Covid, the epidemiologist: “Difficult curve to interpret”

11/02/2020 Health



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Like every Sunday I epidemiological data show a slight decrease, a consequence of the less tampons done the weekend: me data from the Ministry of Health from the November 1 record 29,907 new infections against 31,758 of the previous day, compared to 183,457 buffers, 30,000 less than the 215,886 on December 31. Also recorded less deaths: 208 against 297 the day before, while hospitalizations in intensive care units were 96 more in 24 hours. However, there was no decline in the relationship between positive cases and swabs, come to 16.3% vs. 14.7% October 31: it is the sign of how more and more cases are escaping monitoring.

Among regions, the largest increase in cases was recorded in Lombardy with 8,607, followed by Campania (3860), Tuscany (2379), Lazio (2351) and Veneto (2300).

“As we know, the trend of the curve cannot be calculated in one day, but for a period ”, observes Stefania Salmaso, from the Italian Association of Epidemiology. Seen like this, the curve keeps increasing and interpreting it becomes more and more difficult because a lot of data is leaking. What, according to the epidemiologist, now clearly emerges is that “there are increasing cases that can no longer be attributed to a chain of contagion,” that is, “now there are the inability to trace contacts: it is a sign of how the territorial structures are under pressure ». Precisely this, he continues, is one of the key elements identified in the document “Prevention and response to Covid-19” in which the Ministry of Health and the Istituto Superiore di Sanità outline the four possible scenarios of the pandemic. «That document – points out the expert – in fact indicates the need to raise the guard level when the transmission chains are not identified ‘.

The scenario that corresponds to most serious situation, the fourth, in fact, corresponds to a «situation of uncontrolled transmissibility with critical problems in the health system In the short term. “The figures clearly describe the situation, Salmaso continues, if we think that” the approximately 170,000 cases detected in the last week reside in 5,700 municipalities: that is, there are no more circumscribable outbreaks and that, therefore, the spread of infections is capillary. ”Another sign that deserves attention is the increase in the proportion of cases with symptoms, while more and more asymptomatic cases are not identified.

“Now the system will suffer – observes Salmaso – and the data indicate that cases with symptoms are identified above all: infections cannot be intercepted before they become symptomatic. In short, “the chain of transmission is no longer traceable and the situation becomes less and less easy to control.” A concern that mirrors that of doctors: “more drastic measures are needed to be able to bend the epidemic curve and allow all Italians to be treated ”, observes Filippo Anelli, president of the Federation of Medical Orders (Fnomceo). “For weeks we have been saying that the curve, as it has shot up, does not leave us alone and that, if it continues like this, soon we will not have more places in hospitals to dedicate ourselves to non-Covid patients and then to Covid patients.” Finally, another challenge is to be able to protect the weakest age groups: “last March – Salmaso observes – the average age of people affected by Covid-19 was about 60 years, then it decreased and in the summer it has reached the 30 years, but now he has risen to 43. ”