching 50 for both sexes (It was 60 until the last week of April). In this sense, the greater appearance of asymptomatic cases is probably due to the massive adherence campaign to serological screening tests in many professional categories implemented by the Tuscany Region in recent weeks: this will probably have an impact on the increase in new cases in the next week, which should have the same clinical and demographic characteristics mentioned above. Since the campaign began on April 21, around 45,000 screening tests have been conducted, The venipuncture and venipuncture, which revealed about 400 positive people, was immediately sent to the confirmation platform.
The cures, especially the definitive viral or viral calls (double negative confirmation buffer), took a real leap forward, increasing in proportion 8 times more than the Italian average in the last month.: are now almost 45% of all cases and Tuscany has thus returned to the national average of cured cases. The direct consequence of such a strong increase in cures is obviously the progressive decrease in current positive results (total number of cases less dead and cured).
Hospitalization is undoubtedly the most positive. (see figure): compared to an average of About 1,390 total hospitalizations in the Covid area, found during the last week of Marchthese have been just under 600 in the first week of May. The same data for the occupation of beds in the ICU are 285 and 105 respectively: a reduction for both types of hospitalization of around 60%, compared to 40% of the Italian average of total hospitalizations.
The percentage of occupancy of IT sites compared to total total revenue is always among the highest among regions, demonstrating the highest usage even in cases with fairly unfavorable clinical conditions from the time of admission.
Focusing attention on IT beds, the percentage of beds occupied compared to the maximum capacity (that is, available intensive beds added to those that can be activated in 48 hours, defined as “commitment to surge capacity”) than in the Tuscany are 440) is currently 19%. Part of the beds and departments dedicated to Covid’s care have once again become the original clinical activity.
The figure of the deceased is what remains quite stable: We are still observing the consequences of the cases that arose during the third week of April, which had presented serious clinical conditions. In terms of mortality Tuscany ranks as the region with the lowest mortality compared to all other regions with a large and medium spread of the virus. (see Figure).
From a territorial point of view they are Massa Carrara, Florence and Lucca, the most affected provinces, in coherence and consequence to the territories most affected by the virus, while the territories of the southeast part of our region are the least affected.
Mortality by gender and age group: women die less, and under 50 years a low mortality rate is observed, while it increases exponentially in the older age groups (over 75 years). The so-called comorbidity, derived from presence of one or more chronic pathologies: A recent study by Ars has shown that Tuscan subjects affected by hypertension, dyslipidemia, diabetes and coronary heart disease are at risk of contracting the virus 33, 29, 9 and 8 times more than the general population, respectively, a clear sign that They are the populations that we need to protect from the circulation of the virus.
In conclusion, we arrived at the monitoring indicators that the Dpcm of April 27 foresaw as a system through which to evaluate possible closure measures. Among the various indices that each region will have to monitor weekly is the intensive care occupancy rate, which should remain below 30%, as well as below 40% of hospitalizations in the Covid medical area; the growth rate of coronavirus cases, which must be less than 1, the so-called R
“All the monitoring indicators, provided by the Ministry, for now see Tuscany in line with what is expected and required – comments Fabio Voller, coordinator of the Epidemiology Observatory – In any case, we are building a system to consult the indicators that they can maintain main indicators of the ministerial surveillance system. “
The indicators will also be implemented within the new Ars Toscana data portal: https://bit.ly/2WhgPLe
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