Coronavirus, Update April 13th, Day 53

Coronavirus, Update April 13th, Day 53

The decline of patients being admitted, in particular to the Intensive Care Units is undoubtedly the most concrete sign of an epidemic losing its vigor.  Confirming this, yesterday we had the first significant reduction  in the number of deaths although the number today, unfortunately, was in-line with previous days.  Surpassing 1 million tests administered, yesterday we registered more than 4000 new cases of which 1400 of them were in Lombardy.  On average the positive cases were less serious, often tested outside the hospital on health care workers, in nursing homes and across the region, many of who were complete asymptomatic.

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The figures are reducing, although a bit slower than we would wish given the simultaneous drop in the number of tests given. Let’s enjoy the result, as long as it lasts.

The table showing the percentage increases, is more rewarding than the last days with the national data arriving to 2% with the trend in southern Italy especially good (the regions in central Italy executed many more tests).

Even the mortality rate in Lombardy, which had risen above 18%, gave initial signs of a drop. But as we have understood, that number, which is the tragedy, is in part a result of early testing which was focused on the most serious emergency room cases.  In the end, the mortality rate, calculated per the number of inhabitants, will be much more reliable than the percent per positive cases which is susceptible to numerous variables and which is most certainly 10 to 20 times less than the real amount.  In Lombardy, we have exceeded 1 in a 1000 (who have died) but even here we are missing thousands of non-recorded cases, Covid and non.

In short, the number of hospitalizations dropping is showing that the social distancing is working.  This is the conclusion, definitely comforting which is being highlighted in the news, while the fatigue of the people increases and with it the risk to lose faith and prematurely break the isolation.

We never had doubt that the social distancing measures worked.  The proof is in our posts and our projections which continue to be optimistic.  The question remains, what number of daily infections (if one, greater than zero, exists) which would allow an easing of the lockdown measures without causing a new pickup in the number of deaths.  There is a tendency, certainly in good faith, to discredit the daily data regarding the number of new cases, attributing it to more widespread testing. My worry is we will lose total sight of it by the overwhelming need to restart work and life.  Those saying that we cannot arrive to 0 new infections have valid reasons although the prospects of co-existing with an endemic form of the virus is not reassuring.  It is also worrisome that the official data (of cases, deaths, healed, testing, actually all of the data!) is becoming less reliable day by day.
This, after 53 of days of the epidemic and a month in which the general population is in isolation is truly disappointing
As I said on Saturday, and excuse me if I insist, there is no confirmation regarding the positive cases which were classified as “home isolations”, a  segment which is becoming more and more cumbersome on a national level, defying all logic as well as the silence of the media and the various institutions.  It addresses more than 70,000 cases of the roughly 100,000 actually considered positive (minus those who have recovered).
How long do we need to wait before the Civil Protection and the Istituto Superiore di Sanita realize that in this phase of the epidemic, these numbers should be going down every day, not increasing? Shouldn’t it be a priority,  now that the hospitals have passed the most critical emergency, to follow up on those who we already know have tested positive, trace their contacts, perform control tests and verify that they are in fact abiding by the quarantine before they are officially cleared?

We do not want to add to the chorus of criticism or those who think to have a solution for every problem. We understand the difficulties we are facing. But we would like to understand that we have a plan. It’s not true that the number of positive cases increases every day, they drop. It’s just that we’re not counting them.  It’s shocking to the first data, given every single night is not accurate and no one even comments on it.  

Given the above, I have added graphs & projections for all the regions. Some of you have been asking me for it these lasts days and I made up my mind. Naturally, you have to pay particular attention to the scale on the right to avoid comparing a curve which could represent hundreds of cases to another one which represents thousands or tens of thousands.  As always, take the projections for what they are.  It’s still interesting to note the trends, even for clietns who are in home isolations (here seen as green, whichs the association with the number of people officially cured).  It’s clear that Lombardy, which has almost exclusively tested those who were hospitalized, has a much higher percent of confirmed cases recovered (they are discharged although even for these we don’t have confirmation that that they have tested negative).    In Lombardy, the green quota is not an “instantenous” data point, as it should be for the all the “actively positive” but is a cumulative number as we see with healed & deceased.  Almost all the other regions (except for Umbria and the Marche which seemingly understood they had to do something about it) total these patients in the count without having any confirmation.  My curves, optimistically, continue to hope that they will be traced, sooner or later and gradually be given an “official” outcome.

At this point, most of the curves resemble a rainbow, which if nothing else, is auspicious….
Have a good evening,

Dott. Paolo Spada
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