Coronavirus, Update April 14th, Day 54

Coronavirus, Update April 14th, Day 54

Positive news from the Lombardy results, in truth we were expecting it.

New cases dropped to just over 1k, in the face 4k less tests given.
It’s something we’ve seen in the past, so we won’t get too excited.
More convincing is the data regarding interventions for people in the region with respiratory problems, which have decidedly dropped in the last weeks.

Hospital admissions were stable while the ICU admissions showed a slight drop.  Milano show a real slowdown.  It didn’t scare us yesterday, today it gives us some comfort.

Key concepts to know

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The number of deaths remains high, 602 overall of which 241 in Lombardy.  We have already said it all about this number.  It will be the last to go down and that can never happen soon enough.

For rest of the country,  the results are for the most part good, although on a lower number of tests.  It’s the effect of the holiday weekend so we should refrain from making any harsh judgements before seeing how things progress in the coming days.   Attached are the graphs with all the details for the various regions.

As you’re well aware we’re waiting for some new developments regarding the recording of people healed.

In our projections, that you will find in the graphs, we would like to see the green colored curve (the one which represents patients in home isolation) flatten and eventually start to drop, leaving more space for the blue columns which represents the total number of people healed. In order for this to happen, the regions need to begin tracking these patients, mapping them throughout the region.  Judging by the profile and trend of the graphs, few regions are actually doing this although  more today than in the past (did someone listen to us??).
It’s true that many of these patients are still early on in the course of the disease and we know that the timing of having a confirmed clinical negative can take longer than a month.  Regardless Lombardy is still separating the healed (those that have been discharged from hospital/emergency rooms) from those in isolation.  The latter, having never passed thru any hospital, risk never showing up in the total number of people healed.  They sit there, accumulating, destined to remain apart. I would really like to understand the logic behind this classification especially in light of the suspicion that we have very little information about those who were sick.

I also ask myself, with a sincere wish to understand, how much does it matter  the 2-3% of additional movement recorded in the region? Is it really, as is told each evening, the reason that the numbers are not dropping? People are ready to jump on any transgressor on a trip to the supermarket, on the hunt for the super plague-spreader (did you see the runner being chased on the beach??).  I wonder how big this issue is, especially light of our somewhat fragile but obedient quarantine.   Perhaps we have looked too little in the place we would have likely found the answer: in the houses,  families, among the rooms of people who called but were never answered.

I know,  it has not been possible to do everything.

It would be great to start seeing the databases filling up, thousands of phone calls, mass testing, the data multiplying, applications, personal mapping (to hell with privacy, it’s a national emergency, no?) along with an army of nurses entering all of those houses like the light piercing the April sky…….

I know, I know….we can’t do everything.   But something could happen, maybe we should try!

Dr. Paolo Spada
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He is a vascular surgeon at the Humanitas Institute in Milan: this article, also published on his Facebook profile, is a daily update regarding the trend of COVID-19 in Italy based on official data published after 6 pm by the Ministry of Health.

The reports I publish here are based on official information. I am a doctor, and I report the numbers that the Ministry of Health issues every evening after 6pm. My job was to automate a system of graphs that show the same data over time, and divided by areas, a few minutes later the dissemination of raw data. It is a useful job, first for me, to understand the progress of the epidemic, but that many websites, and newspapers, do better than me, with interactive and much more complete graphics (as well as all over the world, not Italy only). What I add, taking advantage of some years of experience in the development of algorithms applied to medicine, is a series of projections, that is, attempts to predict the epidemic in the following weeks. It is not a question of wanting to see in the crystal ball, but only of getting an idea of ​​the possible scenario, which day by day you can glimpse on the basis of the real data available. The algorithms were initially designed on the basis of the data of the experience of the epidemic in China, the only available benchmark, against which our numbers, which can be almost superimposed in the first few weeks, vary significantly over the course of days. The projections therefore change, as data is acquired, and are also subject to “assumptions” which presuppose a certain degree of arbitrariness. Among the various hypotheses, I try to represent the “minimum” scenario, that is, the one that will probably happen even in the best of cases, or for good that the contagion goes from here on. Compared to this “little but safe” (which however is never safe) I prefer to contemplate more severe scenarios only if supported by further evidence. Finally, it should be added that the same official data are often incomplete, discontinuous, and discordant in the method of collection between one area and another in the country. An example is that of the number of infections, widely and variously underestimated, but it is not the only one, unfortunately. Although with many limitations, and lacking in the representation of the spread spread in the asymptomatic or paucisymptomatic population, these reports still provide a reading of the health burden, the effort required of hospitals, intensive care, and the number of deaths. The emergency is here, and this remains my focus, with the sole purpose of being somehow useful, and in absolute good faith. I therefore distrust anyone from the improper use, or in any case not previously authorized, of the images and comments. The content of these posts is the result of an initiative carried out in a personal capacity, in no way related to my professional activities and the institutions to which I belong. On the other hand, I have an obligation to mention, with pride, the commitment and the high social and human profile shown by doctors, nurses, and by all the staff and management of Humanitas Research Hospital in coping, at the forefront of this dramatic emergency.