Coronavirus, Update April 22nd, Day 62

Coronavirus, Update April 22nd, Day 62

Today Lombardy reported 1.161 new cases out of a total 13.500 new tests.

The data is certainly positive, despite still being over a thousand , assuming the new cases/tests ratio really tells us the truth.

Such numbers are also combined with a significant drop in ICU admissions and overall hospitalizations. Deaths are back to 161, fewer than yesterday but still in line with prior days. Milan Province again deserves the spotlight but in a negative way (with today’s 480 new cases it reached the 17.000 milestone since the beginning of the epidemics).

Key concepts to know

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Milan city is slightly better on a proportional basis (+161 new positive tests).

Anyway, we know that many tests have been carried out nurses homes in the area and we also know that the majority of these individuals are asymptomatic.

Piemonte is also back on the rise but the other northern regions’ paths are more encouraging. Center Italy is overall below the average increase rate experienced in the whole Country, that with 3.370 new cases out of a total of 63.000 tests goes back up to 1.8%.

 

Let’s say it clearly. If you are fed up with the jumps in the number of new cases and tests, just focus on the trend of hospitalizations and ICU admissions, on both the charts and the projections by region.

It is definitely the most reliable sign of a declining epidemic even more than actual deaths (437 today) that are – keep in mind – just the expression of the mid-long term consequences of the contagion, thus just a snapshot of a scenario that has meanwhile strongly improved.

Instead, if you like competition, the “traffic lights table” will allow you to make useful comparisons among regions, as I make adjustments to the color charts, according to my expectations of the final stage of the contagion. Therefore keeping the greener shades is not easy at all, even for the most best performing regions (southern Italy and the islands).

If you really want to brag about your region, the most original way to do it is to show your projection through that green bell-shaped curve representing how thorough the approach is in monitoring self-isolating patients at home. If you still have the peak today, it means you might still need to wait a little while or, better, you may want to ring the bell to the authorities of your area and push them to make sure their numbers match the reality.

Kind Regards,

Dr. Paolo Spada
Link to my Facebook page

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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.