“Tuscany at risk of blockade, is on stage 3”. Hypothesis of the closure of schools and of all social, cultural and sports activities

The weekly report on the progress of the epidemic came out a day earlier and the outlook is alarming. There are 4,913 active outbreaks, of which 1,749 are new throughout Italy.

The incidence of cases in the last 14 days reaches 75 per 100,000 inhabitants, with the national Rt of 1.17. In half of the Regions there is a high risk of rapid progression of the epidemic, with the concrete possibility of temporary local closures.

Among these is also the Tuscany, which runs the risk of exceeding the 30% threshold for intensive care units occupied by Covid patients. A very high risk and terribly real.

Furthermore, Tuscany, together with Abruzzo, Emilia Romagna, Lombardy, Marche, Piedmont, Umbria and Bolzano, is in the so-called “stage 3” established by ISS and the Ministry that foresees, among other things, possible temporary closures at the local level, closure of socio-cultural / sports activities and temporary closure of schools.

Coronavirus: towards a new Dpcm, hypothesis of the curfew

The exponential growth of infections and the related difficulties for health services are put in black and white in the new weekly monitoring of the Ministry of Health and the ISS, published last night and in reference to the period from October 5 to 11 .

“Acceleration – we read – in the evolution of the epidemic that has now entered an acute phase with a progressive increase in the number of cases, evidence of criticality in local services and increases in the occupancy rate of beds in intensive care and medical areas that risk, in some Regions / PA, to reach critical values ​​in the next month “

For Iss and the Ministry of Health, “a rapid analysis of the subregional risk is, therefore, necessary for the timely increase of containment and mitigation measures in the most affected areas based on the guidelines provided in the document” Prevention and response to the Covid-19: evolution of the strategy and planning in the transition phase for the autumn-winter period ”, released last week that indicates four scenarios for the evolution of the pandemic that will be followed by provided interventions.

And then the call to the population “to respect with conscientiousness and precision all the foreseen precautionary rules (in particular physical distancing and the correct and appropriate use of masks) and avoid situations that may favor transmission such as aggregations”. spontaneous and planned to avoid further aggravation that could require generalized territorial restrictions “.

The key points of the report refer to the period from October 5 to 11

• The virus is now circulating throughout the country. This week – notes QuotidianoSanità.it – A strong increase in cases was observed, raising the cumulative incidence (ISS flow data) in the last 14 days to 75 per 100,000 inhabitants (period 28 / 9-11 / 10) (vs 44.37 per 100,000 inhabitants in the period 21 / 9-4 / 10). In the same period, the number of symptomatic cases almost doubled (15,189 symptomatic cases in the period 28 / 9-11 / 10 vs 8,198 symptomatic cases in the period 21 / 9-4 / 10).

• All Regions / ASF, except one, reported an increase in the number of diagnosed cases compared to the previous week (ISS flow). The percentage of new cases that were detected through contact tracing activities continues to decline (28.8% of new cases compared to 31.8% the previous week). The percentage of new cases detected through screening activities also decreased (31.1% vs 33.2%) On the other hand, the percentage of cases detected due to the appearance of symptoms increased (31.6% vs 29.1% last year week). In 8.5% of the cases the diagnostic evaluation was not reported.

• In the period from September 24 to October 7, 2020, the Rt calculated on symptomatic cases is equal to 1.17 (95% CI: 1.03 – 1.50).

• A total of 4,913 active outbreaks were reported, of which 1,749 new (the adopted definition of an outbreak contemplates the identification of 2 or more positive cases linked to each other), both increasing for the eleventh consecutive week (in the previous follow-up week there had been notified 3,805 active outbreaks of which 1,181 new). Outbreaks have been reported in almost all provinces (102/107). Most of these outbreaks continue to occur at home (80.3%). The percentage of outbreaks detected in recreational activities remained stable (4.2% vs 4.1% the previous week).

• Outbreaks in which transmission may have occurred in the school setting are on the rise this week, but intra-school transmission remains a dynamic of limited transmission overall: 3.8% of all new outbreaks in which transmission was reported. However, extracurricular activities can be a trigger for chains of transmission if the planned prevention measures are not respected.

• There is a sharp increase in the number of new cases outside of known transmission chains. This week, the Regions / ASF reported 9,291 cases in which no epidemiological link was found (compared to 4,041 the previous week), which includes 33% of all cases reported in the week. • This week, at the national level, there was a significant increase in the number of people hospitalized (4,519 vs 3,287 in the medical area, 420 vs 303 in intensive care on 10/11 and 10/4, respectively) and, consequently, increased occupancy rates for hospitalizations in the medical area and in intensive care, with some Regions / ASPP above 10% in both areas.

The report’s conclusions

• In Italy: always inform Sanità.it newspaper – The progressive worsening of the SARS-CoV-2 epidemic reported for eleven weeks is accelerating, which is reflected in an increase in the work in local health services. For the first time there are very critical elements related to the spread of the virus in our country.

• The population is asked to avoid, as far as possible, events and initiatives with risk of aggregation in public and private places. We remind you that it is mandatory to adopt strict individual behaviors to limit the risk of transmission and avoid a greater and faster worsening of the epidemic.

• The local transmission of the virus, spread throughout the national territory, causes outbreaks, even of considerable size, especially reported in the home / family. It remains essential to maintain a high awareness of the general population about the now evident and more rapid worsening of the epidemiological situation and the importance of continuing to strictly comply with all necessary measures to reduce the risk of transmission, such as washing hands, wearing masks and physical spacing.

• Outbreaks in which intra-school transmission may have occurred are increasing. Therefore, it remains essential to maintain attention on the measures already implemented to prevent intra-school transmission, such as the detection of daily temperature and the procedures for the management of suspected symptomatic cases in the school setting.

• The location of the cases and their contacts and the consequent reduction in the time between the onset of infection and isolation continue to be fundamental elements to control the spread of the infection that must be pursued absolutely. The increase in outbreaks and cases not associated with chains of transmission highlights the criticality in the commitment of local services (Prevention Departments) to ensure that outbreaks present are identified and investigated promptly.

It is important to strengthen local services, through the extraordinary participation of professional support resources and also through the use of technological tools such as the Immuni “app”, in the activities of diagnosis and investigation of contacts to identify all transmission chains and ensure efficient management, including the quarantine of close contacts and the immediate isolation of secondary cases.

• We recall the importance of the proper use of diagnostic and screening tools, in the context of an epidemiological risk assessment, and of the correct execution of isolation and quarantine procedures when indicated.

• The need to comply with the quarantine measures and other measures recommended by the health authorities is reiterated, both for people returning from countries for which the quarantine is planned, as well as at the request of the health authority, having been identified as close contacts of A case. Although the territorial services have so far managed to contain the local transmission of the virus, an exceptional workload is repeatedly reported that in many cases compromises the timely management of contacts as well as not ensuring activities not related to this emergency. • The situation described in this report highlights important warning signs related to an increase in transmission.

• A new epidemiological phase stands out with an aggravation of the work of the local services that could be reflected in a short time in an overload of the healthcare services.

• The population is advised to pay special attention to the risk of infection in all cases of non-compliance with the recommended measures. We invite you to comply with all the rules of behavior provided for the prevention of the transmission of SARS-CoV-2, in particular towards the most vulnerable groups of the population.

• The Regions / PAs, in conjunction with the Ministry of Health, are invited to carry out a rapid risk analysis, also at the subregional level, and to evaluate the timely increase of containment and mitigation measures in the areas most affected by the level of risk and based on the guidelines contained in the document “Prevention and response to Covid-19: evolution of the strategy and planning in the transition phase for the autumn-winter period”.

Regional analysis: Tuscany

Tuscany. Rt 1.48. Moderate risk classification with high probability of rapid progression. New cases aged> 50 years were reported in the 5 days prior to completion. Increasing cases in both streams. There was a significant delay in the notification of cases in the ISS flow that could make the evaluation of these indicators less reliable. Rt above one in the entire 95% credibility range. The number of active outbreaks and the number of cases outside the transmission chains are increasing. Employment rates in intensive care (+ 1%) and medical areas (+ 2%) are increasing. High probability of reaching critical thresholds in the next month.